Health Motivation as a Predictor of mHealth Engagement Across BMI: Cross-Sectional Survey

Digital health tools, such as mobile apps and wearable devices, have been widely adopted to support self-management of health behaviors. However, user engagement remains inconsistent, particularly among populations with varying BMI. While digital health technologies have the potential to promote healthier behaviors, little is known about how psychological and behavioral factors interact with BMI to influence use patterns.

This study aimed to explore the relationship between BMI and digital health technology use and to examine how factors such as health awareness, self-efficacy, and health motivation contribute to technology engagement.

A cross-sectional online survey was conducted from January 2024 to April 2024. A total of 184 valid questionnaire participants were included in this study. The questionnaire was measured on a 5-point Likert scale. Descriptive statistics, chi-square tests, and multiple regression analyses were applied.

Of the participants, 38.6% (71/184) had a BMI<24 kg/m², 42.4% (78/184) had a BMI between 24 and 29.9 kg/m², and 19% (35/184) had a BMI≥30 kg/m². Significant BMI differences were observed based on sex (P<.001) and age (P<.001) but not based on prior digital health tool use. Use rates for Bluetooth or Wi-Fi devices, wearables, and mobile apps were 32.1% (59/184), 38.6% (71/184), and 39.1% (72/184), respectively. A negative correlation between BMI and mobile app use frequency was identified (P=.02). Multiple regression analysis indicated that health motivation significantly predicted digital health use (P<.001), whereas health awareness, lifestyle, and self-efficacy did not.

Individuals with higher BMI reported a lower frequency of digital health tool use, potentially due to lower health motivation in the studied population. Health motivation was the strongest predictor of digital health engagement. Integrating personalized medical records into apps may enhance health motivation, thereby improving user engagement and promoting healthier behaviors in individuals with higher BMI.