The role of behavioral nudges in sustaining public health engagement through the "Tawakkalna" app: insights from healthcare professionals.

BACKGROUND

Digital health applications, especially those deployed by the governments have become essential tools for managing public health. Several such applications were launched during the COVID-19 pandemic as a part of crisis management, such as Tawakkalna in Saudi Arabia, some of which are continued operating in the post-pandemic period with the introduction of additional services. While behavioral nudges such as reminders, alerts, and notifications in such applications have demonstrated effectiveness in improving health behaviors in previous studies, they are mostly focused on adoption and usability aspects and limited to pandemic period, rather than long-term engagement.

PURPOSE: This study aims to investigate how behavioral design features, such as reminders, alerts, and tailored health notifications, embedded in the Tawakkalna application influence sustained public health engagement in the post COVID-19 pandemic period.

METHODS

A qualitative exploratory design using semi-structured interview technique was adopted in this study. A total of 24 participants from diverse roles including healthcare professionals, digital health strategists, and policymakers participated in the interviews. Braun and Clarke's thematic analysis framework was used to identify key patterns and themes related to behavioral design, engagement, and governance considerations.

RESULTS

Six themes emerged from the analysis of interview data which included personalization and adaptive nudging, engagement dynamics, ethical and trust considerations, system integration, social and community influences, and future directions. Results reflected that adaptive personalization countered notification fatigue; engagement varied by age, context, and emotional framing; ethical concerns emphasized transparency and cultural alignment; system integration enhanced credibility; social/family influences amplified impact; and future designs advocated AI-driven, bidirectional nudges within preventive health journeys.

CONCLUSION

To achieve sustained engagement, applications like Tawakkalna should integrate behavioral nudges which are adaptive, transparent, and socio-culturally attuned.