Principal Findings
INFLUENZA
This study compared 2 digital reporting systems (a web-based notification platform vs a mobile app) for AEFI reporting during the 2020 seasonal influenza vaccination campaign. In total, 2408 individuals agreed to participate in the RCT. A total of 1196 participants were randomized to the CANVAS arm and 1212 to the CANImmunize arm (To be successful, digital solutions must be easy to use, easy to access, and meet the needs of the users [Interestingly, the highest response rate in the mobile app group was observed among 30-39–year-old participants. This was possibly due to this demographic being having a higher level of technological literacy and comfort with mobile apps [The lack of responses to the usability survey is also a potential concern as we were unable to assess exactly what needs to change to make mobile app reporting acceptable and user-friendly. The usability survey was provided as a separate email link after the safety survey was completed, and it may have been missed by users.It is critical to make mHealth solutions accessible, and a barrier may be technological literacy or low perceived ease of use among some populations. It is important that mHealth apps are designed to be user-friendly for target demographics [Current literature suggests that the development of mHealth apps should follow 8 specific categories [Enabling AEFI reporting from individuals who are already using a mobile app for another purpose would require less work for the user and may be a more successful approach. For example, 42% of Canadians report accessing websites, mobile apps, or other interactive web-based services to support or monitor their health [Based on the RCT conducted in this study, it was found that adding the extra step of using the mobile app introduced an additional barrier for participants who may have lower technological literacy. Future mHealth developments should include various participants from the target demographics in the development process to ensure usability.