Evaluating user perceptions of the persuasive system design in a breastfeeding mHealth app: a cross-sectional study

The Persuasive Systems Design (PSD) model identifies software features that enhance mHealth app persuasiveness through behavioural reinforcement. Despite its potential, research remains limited in measuring users' perceptions of these persuasive features. This study validated an instrument for measuring user perceptions of persuasive features in a mHealth app, explored user experiences, and identified areas for improvement. This study used a descriptive cross-sectional online survey to collect quantitative and qualitative data. Construct validity was evaluated through Exploratory Factor Analysis (EFA), with data suitability confirmed by Bartlett's test and Kaiser-Meyer-Olkin measures. Cronbach's alpha assessed internal consistency, and an independent sample t-test examined demographic-response relationships (significance at 0.05, two-tailed).A total of 168 participants completed the survey. EFA revealed a four-factor solution with 23 items explaining 62.71% of total variance. The instrument demonstrated good discriminant validity and excellent internal consistency (Cronbach's alpha > 0.8). No significant demographic variations influenced responses.One-sample t-test results showed significant above-neutral PSD features perception scores (t(167) = −21.7, p <.001), indicating participants perceived all features as persuasive. Thematic analysis of 288 qualitative inputs identified three main themes.Findings confirmed the instrument's validity and reliability for assessing user perceptions of persuasive features in mHealth apps. Practical design recommendations based on the findings are provided.