Overview
The My ME-BYO Record app, developed and managed by the Kanagawa Prefectural Government in Japan, serves as a unique public-sector mHealth tool. Launched in 2017, it records health data, medication use, and physical activity, while the ME-BYO index—introduced in 2020—visualizes an individual’s predisease state to encourage behavioral change. This retrospective study analyzes real-world data to understand who engages with the app, how engagement relates to health status, and what this means for public health strategies.
study design and population
Between April 1, 2020, and July 31, 2023, the Kanagawa Prefectural Government collected data from 186,972 registered users. Of these, 10,239 individuals aged 18 or older accessed the ME-BYO index at least once and were included in the analysis. The ME-BYO index is a self-reported 15-item measure spanning metabolic, locomotor, cognitive, and mental resilience domains, with scores ranging from 0 to 100 (higher scores denote better health).
Researchers compared one-time users with repeat users using standard statistical tests. A logistic regression examined associations between engagement (repeat vs. one-time) and variables such as sex, age, and domain scores. All analyses were conducted with Stata 17 SE, and ethical approval was obtained with waivers for anonymous data analysis.
Key findings: engagement and demographics
Among the 10,239 users, only 21.5% (n=2,202) were repeat users, while 78.5% (n=8,037) engaged with the ME-BYO index just once. This indicates a substantial drop-off after initial use, signaling room for strategies to sustain user engagement in a government-run health app.
Repeat users tended to be older than one-time users. Age appears to influence ongoing engagement with mHealth tools that support self-care and chronic disease monitoring, consistent with prior research showing older adults often adopt public-sector health apps more readily when free features are available.
Health status and domain-specific insights
Notably, repeat users exhibited lower overall ME-BYO scores, with notable deficits in cognitive function. The ME-BYO index is prominently displayed on the home screen; therefore, users with lower scores may experience motivational pushes for ongoing monitoring, or conversely, fear deterioration and continue usage to seek improvement. This dynamic aligns with behavior change theories that highlight feedback as a driver of continued engagement.
In contrast, repeat users showed higher locomotor function scores. This suggests that individuals with better physical activity or mobility may perceive the app as a useful tool for ongoing health monitoring, fostering repeated use. The relationship between mobility and engagement mirrors broader findings that physically active individuals are more inclined to use mHealth solutions to manage health behaviors.
Implications for public health strategy
The study underscores a gap in repeat engagement with the ME-BYO index, raising questions about how to embed this tool within regional health strategies. While the government-led nature of the app provides unique opportunities for public health integration, achieving sustainable engagement may require targeted outreach to older adults, cognitive-function support resources, and features designed to address perceived barriers among one-time users.
Potential strategies include personalized feedback loops, gamification elements tied to cognitive-health insights, and partnerships with clinics to reinforce the app’s role in routine health monitoring. Since the ME-BYO index captures cognitive, metabolic, and locomotor domains, a holistic approach to user support—emphasizing cognitive training, mobility programs, and mental well-being—may improve adherence and health outcomes over time.
Limitations and considerations for future research
Several limitations temper the findings. The majority of app users were over 40, limiting generalizability to younger populations. Self-reported data may introduce reporting biases, and some ME-BYO components require further validation. The dataset lacked granular details such as disease comorbidities and socioeconomic status, which could influence engagement patterns. Future studies should incorporate these confounders and explore longitudinal changes in the ME-BYO index with interventions aimed at improving cognitive and locomotor domains.
Conclusion
This retrospective analysis highlights a substantial gap between initial use and repeat engagement with the My ME-BYO Record’s ME-BYO index. Understanding the demographic and health-status correlates of engagement can guide public-health strategies to integrate the app more effectively into regional health management, ultimately supporting sustained health monitoring and potential behavior change at the population level.
