Navigating childhood fever: A registry-based analysis of parental engagement patterns and information needs in mHealth.

BACKGROUND: Acute childhood fever can lead to parental anxiety which contributes to the overcrowding of pediatric emergency care. Mobile health (mHealth) applications offer support to empower caregivers. Real-world evidence regarding usage disparities and their actual impact on user empowerment remains scarce. OBJECTIVE: This observational study investigates the sociodemographic determinants of mHealth usage and evaluates its effect on parental confidence as parent-reported outcome measure (PROM). METHODS: A FeverApp registry data analysis was conducted. An ecological momentary assessment tool regarding fever management of parents. The main sample (N=24,800) was analyzed to identify sociodemographic usage disparities and thematic navigation patterns using correlation clustering. A subsample (n=3,825) completed a 5-point questionnaire regarding perceived safety in managing fever, as the primary PROM. The relationship between interaction frequency and the PROM was evaluated using an ordinal logistic regression model. RESULTS: Highly educated parents demonstrate the highest engagement (mean = 14.1 interactions) compared to those with lower education (9.8 interactions). The PROM analysis revealed a clear dose-response relationship: higher interaction frequencies strongly predicted higher levels of self-reported safety. Parents with lower educational backgrounds frequently fell below the usage threshold. Furthermore, correlation analysis indicated that parents navigate information in highly structured, action-oriented clusters. CONCLUSIONS: Linking objective data with PROMs suggests that mHealth interventions are positively associated with enhanced parental self-efficacy. The identified equity gap highlights that some designs may leave vulnerable populations behind. To serve as equitable public health tools, future digital health systems must integrate adaptive, low-threshold pathways to ensure the necessary engagement for confident decision-making.