The Paradox of Control: How Self-Quantification in Mobile Health Applications Shapes Empowerment, Health Locus of Control and Adherence—A Self-Determination Theory Perspective

Self-quantification is a prevalent feature in mobile health (mHealth) applications, offering users insights into their health-related behaviors. Guided by the framework of Self-Determination Theory (SDT), this study examines how self-quantification influences empowerment, internal health locus of control (IHLC), and adherence—key factors in promoting sustained engagement with health behaviors. Prior research suggests that self-quantification enhances empowerment, which fosters better health behaviors such as adherence to tracking practices. However, this study argues that self-quantification may also yield negative effects. Using an online survey of 298 users of self-quantification technologies, we reveal a paradoxical effect: while self-quantification enhances empowerment, which improves adherence to tracking behaviors, frequent reliance on self-quantification reduces individuals’ belief that their actions are the primary determinants of their health outcomes—referred to as internal health locus of control (IHLC). In extending SDT, we highlight that although empowerment promotes positive engagement, overreliance on external tracking undermines users’ sense of control, shifting it from internal to external sources and weakening IHLC. This diminished IHLC, in turn, negatively impacts adherence. These findings highlight the complex psychological dynamics inherent in self-quantification practices: empowerment fosters engagement, but an overemphasis on personal agency can introduce stress, making consistent tracking behaviors difficult to sustain. We recommend that mHealth interventions balance empowerment with strategies that avoid overemphasizing individual responsibility, ensuring long-term engagement without psychological strain.