From Awareness to Behaviour Change: Determinants of Mobile Health App Utilisation in South-East Nigeria

Abstract

Background: The global demand for accessible and affordable healthcare has accelerated the adoption of mobile health (mHealth) technologies. In Nigeria, while digital infrastructure is expanding, the transition from simple awareness of these tools to sustained health behaviour change remains a critical area of inquiry.

Objective: This study investigates the awareness, adoption patterns, and health-related motivations of mHealth app users in South-East Nigeria, and explores the technological and psychological determinants that drive proactive health management.

Methodology: Guided by the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2) and Protection Motivation Theory (PMT), the study employed a descriptive survey design. Data were collected from adult respondents across the five states of South-East Nigeria via a validated questionnaire. Descriptive statistics were utilised to analyse levels of awareness, primary motivations, and measurable behavioural outcomes.

Results: The findings indicate a high level of awareness regarding mHealth applications, coupled with moderately high adoption rates. Social validation and perceived usefulness were identified as significant drivers for peer recommendations. Motivations for adoption were primarily rooted in fitness, wellness, and health monitoring. Importantly, consistent engagement with mHealth apps led to improved health behaviour, specifically in adherence to medical instructions and proactive lifestyle adjustments. The results strongly support UTAUT2 constructs (performance expectancy, habit) and PMT constructs (coping appraisal, self-efficacy) as predictors of sustained use.

Conclusion: mHealth applications are emerging as vital tools for preventive health in South-East Nigeria. However, the efficacy of these tools is dependent on bridging the gap between technological exposure and long-term behavioural engagement.

Unique Contribution: This study provides an integrated theoretical perspective by combining UTAUT2 and PMT to explain mHealth adoption in a regional Nigerian context. It provides empirical evidence of how digital health tools serve as agents of self-managed care within a developing healthcare ecosystem.

Key Recommendation: Stakeholders should intensify digital health literacy programmes and integrate verified mHealth platforms into local health policies. Furthermore, developers should prioritise user-centred designs that cater to local health needs to ensure that high awareness translates into persistent, life-saving behavioural changes.