Perceptions and Attitudes Toward the Use of a Mobile Health App for Remote Monitoring of Gingivitis and Willingness to Pay for Mobile Health Apps (Part 3): Mixed Methods Study

Abstract

Background: Gum infection, known as gingivitis, is a global issue. Gingivitis does not cause pain; however, if left untreated, it can worsen, leading to bad breath, bleeding gums, and even tooth loss, as the problem spreads to the underlying structures anchoring the teeth in the jaws. The asymptomatic nature of gingivitis leads people to postpone dental appointments until clinical signs are obvious or pain is evident. The COVID-19 pandemic has necessitated social distancing, which has caused many people to postpone dental visits and neglect gingival health. iGAM is a dental mobile health (mHealth) app that remotely monitors gum health, and an observational study demonstrated the ability of iGAM to reduce gingivitis. We found that a weekly dental selfie using the iGAM app reduced the signs of gingivitis and promoted oral health in a home-based setting.

Objective: The aim of this mixed methods study is to assess perceptions, attitudes, willingness to pay, and willingness to use an mHealth app.

Methods: The first qualitative phase of the study included eight semistructured interviews, and the second quantitative phase included data collected from responses to 121 questionnaires.

Results: There was a consensus among all interviewees that apps dealing with health-related issues (mHealth apps) can improve health. Three themes emerged from the interviews: the iGAM app is capable of improving health, the lack of use of medical apps, and a contradiction between the objective state of health and the self-definition of being healthy. Participants were grouped according to how they responded to the question about whether they believed that mHealth apps could improve their health. Participants who believed that mHealth apps can enhance health (mean 1.96, SD 1.01) had a higher willingness to pay for the service (depending on price) than those who did not believe in app efficacy (mean 1.31, SD 0.87; t₁₁₉=-2417; P=.02). A significant positive correlation was found between the amount a participant was willing to pay and the benefits offered by the app (rs=0.185; P=.04).

Conclusions: Potential mHealth users will be willing to pay for app use depending on their perception of the app's ability to help them personally, provided they define themselves as currently unhealthy.

Keywords: app; attitude; dentist; gum health; mHealth; mixed method; monitoring; mouth; oral health; oral health promotion; perception; public health; willingness; willingness to pay; willingness to use.

Figure 1

Average positive responses based on seeking or not seeking medical information on the internet.

Figure 2

Willingness to pay depending on price according to the belief or lack of belief that mobile apps can improve health based on average positive responses.

Figure 3

Tendency to use apps according to interest or no interest in paying based on average positive responses.

Figure 4

Tendency to use a medical app depending on willingness to pay. X axis: average positive responses to calculating the variable, “Tendency to use medical application.” Y axis: price (in New Israeli Shekel).

Figure 5

Tendency to use and willingness to pay for medical apps depending on belief in their efficacy.