Abstract
BACKGROUND: Self-care mobile health (mHealth) apps empower users to manage their health independently by supporting symptom tracking, medication adherence, and lifestyle changes. Given the limitations of mobile platforms, such as small screens and limited input capabilities, usability is a critical factor influencing the successful adoption of these apps. METHODS: This article presents a systematic review of user-based usability testing practices in self-care mHealth applications. A total of 68 primary studies were retrieved and analyzed from the Scopus database, published between 2014 and 2024, following established systematic review protocols. RESULTS: The review revealed a growing research interest in usability testing for self-care mHealth apps. Usability testing commonly employs mixed-method approaches, combining standardized questionnaires, such as the System Usability Scale, with qualitative methods (think-aloud protocols and interviews). A diverse group of participants, including patients and healthcare professionals, was used for testing. Testing was conducted in both controlled (labs and hospitals) and uncontrolled (homes) environments. The core usability attributes, ease of use, engagement, and satisfaction, were widely used. CONCLUSION: The review offers actionable insights for researchers seeking to improve the usability of self-care applications. Further research is needed in several directions: justifying the appropriate sample size for participants, expanding the scope of usability testing to include underexplored attributes, and conducting longitudinal usability studies, and so on.