Influencing Factors of Mobile Health Application in Kidney Transplant Care: A Systematic Review Using the Consolidated Framework for Implementation Research (Preprint)

BACKGROUND Kidney transplant recipients require lifelong self-management and follow-up care to maintain allograft function. Mobile health (mHealth) effectively improves self-management behaviors and clinical indicators, consequently enhancing nursing care quality. However, these applications commonly face challenges including low adoption rates and high discontinuation. Although researchers have explored associated facilitators and barriers from various perspectives, a systematic review of these influencing factors remains lacking. OBJECTIVE To systematically review the influencing factors of mHealth applications in kidney transplant care and provide evidence for developing targeted interventions. METHODS The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), with a protocol registered in PROSPERO (International Prospective Register of Systematic Reviews, CRD420251091361). PubMed, Web of Science, Embase, Medline and Chinese databases including China National Knowledge Infrastructure (CNKI), Wanfang Data, China Science and Technology Journal Database (VIP) and SinoMed were searched from the establishment of the database until March 2025. The Mixed Methods Appraisal Tool (MMAT) was employed for quality assessment, and influencing factors were identified and coded according to the Consolidated Framework for Implementation Research (CFIR). RESULTS A total of 19 studies (all English publications) were included, comprising 9 qualitative studies, 5 mixed-methods studies, and 5 quantitative studies, involving 1,265 kidney transplant recipients and 34 healthcare providers. Totally 16 facilitators and 14 barriers were identified and categorized into 5 domains: intervention characteristics, outer setting, inner setting, characteristics of individuals, and process. CONCLUSIONS The application of mHealth in kidney transplant care is influenced by multidimensional factors, with intervention characteristics constituting the most prominent domain while outer setting and process being relatively underrepresented. Future research should investigate these influencing factors and implement multidimensional strategies to optimize mHealth applications in kidney transplant care. CLINICALTRIAL The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), with a protocol registered in PROSPERO (International Prospective Register of Systematic Reviews, CRD420251091361).