title: Barriers and facilitators to the use of an immunization application: a qualitative study supplemented with Google Analytics data.
abstract: Barriers and facilitators of mobile app adoption are not known. This study examined usage of a new Pan-Canadian immunization app to identify factors that contributed to usage.
  
  
  
  Women in their third trimester of pregnancy or had given birth in the previous 3 months were recruited from a hospital obstetrical unit. Fifty-five participants were instructed to download the ImmunizeCA app. After at least 6 months, 10 interviews were conducted, transcribed and coded. Themes identified were compared with aggregate ImmunizeCA usage data (n = 74 212 users).
  
  
  
  Facilitators included features that address logistical challenges, improved convenience and information access. Barriers included absence of system integration. Concerns regarding the privacy and security of personal health information were not an inhibitor as long as best practices are followed. Google Analytics data on usage supported qualitative findings.
  
  
  
  Future studies should evaluate the quantitative impact of factors we identified on app uptake and usage. Subsequent mobile app studies may benefit from the use of analytic data as they were found to be effective in helping to validate qualitative data derived from interviews with study participants.
authors.affiliation: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, CanadaK1Y 4E9.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Burgess
authors.affiliation: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada K1Y 4E9.|Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Atkinson
authors.affiliation: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, CanadaK1Y 4E9.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Westeinde
authors.affiliation: Public Health Ontario, Toronto, ON, Canada.|Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
authors.forename: Natasha
authors.initials: N
authors.lastname: Crowcroft
authors.affiliation: Public Health Ontario, Toronto, ON, Canada.|Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
authors.forename: Shelley L
authors.initials: SL
authors.lastname: Deeks
authors.affiliation: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada K1Y 4E9.|Department of Medicine, University of Ottawa, Ottawa, Canada.|Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Canada.
authors.forename: Kumanan
authors.initials: K
authors.lastname: Wilson
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data*; D007407:Interviews as Topic; D063731:Mobile Applications; D010342:Patient Acceptance of Health Care; D011247:Pregnancy; D036301:Qualitative Research
keywords: immunization; mobile applications; privacy; public health; qualitative study