The mHealth Dilemma: Patients' Information Environment and C-Section Overtreatment

Abstract

Mobile health (mHealth) has witnessed impressive growth in recent years. However, half of mHealth interventions fail to achieve significant effects. We examine how a user's information environment affects mHealth effectiveness. Based on a large-scale field experiment on cesarean section (c-section) reduction among 4,629 expectant mothers over a 25-month study period, our findings reveal complex interplays between the information environment, user information needs, and mHealth design. While on average, our mHealth intervention leads to a sizable 25.9% reduction in c-section rates, its effectiveness is heavily moderated by user information environment. In particular, public information strengthens mHealth effectiveness for planned pregnancy but reduces mHealth effectiveness for unplanned pregnancy. For private information, in contrast, the above effects are reversed. Interestingly, further analysis shows that interplay of mHealth with private information channels inadvertently leads to an increase in c-section overtreatment, likely attributable to doctor influence. This research broadens the scope of mHealth studies to include the user's information environment and offers novel empirical insights into the pivotal and complex roles of informational environmental factors as determinants of mHealth effectiveness.

Keywords: mHealth, Information Environment, Public Information, Private Information, Cesarean Section, Field Experiment, Overtreatment