Integrated Framework to Identify Attrition Mechanisms in Digital Healthcare-Based Physical Activity

Abstract

Digital healthcare services are frequently evaluated in terms of functionality, usability, and technical performance, yet their sustainable expansion cannot be fully explained by technical quality alone. This study proposes an integrated framework for identifying attrition mechanisms in digital healthcare by incorporating both service-level features and social-scientific dimensions of user interpretation. To explore this perspective, 23,665 YouTube comments and replies were collected from 16 videos related to Nike Training Club, Strava, and MyFitnessPal and analyzed using BERTopic. The results revealed clear cross-service differences. Strava generated comparatively coherent discourse centered on activity tracking, device integration, and data use, whereas Nike Training Club and MyFitnessPal showed broader thematic dispersion shaped by viral short-form reactions, general wellness talk, and comparisons with competing services. Rather than treating such inconsistency as a simple methodological weakness, this study interprets it as evidence that digital healthcare attrition is socially mediated through trust formation, contextual relevance, comparative evaluation, and platform culture. The findings suggest that sustainable expansion of digital healthcare requires more than technological advancement; it also depends on understanding how services are publicly interpreted, socially positioned, and integrated into everyday routines.

Keywords: Digital Healthcare, Attrition Mechanism, Sustainability, Sociotechnical Perspective, Youtube Comments, BERTopic

DOI: 10.54941/ahfe1007308