Evidence mapPaperPMID 41911021Full record

ArticleJMIR mHealth and uHealth2026

Impact of Different Onboarding Strategies on Low Adoption and Engagement With a Self-Monitoring and Management App for Chronic Musculoskeletal Pain: Prospective Study.

Cinja Nadana Koller, Marc Blanchard, Johanna Mettler, Tiffany Prétat, Pedro Ming Azevedo, Thomas Hügle

Abstract read
In one paragraph

Article in JMIR mHealth and uHealth, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Cinja Nadana KollerLausanne University Hospital and University of Lausanne, Lausanne, Switzerland.ORCID https://orcid.org/0009-0009-4612-4221
Marc BlanchardLausanne University Hospital and University of Lausanne, Lausanne, Switzerland.ORCID https://orcid.org/0000-0002-4018-9325
Johanna MettlerLausanne University Hospital and University of Lausanne, Lausanne, Switzerland.ORCID https://orcid.org/0009-0002-1540-2347
Tiffany PrétatLausanne University Hospital and University of Lausanne, Lausanne, Switzerland.ORCID https://orcid.org/0009-0009-8076-1769
Pedro Ming AzevedoLausanne University Hospital and University of Lausanne, Lausanne, Switzerland.ORCID https://orcid.org/0000-0003-3321-266X
Thomas HügleLausanne University Hospital and University of Lausanne, Lausanne, Switzerland.ORCID https://orcid.org/0000-0002-3276-9581

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSuboptimal adoption and engagement rates of digital health applications present challenges to their effectiveness, particularly in chronic disease management such as fibromyalgia. Up to half of patients do not download the prescribed digital health applications or actively engage with them, making effective onboarding a critical opportunity for improvement.

objectiveWe aimed to investigate the impact of 3 different patient onboarding strategies on adoption, adherence, and engagement with a digital health application for the symptom management of chronic pain syndromes.

methodsWe conducted a 4-week nonrandomized prospective study comprising patients (aged ≥18 years) with chronic musculoskeletal pain who fulfilled the fibromyalgia criteria and were using a new self-monitoring and management application after onboarding. The pain organizer and companion system consists of symptom reporting, symptom monitoring, and an advice and exercise section. Participants in group 1 (standard) received an email-based onboarding with detailed instructions on application download, registration, use, usability data capture, data security, and study procedures without any in-person assistance. Group 2 (video) received the same email plus a video tutorial explaining the application's use also without any in-person assistance. Group 3 (assisted) underwent an enhanced in-person onboarding, which included hands-on support for application setup and guided instructions from a health care professional. Primary outcomes included adoption, engagement, and adherence, measured respectively by successful application download with at least 1 log-in, cumulative activations, and connection at least once per week over 4 weeks.

resultsA total of 48 patients were recruited (mean age 45.7, SD 12.2; range 19-79 years). In the assisted group, all 15 participants in the assisted onboarding group downloaded the application compared to 63% (10/16) in the standard group and 77% (13/17) in the video group. A significant difference in adoption between the in-person onboarding group (group 3) and the remote groups (groups 1 and 2) with P=.009 was observed. Overall engagement, measured by cumulative app activation, ranged between 0 and 28 log-ins, with no significant difference (P=.18) in mean log-ins across the 3 groups. Overall adherence was low with 27% (13/48) of participants meeting adherence criteria and a retention rate of 46% (22/48) at week 4. Responses to the System Usability Scale survey were limited to 8 responses but achieved a score of 70.31, indicating good usability of the application.

conclusionsUnassisted downloading and account creation might be barriers to adopting a digital health app among patients with chronic musculoskeletal pain.

Indexed as

Mobile ApplicationsMusculoskeletal PainSelf-ManagementAdultAgedChronic PainDigital HealthFemaleHumansMaleMiddle AgedProspective StudiesSurveys and Questionnairesadherenceadoptionchronic musculoskeletal painengagementmHealthonboarding strategies

Identifiers

PMID41911021
PMCPMC13077279

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.