Examining the Fidelity and Dose of a Mobile Health App for Micro-entrepreneurs' Recovery from Work-related Stress

Mobile apps as health interventions have proven effective in various settings such as the management of weight, sleep deprivation and depression. Yet, thorough descriptions and analyses of the development and implementation processes of such apps are still quite rare. Moreover, app process evaluations covering more than one health behaviour are even more scarce. This study describes a process evaluation for the implementation of a digital intervention developed for supporting micro-entrepreneurs' well-being through recovering from work and job strain in a study trial setting. The health intervention was implemented as a mobile app, which coached the users in seven selected health related domains: 1) Exercising (physical activity), 2) Stress management, 3) Time management (efficient working hours), 4) Recovery from work, 5) Sleep, 6) Healthy nutrition (dietary behaviour) and 7) Sedentary behaviour (excessive sitting). A total of 1225 eligible micro-entrepreneurs were included in the intervention study out of which 613 participants were randomized to the intervention group and 612 to the control group. A process evaluation regarding the intervention group was carried out after the trial. This paper focuses on discussing the technological intervention's fidelity and dose, the latter including both doses delivered and received. The dose delivered was extensive, whereas the dose received was less extensive. Fidelity was met with various levels, from none to some depending on user activity, as those users who used the app gained support for reaching their goals.