The proliferation of mobile health (mHealth) applications presents significant opportunities for improving healthcare delivery and patient engagement. With capabilities ranging from self-monitoring tools to integration with electronic health records (EHRs), health apps have gained attention across Europe. However, their successful implementation hinges on public trust, digital literacy and data-sharing acceptance. A cross-sectional survey conducted in eight European countries—Italy, the Netherlands, France, Germany, Spain, Poland, Romania and Hungary—assessed how demographic and educational factors shape perceptions of mHealth and data sharing. The findings point to generational gaps, regional disparities and privacy concerns that must be addressed to realise the potential of mHealth technologies.
Generational and Educational Influences on mHealth Engagement
The study highlights generational disparities in the adoption of health apps. Younger cohorts, particularly Generation Z and Millennials, display higher usage rates and interest in adopting health apps compared to older groups. This trend is consistent with a general comfort with digital technologies among younger individuals. Nevertheless, the Silent Generation emerged as unexpectedly supportive of health app usage and data sharing, possibly driven by their heightened healthcare needs and growing awareness of the benefits of digital health tools.
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Education level also plays a decisive role. Individuals with tertiary education are significantly more likely to engage with health apps, request detailed information about their use and share their data with healthcare providers and research institutions. These respondents demonstrated a greater capacity to understand the functionalities, benefits and implications of using health technologies. Their positive attitudes suggest that educational attainment enhances confidence in navigating digital tools and strengthens trust in data governance practices. The findings imply that interventions aimed at boosting digital literacy and health education may improve adoption rates among less educated populations.
Privacy Concerns and Data Sharing Preferences
Despite growing interest in mHealth tools, data privacy remains a central barrier to adoption. Concerns about data misuse—such as discriminatory practices, identity theft or unauthorised commercial exploitation—were reported by over 70% of respondents. Nearly two-thirds also feared hacking incidents. These concerns suggest that the public is wary of potential breaches of trust and mismanagement of sensitive personal information.
Preferences for data sharing were conditional on the recipient and purpose. Over half of the respondents were willing to share data with healthcare providers through integrated patient portals. However, fewer expressed willingness to share with research entities, particularly private institutions. Transparency in data usage emerged as a priority, with respondents seeking clear information about data access, storage, deletion rights and privacy policies. The demand for transparency was strongest among older generations and those with higher education, both of whom were more likely to request detailed information before using a health app. These findings highlight the need for clear communication and robust privacy safeguards to reassure users and encourage engagement.
Regional Disparities and the Need for Targeted Strategies
Geographical variations across Europe further influence mHealth adoption. Respondents from Eastern and Southern Europe reported higher usage and more positive attitudes toward health apps than those from Central Europe. These differences may reflect varying levels of investment in digital health infrastructure, differing health system priorities or cultural attitudes toward technology. Regional disparities also emerged in willingness to share data, with Romanian respondents being the most open to sharing and French respondents the most reluctant.
Such findings underline the importance of tailored strategies that account for local contexts. In regions with lower engagement or higher scepticism, public health authorities should invest in community-specific education campaigns and digital inclusion initiatives. Ensuring equitable access to mHealth technologies will require overcoming infrastructural gaps and addressing barriers related to trust, awareness and digital competency. By aligning policy initiatives with the needs of different demographic and regional groups, European health systems can foster greater adoption and trust in digital health tools.
The survey underscores both the potential and the challenges of mHealth adoption across Europe. While interest in using health apps is growing—especially among younger and more educated populations—significant concerns about data privacy persist. Older generations and individuals with higher educational backgrounds demand more information and express higher levels of caution, suggesting that transparency and trust are essential to broader acceptance. Regional differences point to the need for nuanced, context-sensitive policy responses. To fully leverage the benefits of mHealth, European policymakers and healthcare providers must prioritise robust data protection, clear communication and inclusive digital health strategies that bridge generational, educational and geographical divides.
Source: European Journal of Public Health
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