budget management research paper

Research and Application of an Integrated Budget Management System for Provincial Financial Management

• Conference paper
• First Online: 21 March 2024
• Cite this conference paper

• Ting Cao 7  

Part of the book series: Smart Innovation, Systems and Technologies ((SIST,volume 369))

Included in the following conference series:

• International Conference on Artificial Intelligence and Communication Technology

19 Accesses

Financial management is an important link in government management work, and the exercise of functions and powers by government agencies at all levels both domestically and externally relies on financial management work. If financial management is chaotic or fails to reflect the demands of government management, it will have a huge negative impact on the operation and function of the government, and even result in the lack of functionality of government institutions. Budget management is the primary link of financial management, which determines the success or failure of government financial expenditure and its guiding role. After decades of continuous practice and exploration, the methods and practical conditions of budget management are gradually developing towards standardization and information. Budget management needs to consider numerous factors in social management. If not fully considered, it will seriously affect and mislead the accuracy of the budget. This article proposes an integrated budget management method for provincial-level financial management and studies the implementation method of the system, which is applied and verified in financial management practice.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

• Available as PDF
• Read on any device
• Instant download
• Own it forever
• Available as EPUB and PDF
• Durable hardcover edition
• Dispatched in 3 to 5 business days
• Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Chen, J.: Integrated information construction of financial management with budget as the core. Charming China (2019). (In Chinese)

Google Scholar  

Huang, A.: Research on university project performance management under the integration of budget management. Economics 5 (3), 139–141 (2022). (In Chinese)

Bao, G., Zhang, R.: From “Budget performance” to “Performance budgeting”-review and prospect of budget performance evaluation in China. J. Lanzhou Univ. Soc. Sci. Ed. 47 (5), 9 (2019). (In Chinese)

Wang, G., Zhang, X.: The construction path of university budget management system based on budget integration. Budg. Manag. Account. 5 (4), (2021). (In Chinese)

Liu, Y.: Promote efficient financial management of administrative institutions based on the integrated budget financial management system. Chin. Sci. Technol. J. Database (Full Text Ed.) Econ. Manag. 11 (4), (2022). (In Chinese)

Wang, L., Wang, C., Zhu, Hi., et al.: Research on the strategy of integrated management of financial budgeting in universities under the background of integration of industry and finance. China’s Collect. Econ. 3 (3), (2023). (In Chinese)

Bulgurcu, B.: Application of TOPSIS technique for financial performance evaluation of technology firms in Istanbul stock exchange market. Procedia-Soc. Behav. Sci. 62 , 1033–1040 (2017)

Article   Google Scholar  

Moslem, A., Abbas, B.: A comparative analysis of dynamic and cross-sectional approaches for financial performance analysis. Am. J. Financ. Account. 5 (3), (2018)

Wu, P.: State owned asset management in public institutions under the background of budget integration. Chin. Sci. Technol. J. Database (Full Text Ed.) Econ. Manag. 12 (3), (2022). (In Chinese)

Song, M.: The impact of budget integration on the financial work of administrative institutions. Wealth Manag. Collect. 4 , 3 (2023). (In Chinese)

Download references

Author information

Authors and affiliations.

Financial Information Management Center of Jiangsu Provincial Department of Finance Nanjing, Jiangsu, 210024, China

You can also search for this author in PubMed   Google Scholar

Corresponding author

Correspondence to Ting Cao .

Editor information

Editors and affiliations.

Technical University of Sofia, Sofia, Bulgaria

Roumen Kountchev

SOA University, Bhubaneswar, India

Srikanta Patnaik

University of Hyogo, Kobe, Japan

Kazumi Nakamatsu

TK Engineering, Sofia, Bulgaria

Roumiana Kountcheva

Rights and permissions

Reprints and permissions

Copyright information

© 2024 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

About this paper

Cite this paper.

Cao, T. (2024). Research and Application of an Integrated Budget Management System for Provincial Financial Management. In: Kountchev, R., Patnaik, S., Nakamatsu, K., Kountcheva, R. (eds) Proceedings of International Conference on Artificial Intelligence and Communication Technologies (ICAICT 2023). ICAICT 2023. Smart Innovation, Systems and Technologies, vol 369. Springer, Singapore. https://doi.org/10.1007/978-981-99-6956-2_32

Download citation

DOI : https://doi.org/10.1007/978-981-99-6956-2_32

Published : 21 March 2024

Publisher Name : Springer, Singapore

Print ISBN : 978-981-99-6955-5

Online ISBN : 978-981-99-6956-2

eBook Packages : Engineering Engineering (R0)

Share this paper

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Publish with us

Policies and ethics

• Find a journal
• Track your research

Budgeting as practice and knowing in action: experimenting with Bourdieu's theory of practice: an empirical evidence from a public university

Asian Journal of Accounting Research

ISSN : 2459-9700

Article publication date: 11 February 2021

Issue publication date: 7 September 2021

The present study aims to explore how various doings, strategic actions and power relations stemming from internal agents are instrumental in (re)constituting the different forms and meanings of budgeting in a specific field.

Design/methodology/approach

The paper uses a single-case study method based on a Sri Lankan public university. Data are collected using interviews, documentary evidence and observations.

The empirical evidence suggested that internal agents are crucial, and they are the producers of budgetary practice as they possess practical knowledge and power relations in the field where they operate. The case data demonstrate that organisational agents do have real essence as active and acting to produce effects in budgeting practices, and the significance of exploring the singularity of multiple agents in terms of their viewpoints, trajectories, dispositions and power relations, who may form, sustain or interrupt budgetary practices in a given setting.

Research limitations/implications

As the research is directed towards the selection of in-depth enquiry of specific setting infused with culture, values, perception and ideology, it might cause to diminish the researcher's analytical objectivity and independence of the research.

Practical implications

As budgetary practices are product of human interaction, it is important to note that practitioners should be concerned with what agents do in actual practice and their inactions, influences and power relations in budgeting practices, which might not align with the structural forces enlisted in the budgeting. It would be of interest for future empirical research to explore the interplay between the diverse interests of organisational agents and agents beyond the individual organisations.

Originality/value

This study contributes to the literature on management control practices by documenting the importance of understanding the “practice” through relational thinking of all three concepts is emphasised, such interrelated theoretical insights are seldom used to understand accounting practices. This research emphasises the importance of bringing out the microprocessual facets of management control to open up its non-conscious, non-strategic and non-rationalist forms.

• Budgeting practice
• Practical knowledge
• Power relations

Seneviratne, C.P. and Martino, A.L. (2021), "Budgeting as practice and knowing in action: experimenting with Bourdieu's theory of practice: an empirical evidence from a public university", Asian Journal of Accounting Research , Vol. 6 No. 3, pp. 309-323. https://doi.org/10.1108/AJAR-08-2020-0075

Emerald Publishing Limited

Copyright © 2021, Chaturika Priyadarshani Seneviratne and Ashan Lester Martino

Published by Emerald Publishing Limited. This article is published under the Creative Commons Attribution (CC BY 4.0) licence. Anyone may reproduce, distribute, translate and create derivative works of this article (for both commercial and non-commercial purposes), subject to full attribution to the original publication and authors. The full terms of this licence may be seen at http://creativecommons.org/licences/by/4.0/legalcode

Background of the study

Budgets are vital in management control processes and generally considered as formal, structural controlling mechanisms enlisted to support the controlling use. Thus, the budget is primarily considered as a coercive tool to assist management to coerce employees' compliance and effort ( Aleksandrov et al. , 2018 ; Horngren et al. , 2014 ; Lambovska et al. , 2019 ; Simons, 1994 ; Sponem and Lambert, 2016 ). However, budgets are not only a diagnostic tool to serve a routine controlling use with a coercive orientation but a mode of coordinating and communicating the strategic priorities of the organisation ( Abernethy and Brownell, 1999 ; O'grady, 2019 ). In the study of a rolling budget, viewing the process from enabling perspective, Henttu-Aho (2016) emphasises that new budgetary practice enables to build a holistic view of the totality of control and supply more relevant information about organisation in a more realistic manner while improving the flexibility and effectiveness of the budgetary work. In public sector organisations, diverse aspect of budgeting including diagnostic and enabling uses are investigated within the effort of complying with statutorily obligations to improve the efficiency ( Jakobsen and Pallesen, 2017 ; Mkasiwa, 2019 ).

By moving beyond the technical–rational function of budgeting as a means of affecting control, the budget is considered as a “multi-faceted phenomenon” in public sector organisations ( Covaleski et al. , 2013 ). Within the wider depiction of budgetary control as a socially constructed phenomenon, an array of research focusses on how budgets are instrumental in shaping behaviour and how budgets emerge as a response to governmental reforms, multiple logics and strategic behaviour in public organisational settings ( Aleksandrov et al. , 2018 ; Célérier and Botey, 2015 ; Covaleski and Dirsmith, 1983 , 1986 ; Covaleski et al. , 2013 ; Ezzamel et al. , 2012 ; Harun et al. , 2020 ; Moll and Hoque, 2011 ).

In what ways are specific patterns of dispositions and power relations attuned with the taken-for-granted (doxical) elements in constituting/reconstituting budgetary control practices?

What are the strategies of action [1] of internal agents, how do strategies of action or series of moves emanate from the “practical sense” of budgeting and are deployed in constituting/reconstituting budgetary control practices in a specific field?

This article results from a study of budgetary practice by deploying a qualitative in-depth case study approach in a one large Sri Lankan public university, and the paper differs from prior research in two aspects. First, this study contributes to the management accounting literature by investigating how the impacts stemming from the micro level, including specific practices, competing interests and diverse power relations of internal agents, can shape budgetary control practices of a specific setting. Second, the current study emphasises the significance of understanding the budgetary practice and its practical logic, as opposed to formal, conscious and strategic forms of a public university.

Theoretical framework

The notion of “practice” shares a common theme as the “understanding of how people act in organizational context and relations between the actions people take and the structures of organizational life” ( Feldman and Orlikowski, 2011 , p. 1240). Based on sociological perspectives, Bourdieu formulated a practice theory based on relational thinking to understand the social world in an alternative way ( Bourdieu and Wacquant, 1992 ). According to Bourdieu, habitus, capital and field are necessarily interconnected, interdependent and co-constructed, conceptually and empirically ( Grenfell, 2008 ). Bourdieu presented an equation to summarise the practice as a result of relations between one's disposition (habitus) and position in the field, which is primarily determined by endowed capital within the contemporary state of play in a particular social domain in its pragmatic sense ( Bourdieu, 2013 , p. 95): ( Habitus × Capital ) + Field = Practice .

In any field, people's behaviour/activities (what people do) are governed by an array of dispositions (practical senses), dubbed as “habitus” ( Bourdieu, 1990 ). Habitus is considered as a practical feel or practical mastery for the game agents' strategic actions are informed by habitus in a given field are not imputed by rational or conscious choice ( Bourdieu, 1990 ; Hurtado, 2010 ) but beyond the deliberate control ( Bourdieu and Wacquant, 1992 ; Lamaison and Bourdieu, 1986 ; Wacquant, 1998 ). Generally, social practices are denoted as strategies, and particular types of social actions or strategies of different groups are generated by that particular group's habitus ( Hurtado, 2010 ).

Central to assertions put forth by Bourdieu (1990) , social space is dubbed as the “field” in which people undertake diverse activities, ruled according to specific interests and its own stakes. The notion of field is created as an attempt to conceptualise a configuration of a network, of objective relations between positions ( Bourdieu and Wacquant, 1992 ), hierarchically endowed with diverse types of capital. “Doxa” is defined as a set of pre-reflexive, commonly shared, unquestioned, taken-for-granted understandings, spontaneous perceptions and opinions prevailing across the social space determining the natural practice and sense of limits of habitus of the agents in a particular field ( Emirbayer and Williams, 2005 ; Grenfell, 2008 ). Agents in dominant positions in the field are granted the power to mould or shape the doxic elements prevailing in the field ( Bourdieu, 1977 ; Bourdieu and Wacquant, 1992 ).

As “capital does not exist and function except in relation to a field” ( Bourdieu and Wacquant, 1992 , p. 101), field situates agents in the field of forces, power relations and desires towards practices. Capital is the stake or weapon mobilised in ongoing power balancing between actors and considered as an outcome of the ongoing position-takings in everyday work ( Bjerregaard and Klitmøller, 2016 ; Chudzikowski and Mayrhofer, 2011 ; Emirbayer and Johnson, 2008 ; Maclean et al. , 2012 ; Schneidhofer et al. , 2015 ). In the theory of power relations, Bourdieu terms “species of capital” as a diverse range of materials and other types of resources accrued by agents in achieving a privileged position in a particular social space ( Emirbayer and Williams, 2005 ). Cultural capital, economic capital and social capital are recognised as different forms of capital or resources.

Baxter and Chua (2008) empirically narrated the chief financial officer’s (CFO) practical involvement in terms of habitus in organisational projects and the unorthodox management accounting practices implemented in the organisational setting. In a different context, Lodhia and Jacobs (2013) used Bourdieu's triad concepts of field, habitus and capital in a public sector department in Australia to examine the practical logics of internal practices produced at an individual level in environmental reporting. Goddard (2004) investigated the association between accounting, governance and accountability in local government in the UK, emphasising Bourdieu's notion of habitus. Célérier and Botey (2015) reported a socio-ethnographic study on how participatory budgeting was characterised by accountability practices favouring the election of councillors with distinctive capitals, who were “dominated-dominants dominating the dominated” amongst the budgeting participants. By taking an ethnographic approach, Bourdieu's interdependent relation between habitus, capital and field was used by Jayasinghe and Wickramasinghe (2011) to capture how a particular structural logic governed the resource allocation mechanism of the village. The study by Xu and Xu (2008) investigated interactions and relations between social actors in the field of Chinese banking to demonstrate how actors in social positions possess diverse resources, power and capital, leading some to dominate others.

Strategy as a practice has been merged in a distinctive approach to study organisational strategy and strategising, inclusive of strategic management, decision-making and managerial work ( Gomez, 2010 ; Hurtado, 2010 ; Jarzabkowski et al. , 2007 ; Whittington, 1996 , 2006 ). Hutaibat (2019) used Bourdieu's theory of practice in a Jordanian higher education sector to examine the perceptions of actors in the field, regarding strategising, accounting for strategic management and power structures. Drawing insights from Bourdieusian perspective, Bjerregaard and Klitmøller (2016) examined how subsidiary actors accommodate, actively support and resist various parts of an HQ-mandated management control system in a multinational corporation in a Mexican special economic zone.

Overall, while the above research has been influential in informing the application of the Bourdieusian threefolded concepts to explore the dynamics of individuals, our study aims to explore the internal agents' practical actions, providing a sense of the practices in budgetary controls which were being enacted through the agents who are situated in diverse positions in a field study of a public university.

Research setting, method and design

Based on the research questions and theoretical considerations, this study is founded on qualitative data, applying a single-case study strategy. According to Bourdieu's methodological principles, a one large Sri Lankan public university, i.e. University Sigma is selected as “determinate place in social space”, ( Bourdieu and Wacquant, 1992 , p. 214) and data are collected over a period of six months during 2014/2015. It is a period in which University Sigma is receptive as it is moving towards an outcome-oriented culture and striving to achieve the standards of a world-class university, under the strategic plan of the Ministry of Higher Education (MHE) of Sri Lanka in 2010. As the performance-based initiatives have been reinforced through the circulation of finance circulars informing all universities that additional funds will be released based on the performance, initial steps have been taken to change the strategic performance management system, along with university budgeting to create high-performing state-owned universities.

Currently, University Sigma operates under the Universities Act No. 16 of 1978, which provides powers to the University Grants Commission (UGC) to intervene directly in university's routine and non-routine operations. University Sigma must comply with the rules and regulations enforced by the UGC and MHE and is subject to the usual public sector financial regulations of the Treasury and Ministry of Finance and Planning. This affects the university's ability to set salaries, retain income generated, sell assets and reinvest the proceeds and raise capital through loans from banks. The governance structure of University Sigma consists of four official boards: the administrative council, the senate (academic board), faculty boards and postgraduate academic boards. Amongst these, the university council is the primary governing body. Other than the chancellor, the main officers of the university are recognised in the University Act as the vice chancellor, registrar, librarian, bursar (treasurer) and the deans of faculties. The vice chancellor is the chief executive officer and principal academic officer who entitled to convene, be present and speak at any meeting of University Sigma.

A total of 35 in-depth interviews were conducted with diverse agents at various hierarchical levels within the research organisation, and interviewees were selected based on the importance of their role with respect to budgetary control. To complete the interview, time varies from 40 min to 120 min. Leaning on the theoretical lens of Bourdieu's practice theory, broad questions were formulated to guide the pilot interviews. Being capitalised on the insights made initially, questions for the subsequent interview questions were refined, capturing the richness of the field. Interview and non-participant observational data were supplemented by different archival records to reinforce the interviewee findings. Moreover, complementing the interviews, direct observations were carried out and field notes were compared to reconfirm and add more insights into interviewee comments.

Thematic analysis is commenced as a prerequisite to making sense, verifications and drawing conclusions from the empirical findings. The interviews were transcribed and then the transcripts were closely examined, key themes highlighted and coding carried out. Once themes have been finalised, templates were prepared for each and every theme to tag and place the information from interview transcripts, observational notes, field notes and archival documents into the identified categories. Thus, to bring the richness of the phenomena under study, the theoretical framework also becomes an important guide in searching for the patterns amongst the coded field evidence and thereby the sense-making process and drawing conclusions were essentially integrated with the theoretical underpinnings of Bourdieu's theory of social actions.

Budgeting control: knowing in practice

The next section discusses how budget as a means of affecting control and also to facilitate the attainment of imposed strategic priorities take place confronting complexities, concerns and conflicting goals amongst the multiple agents within a public university setting.

Individual/group power on the university budget preparation

The budgeting process is officially initiated in the month of August, with the acceptance of the finance circular of the budget call from the UGC. After this, the university bursar communicates the budgetary guidelines to faculty deans, faculty bursars, the registrar and all heads of the service units as a prerequisite to embark on the journey of the budget preparation. The budget committee consists of the deans of the faculties, senior financial and administrative officers (bursars and registrars), the librarian and all other heads of service units of University Sigma and it coordinates the planning phase. The budget committee is chaired by the vice chancellor, who is supposed to act as chair; however, a university bursar is accountable for all deliberations, ranging from the planning to controlling facets in the budgeting process.

We don't have any guarantee whether we'll be given the necessary funds that we requested through the budgetary allocations. So, our staff may not be motivated to participate actively in the planning processes. So why should we prepare our plans if there is no assurance of getting the requested funds?

Consistent with Bourdieu, acknowledging the fact that habitus could be reflected in all practices, the particular action patterns of academic members in budget planning is understood by referring to the deeply embedded doxic experiences that are self-evident within the existing relations of a specific setting ( Lau, 2004 ). According to Hutaibat (2019) , academics tend towards the passively supporting for a proposal collection phase depending upon their doxa and their relation to the more power structure which is embedded in a specific setting. As departmental agents believe that the submission of their proposals will not be fruitful due to possible funding constraints, such regularities potentially impact on making sense of particular action patterns of agents [1] in a specific context ( Grenfell, 2008 ). In a similar vein, another member of an academic department spelled out the underlying reason for their passive participation in the budgetary planning process, “What is the point of spending quite a lot of time in preparing the budget proposals if we can get small amount comparative to what we request?” As above, words provide evidence that actions and perceptions of general academics are habituated by the realities perceived and regularities pursued in relation to the difficulty of getting intended monetary allocations in the particular social space ( Bourdieu and Wacquant, 1992 ). According to Vaughan (2002), when understanding practical actions, people's habitus is not merely informed by surroundings of their early lives but also by the doxa that remains as unquestioned opinions and perceptions to determine the “sense of limits” of agents participating in the budgeting practice ( Grenfell, 2008 , p. 120).

Persuaded by the importance of capturing the profound aspect of overall habitus of general academics (doxa), the interviews conducted with administration/financial officers of University Sigma highlighted the implicit power that academics possessed based on the doxic understanding that persists in the specific social setting. Hence, from the theoretical point of view, as “doxa” in the organisational setting is necessary for symbolic power ( Hurtado, 2010 ), it causes to attune the habitus of the agents in the research setting under study. A senior project officer reiterated a sense of disappointment, reflecting that doxa refers to capital concerning the symbolic power of academic agents ( Kloot, 2009 , p. 472) and how possession of symbolic power tends to influence the initial planning stage. Alongside symbolic capital informed by doxa, departmental academics are endowed with not only an institutionalised form of cultural capital, in terms of certificates, skills and knowledge, but also intellectual capital, termed “scientific renown” [2] , associated with scholarly reputation on research ( Bourdieu and Wacquant, 1992 , p. 76). In the public higher education field, those with the institutionalised form of cultural capital, together with intellectual capital, are considered to be “advantaged at the outset as the field depends mainly on such forms of capitals” ( Grenfell, 2008 , p. 69). Since such forms of capitals are valued by the social agents who operate in that social space, they become symbolic capital in the specific field.

Hence, as confessed by several interviewees, general academics are assigned with symbolic authority that situates them in a privileged position of power at Sigma, enabling them to secure benefits and enhance their stake in the social area ( Bjerregaard and Klitmøller, 2016 ; Célérier and Botey, 2015 ; Hurtado, 2010 ). Given that general academics are granted the power to shape understanding in relation to budgetary practice, in applying the rules and procedures of the practice in the university setting ( Bourdieu, 1977 ; Bourdieu and Wacquant, 1992 ), they tend to impose their doxical understanding on the control practice, even while overlooking the accepted procedures to be accomplished in budgetary planning ( Kloot, 2009 ).

Therefore, corresponding with Bourdieu's assertions, it could be argued that general academics are not mere preprogrammed automatons governed by immutable and unchanging laws as their practices are minimally determined by the specific rules and requirements of budgetary practice. As Bourdieu and Wacquant (1992) asserted, based on the distinct profiles of capital (power resources) associated with agents in the research organisation, a distinction is drawn between dominant and dominated positions ( Célérier and Botey, 2015 ; Emirbayer and Williams, 2005 ). Within the field, winners/losers and dominancy of the field are determined by the volume and structure of resources associated with different agents; agents possessing more capital relevant to a particular field are considered dominant, with greater possibility in actions to be executed. Dominant agents pursue conservation strategies to preserve the hierarchical principles and safeguard their positions in the hierarchy; in contrast, subversion strategies are pursued by dominated agents to transform the existing system of authority for their benefit ( Wacquant, 1998 ). Thus, as the general academics are situated in the dominant positions, holding symbolic power to secure their stake within the power configuration of University Sigma ( Célérier and Botey, 2015 ), their symbolic power exacerbates goal conflicts amongst other agents being potentially problematic for effective planning of the university budget ( Bjerregaard and Klitmøller, 2016 ). At University Sigma, capacity over interpreting some budgeting procedures is transferred from agents of the university top management to general academics rather by losing the power to obtain the desired contribution from general academics in the planning phase ( Mutiganda et al. , 2013 ).

Against a backdrop where pervasive power relations operate at the bottom level of the social space, it was difficult to determine whether deans have the capacity to exercise power over agents at the departmental level in enforcing their participation in the planning phase. Top faculty agents hold significant academic capital [3] , which is acquired and maintained by taking a top position in the management hierarchy of the university and enables domination of other positions ( Kloot, 2009 ). Such academic capital mainly depends on the principle of legitimation, corresponding to the fact that the organisational hierarchy is well aligned with social power ( Kloot, 2009 ). Given that, faculty deans are identified as powerful or dominant agents, possessing broad power resources and organisational capital, providing the ability to act as “master” in terms of the rules and procedures of planning and other operational matters associated with the budgetary process ( Bourdieu, 2005 ).

In terms of capturing actual practices of key university agents in the planning phase, this revealed that the faculty dean's actions, interests and perceptions are derived as adherence to the sense of what is appropriate and proper in a given situation ( Lodhia and Jacobs, 2013 ). According to Célérier and Botey (2015) , being an influential agent in the faculty, the faculty dean has the liberty to decide and accommodate the activities in the faculty budget, without referring to subordinate agents' proposals (the heads of departments). Based on the endowed social networks, the faculty dean has the capacity to obtain necessary funds for the budget proposals that he included in faculty budgets according to his discretion, bypassing the granted budget allocations.

Substantiating the above insights, faculty dean 2 described how agents tend to act on the practical understanding of the logic of budgeting, which determines the “doable and thinkable” limits over the phase of budget planning ( Grenfell, 2008 , pp. 54–59; Lamaison and Bourdieu, 1986 ). As the top faculty officers possessing practical expertise in planning and operational issues pertinent to the faculty budgetary process, they tend to minimise lapses which arise due to insufficient participation from the academic departments. Irrespective of the formal budget procedures, they act with the tacit knowing of the way of things happen in the particular social space, to achieve the full potential of the faculty through budgetary planning ( Gomez, 2010 ). Thus, the field empirical evidence revealed that due to insufficient participation of departmental agents in gathering necessary input to prepare the budget, budget planning is centred in the hands of the bursar and dean of the faculty.

In the second phase, the programme budget [4] is prepared by considering budget proposals included in the budget call. As stipulated by the UGC in the budget specimen, the accounting rationale of linking performance indicators, action plans and monetary allocations is to intensify the controlling aspect of the university budget. Moreover, by reiterating the negative consequences of passive participation of academic departments in the initial budget planning, university bursar 1 highlighted the challenge of identifying key performance indicators and linking such measures accurately to ensure employees' behaviour aligned with targets stipulated in the university budget ( Widener, 2007 ).

From an accounting perspective, planning is considered as an important aspect of budgetary process because it is related to the subsequent control phase in the organisational control process. However, in the absence of realistic information from the bottom level as senior bursars at the university level tend to act without clear strategic intentions linking desired outcomes and budgetary allocations. They tend to preserve the existing order in preparing the budget in compliance with the UGC, in spite of the underlying accounting logic of prioritising and linking strategic aims with the estimated financial disbursements. Hence, the budget as a “control tool” is not effective in the planning process ( Covaleski et al. , 2013 , p. 338); rather, planning merely fulfils compliance controls, to avoid any explicit violation of budget guidelines imposed by higher education authorities ( Cunningham, 2004 ).

Practical logics of actions in managing the university budget

Examining human conduct around the programme budget reveals that it is a product of individual strategic choice in a university setting ( Lodhia and Jacobs, 2013 ). Speaking about the pervasive engagement undertaken in fulfilling the requests for financial disbursements made by diverse organisational agents, either within or beyond the given programme budget, university bursar 1 continued, “Budget is a guideline. But we can do more work even beyond the budget if we really want to work in improving the status of university”. Many interviews with bursars at different hierarchical and faculty levels reflected the need to take spontaneous actions without being merely confined to the programme budget ( Bourdieu, 1990 ; Lamaison and Bourdieu, 1986 ). Acknowledging this, a senior assistant bursar of the finance division noted, “Even though some of the activities are not in a budget plan, there are possibilities to meet those requests with the special approval”. According to Bourdieu's terminology, in fulfilling the diverse requests made by internal agents, bursars pursue “immanent necessity”, without being restricted to the preprogrammed disbursement levels ( Lamaison and Bourdieu, 1986 ).

Noting that budgetary requests are facilitated in a manner compatible with the budget guidelines, an assistant bursar said, “In many instances, we had to handle requests for financial disbursements on situational basis without violating the fundamental budget guidelines”. Thus, bursars have developed a strong practical mastery in the art of managing the university budgetary process, without explicitly violating the budgetary rules and guidelines on stipulated strategic objectives and budget limits in day-to-day operations ( Baxter and Chua, 2008 ). In accordance with these insights, university bursar 1 noted the significance of undertaking actions based on reasonableness and the effort she made in handling such requests from the departmental level.

In particular, a university bursar is endowed with “technically-based bureaucratic capital” and “bureaucratic capital of experience” through acquiring knowledge of regulations and more rationalised procedures and techniques pertinent to the budgetary practices over a longer period ( Bourdieu, 2005 , p. 117). Therefore, based on the wider positional capacities, the university bursar is capable of reconsidering whether to facilitate ad hoc financial disbursement requests made by the faculty bursar that are not appropriately tabled in the programme budget or for which allocated funds are not adequate. Thus, the dispositions of bursars are set up by unconscious learning and also incorporating embedded field values in the practice of university budgeting.

In compliance with the budgetary guidelines, the university bursar may strive to obtain special approval from the finance committee of University Sigma to fulfil requests of a recurrent nature beyond the programme budget. In another instance, a university bursar noted how she struggled to get approval for disbursements of a capital nature from the UGC, which was supposed to be approved by the finance committee and council of University Sigma. From a practice perspective, rules do not always bring an end to actions; rather, agents negotiate the rules with the necessary authorities in order to facilitate the accomplishment of certain actions, by overseeing budgetary limits strategically in the social space under study ( Swartz, 2002 ). Seen in this light, the university bursar is an individual who is capable of justifying certain actions or requests to the higher authorities of the university (i.e. the finance committee and council), which are not in fact explicitly specified in university budget but accepted by higher authorities of university as appropriate ( King, 2000 ).

Consistent with Inghilleri (2005) , it is evident that the strategic actions pursued by bursars depend on the knowledge gathered to “know” how budgetary controls operate, embodied in the negotiating the official budgetary rules to minimise adverse effects, for their own conservation in a university setting. However, field evidence vividly reflects how tension is triggered between the need to fulfil the ad hoc requests with necessary monetary disbursements outside to the budget and the necessity to comply with budgetary limits and procedures. As bursar 6 noted, “However by satisfying our staff's requests, we should be compliance with budgetary rules and guidelines. We have to manage both sides”. Further substantiating these views, bursar 4 voiced her grievances about how the symbolic power of departmental agents creates conflicting interests in managing the budget within the pre-planned budget limits ( Semeen et al. , 2016 ). According to Farjaudon and Morales (2013) , it is clear that the dominated, i.e. bursars may “participate in the pursuit of dominant interests, possibly unknowingly or in the belief that they are pursuing their own interests” (p. 155).

The given nature of bursars' practices could be understood as a practical logic of the way that things happen in the budgetary process in the specific research setting under study. Therefore, without strictly adhering to programme budgets, agents may pursue strategies premised on a practical sense of budgetary practice to produce certain actions in the social space under enquiry ( McDonough, 2006 ). Interviewees at the finance division revealed that, irrespective of the requests made beyond the budget, bursars tend to capitalise on their practical mastery of budgetary functions to fulfil requests not only to satisfy the departmental or faculty-level agents but to maintain or enhance personal credibility amongst members of University Sigma ( Lodhia and Jacobs, 2013 ).

As revealed in the interviews with financial officers, university financial officers have devised strategies to ensure the continuity of university operations increasing the capabilities of University Sigma and to maintain or develop credibility towards bursars by negotiating budgetary rules with the necessary authorities ( Lamaison and Bourdieu, 1986 ). Hence, being the embodiment of “immanent regularities and tendencies” relating to the budgeting practice ( Bourdieu and Wacquant, 1992 , p. 138), the specific perceptions and actions of university bursars are attuned to expedite activities as planned in the university budget. This is consistent with the exploration of Baxter and Chua (2008) , who characterised the CFO's habitus from a technical accounting angle, allowing a demonstration of the competencies in managing a diverse range of activities of different lines of business in a large company.

Being an agent responsible for the overall university budgetary process, the university bursar (top financial officer) explained how her individual practices are frequently inscribed with social determination attached to the position where she operates ( King, 2005 ). However, there are instances where the university bursar engaged in budgetary process significantly depends on her discretion to realise the targets in the university budget. Thus, day-to-day individual actions are not simply constrained by the external constraints; instead, they are informed by the deeply ingrained past experiences and restraints offered by the present conditions ( Swartz, 2002 ). Although the budget is considered a mechanism to exert control over the agents who are expected to operate within the predefined limits, these limits can be exploited by the specific practical actions of the bursars ( Ahrens and Chapman, 2004 ; Wouters and Wilderom, 2008 ). Without explicitly violating the rules of budgetary practice, bursars place great emphasis on enabling the situations by going beyond the pre-planned budgetary limits in line with their “sense of practice” to ensure the best for University Sigma ( Grenfell, 2008 ; Lamaison and Bourdieu, 1986 ; Raedeke et al. , 2003 ; Swartz, 2002 ).

Concluding discussion

The paper has examined in what ways do field, capital and habitus interplay to determine individual strategies of actions (practices) reflected through perceptions, appreciations, tensions and conflicting interests and how do they influence budgetary control practice. In conclusion, the empirical evidence suggested that practices are not conscious or mechanistic obedience to a rigid set of rules, guidelines and procedures of budgetary control; instead, their specific practices are attuned with “practical sense” or “taken-for-granted sense” of the regular budgetary practice prevailing in the public university setting ( Bourdieu, 1990 ; Bourdieu and Wacquant, 1992 ; Hutaibat, 2019 ). Further, Bourdieu's theorisation of social practices illustrated how individuals/groups are enabled to choose strategies of actions in budgetary control as a product of specific dispositions and interests associated with the particular power position in a given field ( Battilana, 2006 ; Boedker, 2010 ; Carter et al. , 2011 ; Hutaibat, 2019 ; Khanchel and Kahla, 2013 ; Vaughan, 2008 ). Taking into account Bourdieu's practice insights, as the dispositions of general academics are informed by symbolic power, doxa and self-evident understanding in the particular setting, the subversion strategies are evident in the budget-setting phase ( Célérier and Botey, 2015 ; Emirbayer and Johnson, 2008 ; Emirbayer and Williams, 2005 ; Hutaibat, 2019 ; Semeen et al. , 2016 ).

As Hutaibat (2019) asserted different forms of capital create power structures of the specific field, such power diversity and power relations are evident amongst the agents of University Sigma. Further, being consistent with Carter et al. (2011) who suggested that power structures are capable of influencing the strategising, accounting and decision- making, it is evident that budgeting practices are shaped by key university agents (i.e. deans) and their experiences. Similarly, being situated in the subservient position in the university power configuration, finance/administrative officers tend to silently accept the budgetary rules in the policy-laden context by indicating successive strategies.

As with the findings of Lodhia and Jacobs (2013) , particularly finance/administrative officers are skilful agents with a strong sense of practical mastery in the art of operating the budgetary process. By negotiating the rules of budgetary practice, their actions typically emanate from the “immanent necessary” to sustain the enlisted coercive tendencies in support of achieving control in the budgetary process ( Lamaison and Bourdieu, 1986 ; Swartz, 2002 ). However, based on the sense of practice, with a vested interest in compliance with the existing order of control practice to ensure survival in the current position in the university hierarchy, there could be instances where agents may act by giving an appearance of obeying rules in the actual budgetary practice ( Lamaison and Bourdieu, 1986 ).

When probing the practices of internal agents, it is suggested that budgetary practice is often driven by financial/administrative agents who are situated at subservient positions in the university field. In conclusion, the case data on institutionally imposed budgeting practice suggested that the micro effects stemming from multiple agents who pursue competing interests, mutually opposed strategies and power relations are significant in understanding variability in budgetary practice in a public university setting ( Al-Htaybat and Von Alberti-Alhtaybat, 2018 ).

It is discerned through this study that differing positions in the power configuration, access to resources in the field and dispositions of individuals determine the nature and extent of effects that agents can produce on management control practices ( Battilana, 2006 ; Khanchel and Ben Kahla, 2013 ; Lodhia and Jacobs, 2013 ; Vaughan, 2008 ). In line with Vaughan's (2008) assertion, “social location was crucial to the outcome” (p. 76); the study suggested that an individual's position in the organisational power hierarchy is essential in understanding how their perceptions, appreciations and power relations are enabled to deploy specific practices and exert power in an organisational setting. Consistent with Emirbayer and Williams (2005) , the field analysis provides understanding on the mutually opposing interests and strategies of internal agents pursuing conservation, subversion and successive strategies in management control practice, depending on the degree of dominated or dominant poles recognised in the power configuration ( Emirbayer and Johnson, 2008 ; Vaughan, 2008 ).

The most compelling implication for practitioners arising from the study is the importance of understanding that management controls are not all they seem to be; rather, they could operate differently, in irrational, unconscious or non-strategic ways, in the actual practice of the budgetary process. It is vital to understand that management controls (i.e. budgeting) are commonly shaped by the micro-facets stemming from the individual/group level of the specific organisational setting. Thus, the study provides insights about the need to explore below the surface as management control practice is seldom as it appears to be.

As several agents interact in management control practices in diverse ways, agents are generally recognised according to the nature of their duties and professional capacity in the Sigma setting. The first category is identified as agents who are predominantly academics, who currently hold top administrative positions in the faculty or university level in the research setting. In order to denote the positions that carry these characteristics, we use the term “key university official”. The second category is identified as agents who purely hold middle- and top-level administrative and administration of finance positions, such as the university registrar and bursar. The third category is denoted as “academic member”, with a primary role dealing with teaching, learning and research.

Scientific renown refers to intellectual or scientific capital deriving from scholarly reputation and is not necessarily connected to position within the institution ( Bourdieu and Wacquant, 1992 , p. 76).

Obtaining and maintaining the top hierarchical position enables domination of other positions and holders of different capital.

In this phase, the budget preparation changes from a “needs” basis to an “availability” basis.

Abernethy , M.A. and Brownell , P. ( 1999 ), “ The role of budgets in organizations facing strategic change: an exploratory study ”, Accounting, Organizations and Society , Vol. 24 No. 3 , pp. 189 - 204 , doi: 10.1016/S0361-3682(98)00059-2 .

Ahrens , T. and Chapman , C.S. ( 2004 ), “ Accounting for flexibility and efficiency: a field study of management control systems in a restaurant chain ”, Contemporary Accounting Reshearch , Vol. 21 No. 2 , pp. 271 - 301 , doi: 10.1506/VJR6-RP75-7GUX-XH0X .

Ahrens , T. and Chapman , C.S. ( 2007 ), “ Management accounting as practice ”, Accounting, Organizations and Society , Vol. 32 No. 1 , pp. 1 - 27 , doi: 10.1016/j.aos.2006.09.013 .

Al-Htaybat , K. and Von Alberti-Alhtaybat , L. ( 2018 ), “ Integrated thinking leading to integrated reporting: case study insights from a global player ”, Accounting, Auditing & Accountability Journal , Vol. 31 No. 5 , pp. 1435 - 1460 , doi: 10.1108/AAAJ-08-2016-2680 .

Aleksandrov , E. , Bourmistrov , A. and Grossi , G. ( 2018 ), “ Participatory budgeting as a form of dialogic accounting in Russia: actors’ institutional work and reflexivity trap ”, Accounting, Auditing & Accountability Journal , Vol. 31 No. 4 , pp. 1098 - 1123 , doi: 10.1108/AAAJ-02-2016-2435 .

Battilana , J. ( 2006 ), “ Agency and institutions: The enabling role of individuals’ social position ”, Organization , Vol. 13 No. 5 , pp. 653 - 676 , doi: 10.1177/1350508406067008 .

Baxter , J. and Chua , W.F. ( 2008 ), “ Be (com) ing the chief financial officer of an organisation: Experimenting with Bourdieu's practice theory ”, Management Accounting Research , Vol. 19 No. 3 , pp. 212 - 230 , doi: 10.1016/j.mar.2008.06.001 .

Bjerregaard , T. and Klitmøller , A. ( 2016 ), “ Conflictual practice sharing in the MNC: a theory of practice approach ”, Organization Studies , Vol. 37 No. 9 , pp. 1271 - 1295 , doi: 10.1177/0170840616634126 .

Boedker , C. ( 2010 ), “ Ostensive versus performative approaches for theorising accounting- strategy research ”, Accounting, Auditing & Accountability Journal , Vol. 23 No. 5 , pp. 595 - 625 , doi: 10.1108/09513571011054909 .

Bourdieu , P. ( 1977 ), “ Outline of a theory of practice ”, translated by R. Nice , Cambridge .

Bourdieu , P. ( 1990 ), The Logic of Practice , Stanford University Press .

Bourdieu , P. ( 2005 ), The Social Structures of the Economy , Polity Press , Cambridge .

Bourdieu , P. ( 2013 ), Distinction: A Social Critique of the Judgement of Taste , Routledge , London .

Bourdieu , P. and Wacquant , L.J. ( 1992 ), An Invitation to Reflexive Sociology , University of Chicago Press .

Carter , C. , Clegg , S. and Kornberger , M. ( 2011 ), “ Re-framing strategy: power, politics and Accounting ”, Accounting, Auditing & Accountability Journal , Vol. 23 No. 5 , pp. 573 - 594 , doi: 10.1108/09513571011054891 .

Célérier , L. and Botey , L.E.C. ( 2015 ), “ Participatory budgeting at a community level in Porto Alegre: a Bourdieusian interpretation ”, Accounting, Auditing & Accountability Journal , Vol. 28 No. 5 , pp. 739 - 772 , doi: 10.1108/AAAJ-03-2013-1245 .

Chudzikowski , K. and Mayrhofer , W. ( 2011 ), “ In search of the blue flower? Grand social theories and career research: the case of Bourdieu’s theory of practice ”, Human Relations , Vol. 64 No. 1 , pp. 19 - 36 , doi: 10.1177/0018726710384291 .

Covaleski , M.A. and Dirsmith , M.W. ( 1983 ), “ Budgeting as a means for control and loose coupling ”, Accounting, Organizations and Society , Vol. 8 No. 4 , pp. 323 - 340 , doi: 10.1016/0361-3682(83)90047-8 .

Covaleski , M.A. and Dirsmith , M.W. ( 1986 ), “ The budgetary process of power and politics ”, Accounting, Organizations and Society , Vol. 11 No. 3 , pp. 193 - 214 , doi: 10.1016/0361-3682(86)90021–8 .

Covaleski , M.A. , Dirsmith , M.W. and Weiss , J.M. ( 2013 ), “ The social construction, challenge and transformation of a budgetary regime: the endogenization of welfare regulation by institutional entrepreneurs ”, Accounting, Organizations and Society , Vol. 38 No. 5 , pp. 333 - 364 , doi: 10.1016/j.aos.2013.08.002 .

Cunningham , L.A. ( 2004 ), “ The appeal and limits of internal controls to fight fraud, terrorism, other ills ”, Journal of Corporation Law , Vol. 29 No. 2 , p. 267 .

Emirbayer , M. and Johnson , V. ( 2008 ), “ Bourdieu and organizational analysis ”, Theory and Society , Vol. 37 No. 1 , pp. 1 - 44 .

Emirbayer , M. and Williams , E.M. ( 2005 ), “ Bourdieu and social work ”, Social Service Review , Vol. 79 No. 4 , pp. 689 - 724 , doi: 10.1086/491604 .

Ezzamel , M. , Robson , K. and Stapleton , P. ( 2012 ), “ The logics of budgeting: theorization and practice variation in the educational field ”, Accounting, Organizations and Society , Vol. 37 No. 5 , pp. 281 - 303 , doi: 10.1016/j.aos.2012.03.005 .

Farjaudon , A.L. and Morales , J. ( 2013 ), “ In search of consensus: the role of accounting in the definition and reproduction of dominant interests ”, Critical Perspectives on Accounting , Vol. 24 , pp. 154 - 171 , doi: 10.1016/j.cpa.2012.09.010 .

Feldman , M.S. and Orlikowski , W.J. ( 2011 ), “ Theorizing practice and practicing theory ”, Organization Science , Vol. 22 No. 5 , pp. 1240 - 1253 , doi: 10.1287/orsc.1100.0612 .

Goddard , A. ( 2004 ), “ Budgetary practices and accountability habitus: a grounded theory.Accounting ”, Auditing and Accountability Journal , Vol. 17 No. 4 , pp. 543 - 577 , doi: 10.1108/09513570410554551 .

Gomez , M.L. ( 2010 ), “ A Bourdieusian perspective on strategizing in Golsorkhi ”, D. , Leca , B. , Lounsbury , M. and Ramirez , C. (Eds), Cambridge Handbook of Strategy as Practice , Cambridge University Press , Cambridge , pp. 141 - 154 .

Grenfell , M. ( 2008 ), Pierre Bourdieu: Key Concepts , Acumen Stocksfield .

Harun , H. , Carter , D. , Mollik , A.T. and An , Y. ( 2020 ), “ Understanding the forces and critical features of a new reporting and budgeting system adoption by Indonesian government ”, Journal of Accounting and Organizational Change , Vol. 16 No. 1 , pp. 145 - 167 , doi: 10.1108/JAOC-10-2019-0105 .

Henttu-Aho , T. ( 2016 ), “ Enabling characteristics of new budgeting practice and the role of controller ”, Qualitative Research in Accounting and Management , Vol. 13 No. 1 , pp. 31 - 56 , doi: 10.1108/QRAM-09-2014-0058 .

Horngren , C.T. , Datar , S.M. and Rajan , M.V. ( 2014 ), Cost Accounting: A Managerial Emphasis , 14th ed . Pearson Higher Education , New Jersey, NJ .

Hurtado , P.S. ( 2010 ), “ Assessing the use of Bourdieu’s key concepts in the strategy-as-practice field ”, Competitiveness Review: An International Business Journal , Vol. 20 No. 1 , pp. 52 - 61 , doi: 10.1108/10595421011019975 .

Hutaibat , K. ( 2019 ), “ Accounting for strategic management, strategising and power structures in the Jordanian higher education sector , Journal of Accounting and Organizational Change , Vol. 15 No. 3 , pp. 430 - 452 , doi: 10.1108/JAOC-06-2018-0054 .

Inghilleri , M. ( 2005 ), “ The sociology of Bourdieu and the construction of the ‘object’ in translation and interpreting studies ”, The Translator , Vol. 11 No. 2 , pp. 125 - 145 , doi: 10.1080/13556509.2005.10799195 .

Jakobsen , M. and Pallesen , T. ( 2017 ), “ Performance budgeting in practice: the case of Danish hospital management ”, Public Organization Review , Vol. 17 No. 2 , pp. 255 - 273 , doi: 10.1007/s11115-015-0337-8 .

Jarzabkowski , P. , Balogun , J. and Seidl , D. ( 2007 ), “ Strategizing: the challenges of a practice perspective ”, Human Relations , Vol. 60 No. 1 , pp. 5 - 27 , doi: 10.1177/0018726707075703 .

Jayasinghe , K. and Wickramasinghe , D. ( 2011 ), “ Power over empowerment: encountering development accounting in a Sri Lankan fishing village ”, Critical Perspectives on Accounting , Vol. 22 No. 4 , pp. 396 - 414 , doi: 10.1016/j.cpa.2010.12.008 .

Khanchel , H. and Kahla , K.B. ( 2013 ), “ Mobilizing Bourdieu’s theory in organizational research ”, Review of General Management , Vol. 17 No. 1 , pp. 86 - 94 .

King , A. ( 2000 ), “ Thinking with Bourdieu against Bourdieu: a ‘practical’ critique of the habitus ”, Sociological Theory , Vol. 18 No. 3 , pp. 417 - 433 , doi: 10.1111/0735-2751.00109 .

King , A. ( 2005 ), “ The habitus process: a sociological conception ”, Journal for the Theory of Social Behaviour , Vol. 35 No. 4 , pp. 463 - 468 , doi: 10.1111/j.1468-5914.2005.00286.x .

Kloot , B. ( 2009 ), Exploring the value of Bourdieu’s framework in the context of institutional change , Studies in Higher Education , Vol. 34 No. 4 , pp. 469 - 481 , doi: 10.1080/03075070902772034 .

Lamaison , P. and Bourdieu , P. ( 1986 ), “ From rules to strategies: an interview with Pierre Bourdieu ”, Cultural Anthropology , pp. 110 - 120 . available at : https://www.jstor.org/stable/656327 .

Lambovska , M. , Rajnoha , R. and Dobrovič , J. ( 2019 ), “ From quality to quantity and vice versa:How to evaluate performance in the budgetary control process ”, Journal of Competitiveness , Vol. 11 No. 1 , pp. 52 - 69 , doi: 10.7441/joc.2019.01.04 .

Lau , R.W. ( 2004 ), “ Habitus and the practical logic of practice: an interpretation ”, Sociology , Vol. 38 No. 2 , pp. 369 - 387 , doi: 10.1177/0038038504040870 .

Lodhia , S. and Jacobs , K. ( 2013 ), “ The practice turn in environmental reporting: a study into current practices in two Australian commonwealth departments ”, Accounting, Auditing & Accountability Journal , Vol. 26 No. 4 , pp. 595 - 615 , doi: 10.1080/0969160X.2013.845033 .

Lounsbury , M. ( 2008 ), “ Institutional rationality and practice variation: new directions in the institutional analysis of practice ”, Accounting, Organizations and Society , Vol. 33 No. 4 , pp. 349 - 361 , doi: 10.1016/j.aos.2007.04.001 .

Lounsbury , M. and Ventresca , M. ( 2003 ), The New Structuralism in Organizational Theory. Organization , Vol. 10 No. 3 , pp. 457 - 480 , doi: 10.1177/13505084030103007 .

Maclean , M. , Harvey , C. and Chia , R. ( 2012 ), “ Reflexive practice and the making of elite business careers ”, Management Learning , Vol. 43 , pp. 385 - 404 , doi: 10.1177/1350507612449680 .

McDonough , P. ( 2006 ), “ Habitus and the practice of public service ”, Work, Employment & Society , Vol. 20 No. 4 , pp. 629 - 647 , doi: 10.1177/0950017006069805 .

Mkasiwa , T.A. ( 2019 ), “ Budgeting and monitoring functions of the Tanzanian Parliament ”, Journal of Accounting in Emerging Economies , Vol. 9 No. 3 , pp. 386 - 406 , doi: 10.1108/JAEE-11-2018-0120 .

Moll , J. and Hoque , Z. ( 2011 ), “ Budgeting for legitimacy: the case of an Australian university ”, Accounting, Organizations and Society , Vol. 36 No. 2 , pp. 86 - 101 .

Mutiganda , J.C. , Hassel , L.G. and Fagerström , A. ( 2013 ), “ Accounting for competition, ‘circuits of power’ and negotiated order between not-for-profit and public sector organisations ”, Financial Accountability and Management , Vol. 29 No. 4 , pp. 378 - 396 , doi: 10.1111/faam.12023 .

O'grady , W. ( 2019 ), “ Enabling control in a radically decentralized organization ”, Qualitative Research in Accounting and Management , Vol. 16 No. 2 , pp. 224 - 251 , doi: 10.1108/QRAM-07-2017-0065 .

Raedeke , A.H. , Green , J.J. , Hodge , S.S. and Valdivia , C. ( 2003 ), “ Farmers, the practice of farming and the future of agroforestry: an application of Bourdieu's concepts of Field and Habitus ”, Rural Sociology , Vol. 68 No. 1 , pp. 64 - 86 , doi: 10.1111/j.1549-0831.2003.tb00129.x .

Schatzki , T.R. ( 2006 ), “ On organizations as they happen ”, Organization Studies , Vol. 27 No. 12 , pp. 1863 - 1873 , doi: 10.1177/0170840606071942 .

Schneidhofer , T.M. , Latzke , M. and Mayrhofer , W. ( 2015 ), “ Careers as sites of power: a relational understanding of careers based on Bourdieu’s cornerstones ”, in Tatli , A. , Özbilgin , M. and Karatas-Özkan , M. (Eds), Pierre Bourdieu, Organization and Management , Routledge , New York , pp. 19 - 36 .

Semeen , H. , Islam , M.A. and Quayle , A. ( 2016 ), “ The accounting and accountability practices of fairtrade international (FLO) ”, Social and Environmental Accountability Journal , Vol. 36 No. 3 , pp. 170 - 187 , doi: 10.1080/0969160X.2016.1246376 .

Simons , R. ( 1994 ), “ How new top managers use control systems as levers of strategic renewal ”, Strategic Management Journal , Vol. 15 No. 3 , pp. 169 - 189 , doi: 10.1002/smj.4250150301 .

Sponem , S. and Lambert , C. ( 2016 ), “ Exploring differences in budget characteristics, roles and satisfaction: a configurational approach ”, Management Accounting Research , Vol. 30 , pp. 47 - 61 , doi: 10.1016/j.mar.2015.11.003 .

Swartz , D.L. ( 2002 ), “ The sociology of habit: the perspective of Pierre Bourdieu ”, Occupational Therapy Journal of Research , Vol. 22 , pp. 61S - 69S , doi: 10.1177/15394492020220S108 .

Vaughan , D. ( 2008 ), “ Bourdieu and organizations: the empirical challenge ”, Theory and Society , Vol. 37 No. 1 , pp. 65 - 81 , doi: 10.1007/s11186-007-9056-7 .

Wacquant , L. ( 1998 ). Pierre Bourdieu , Key Sociological Thinkers , pp. 215 - 229 .

Whittington , R. ( 1996 ), “ Strategy as practice ”, Long Range Planning , Vol. 29 No. 5 , pp. 731 - 735 .

Whittington , R. ( 2006 ), “ Completing the practice turn in strategy research ”, Organization Studies , Vol. 27 No. 5 , pp. 613 - 634 , doi: 10.1177/0170840606064101 .

Widener , S.K. ( 2007 ), “ An empirical analysis of the levers of control framework ”, Accounting, Organizations and Society , Vol. 32 No. 7 , pp. 757 - 788 , doi: 10.1016/j.aos.2007.01.001 .

Wouters , M. and Wilderom , C. ( 2008 ), “ Developing performance-measurement systems as enabling formalization:A longitudinal field study of a logistics department ”, Accounting, Organizations and Society , Vol. 33 No. 4 , pp. 488 - 516 , doi: 10.1016/j.aos.2007.05.002 .

Xu , Y. and Xu , X. ( 2008 ), “ Social actors, cultural capital, and the state: the standardization of bank accounting classification and terminology in early twentieth-century China ”, Accounting, Organizations and Society , Vol. 33 No. 1 , pp. 73 - 102 , doi: 10.1016/j.aos.2006.09.011 .

Further reading

Christiansen , J.K. and Skærbæk , P. ( 1997 ), “ Implementing budgetary control in the performing arts,: games in the organizational theatre ”, Management Accounting Research , Vol. 8 No. 4 , pp. 405 - 438 , doi: 10.1016/j.aos.2007.04.001 .

Geiger , D. ( 2009 ), “ Revisiting the concept of practice: toward an argumentative understanding of practicing ”, Management Learning , Vol. 40 No. 2 , pp. 129 - 144 , doi: 10.1177/1350507608101228 .

Corresponding author

Related articles, we’re listening — tell us what you think, something didn’t work….

Report bugs here

All feedback is valuable

Please share your general feedback

Join us on our journey

Platform update page.

Visit emeraldpublishing.com/platformupdate to discover the latest news and updates

Questions & More Information

Answers to the most commonly asked questions here

• Accounting and Corporate Management
• Vol 5, Issue 11, 2023

Research on Comprehensive Budget Performance Management in Universities under the Background of Smart Finance

DOI: 10.23977/acccm.2023.051101 | Downloads: 65 | Views: 472

Shunchao Hu 1,2

Affiliation(s)

1 Linyi University, Linyi, Shandong, 276000, China 2 Philippine Christian University Center for International Education, Manila, 1004, Philippines

Corresponding Author

The comprehensive implementation of budget performance management is an inherent requirement for promoting the modernization of the national governance system and governance capacity. It is an important measure to optimize the allocation of educational resources, improve the quality of educational public services, promote the acceleration of education modernization, and improve the management level of universities. At present, there are still significant limitations in the application of smart finance in universities, such as low fund settlement efficiency, insufficient integration of financial systems, insufficient financial data analysis and decision support, and insufficient internal financial control, which seriously affect the breadth and depth of smart finance application in universities. Based on this situation, universities need to use intelligent information technology to provide technical support and guarantee for the precise implementation of budget performance management systems. The school should restructure the intelligent financial reimbursement model, promote online reimbursement, strengthen the interconnection between financial systems, and improve the intelligent data analysis and decision-making platform. This can effectively improve the efficiency of financial governance and promote the intelligent and high-quality development of university finance.

CITE THIS PAPER

Shunchao Hu, Research on Comprehensive Budget Performance Management in Universities under the Background of Smart Finance. Accounting and Corporate Management (2023) Vol. 5: 1-6. DOI: http://dx.doi.org/10.23977/acccm.2023.051101.

[1] Min W, Peng Minjiao. Analysis of Opportunities and Challenges Faced by Comprehensive Budget Performance Management in the Age of Big Data [J]. Economic Review Journal, 2021, 25(16):12-18.  [2] Zecai W. Budget Performance Management: Towards the Comprehensive Performance Management in the New Era [J]. Chinese Public Administration, 2021, 39(7):49-56.  [3] Yongyun C. Research on Comprehensive Budget Management of Colleges and Universities [J]. Accounting and Finance, 2020, 41(22):19-43.  [4] Lijuan J, Department F. Application of Budget Management in Financial Management of Colleges and Universities [J]. Journal of Qilu Normal University, 2021, 28(11):19-27.  [5] Le, Oanh Thi Tu, Nguyen N T. Management Efficiency of Budgeting: Evidence from Public Universities in Vietnam [J]. International Journal of Accounting & Finance Review, 2020, 5(1):105-115.  [6] Zhihui Y, Yeling Xu, et al. Reflections on the Financial Budget Management of Colleges and Universities under the Background of "Double Tops" Construction [J]. Journal of Anhui University of Technology (Social Sciences), 2022, 33(16):25-38.  [7] Jingjing S. The Construction of Comprehensive Budget Management Information System in Colleges and Universities in the New Era [J]. Journal of Qujing Normal University, 2021, 19(4):9-18.  [8] Bingxin W, Finance D O. Research on Problems in Colleges' and Universities' Budget Management [J]. Journal of Jilin Institute of Chemical Technology, 2022, 36(12):15-20.  [9] Hongyi N. The Practice of Performance Budget Management and the Design of the Index System in Local Colleges and Universities [J]. The Science Education Article Collects, 2022, 16(5):41-49.  [10] Qingming N, Rongjing D, Finance D O. Design and Practice of Budget Management System in Colleges and Universities under the Background of Financial Informatization [J]. Journal of Wuxi Institute of Technology, 2021, 13(5):17-23.

Sponsors, Associates, and Links

• Open Access
• Author Guidelines
• Librarian Guidelines
• Propose a New Journal
• Call for Special Issue Proposals
• Join Reviewer Team
• Join Editorial Board
• Join Editor-in-chief Group
• Responsibilities
• Qualification & Requirement

PUBLICATION SERVICES

• Special Issues
• Proceedings
• Clausius Scientific Press Inc.
• CANADA Office
• CHINA Office
• United Kingdom Office
• HONGKONG Office

All published work is licensed under a Creative Commons Attribution 4.0 International License .

Concept of the Budget Management Research Paper

According to QFinance dictionary, budget management refers to “the comparison of actual financial results with the estimated expenditures and revenues for the given time period of a budget and the taking of corrective action” (Para 1).

It entails the process of formally identifying, approving and paying all costs or expenses incurred in a project or any other activity for which a budget is prepared (“The Project Budget”, Para.18). A budget on the other hand is “a quantitative statement, for a defined period of time, that may include planned revenues, expenses, assets, liabilities, and cash flows” (QFinance Dictionary). Budgets enable people to predict revenues and expenditures.

This enables people and various organizations to measure the actual expenditure their business against the predicted expenditure in the budget. The budget becomes the focus of an individual or organization during spending as it helps to organize and direct activities as well as allocating resources. For an individual or a group of people to manage well a budget, they must have an intimate knowledge of the business the budget is addressing.

Large deviations from the budget reflect either mismanagement of the budget or insufficient knowledge of the revenue and costs of equipment and services by the people involved in coming up with that budget. Without proper budget management, the managers may not achieve the purpose, goals and objectives of the budget. The process of budget management also refers to budget control. Budget management is important in enabling individuals, groups, organizations and governments to achieve their goals.

Budget management ranges from the use of simple methods to the use of complex methods. Personal budgets may require the use of simple methods in management like the use of pen and paper to simple spreadsheets while complex budgets in big organizations may require complex computer programs to effect budget management. They may also employ other techniques like auditing, taking financial reports, control of operations or management by exception.

In any of these cases, it is important to remember that a budget is a tool, which the management or individuals use to achieve their goals. They prepare budgets prior to the effective period and therefore “effective budget management requires thinking ahead, anticipating needs based on relatively predictable conditions” (Sennewald, pg 175). Budget management should be an organized activity and must, among other components, embrace planning and control of the all activities involved within the budget (Bryans, pg. 154).

All the plans should be realistic and the managers or individuals should document them well. All activities should also be under control to ensure that there are no wide variations from the budget. Recording and reporting are also important components of budget management because they provide important information and data necessary to calculate deviations from the budget.

There is a wide range of budget management strategies. It ranges from highly centralized budget management strategy to highly decentralized management strategy. In a highly centralized budget management strategy, the chief management officer is takes the responsibility of managing the budget and holds the budget managers responsible for carrying out expenditure as stipulated in the original budget.

The main aim of the manager in this case is to achieve the goals of the budget and is less strict on what comprises a good budget management (Ferren & Stanton, pg. 125).

The manager has to approve all expenditures and any adjustments that have to be made to the existing budget. In decentralized budget management, the managers closest to the activities have the power to make decisions on effecting expenses and making minor adjustments to the budget.

This promotes accountability, which in turn leads to increased performance. In all these management strategies, we should understand that a budget does not give people an authority to spend. All expenses and adjustments to the budget have to be justified.

This is why, especially in highly centralized budget management, the management has to make approvals for every expenditure and adjustment to the budget. Even in this case, “good budget management requires flexibility” (pg.126). Cooperation and responsible management is necessary at both unit level and in senior management level in order to achieve the desirable goals.

Budget management should work in such a way to reduce overspending which might lead to a serious deficit and create serious problems to a firm, government or an individual. If overspending persists, there will be no money to pay wages and other expenses and this may lead to liquidation of a firm. People expect a good managed budget to produce books that balance. This is likely to be the case if suitable managers delegated with responsibility and authority for spending work at the field.

However, if the management imposes many rules, it may impair the success of budget management both at departmental level and even at the top management level. Therefore, if managers need to achieve good budget management, they should record and scrutinize all the records from the local management and take a corrective action to the budget where applicable.

In order to achieve effectiveness in budget management systems, budget managers have to consider a number of issues. They first have to understand the size and scope of the budget. This is because size and scope of a budget will affect the performance of the budget and will dictate the level of management input needed to achieve success. Therefore, managers must employ management principles to achieve success in delegation while at the same time taking into consideration the sustainability of the budget.

The managers also need to get financial information in time in order for them to take remedial action at the required time. The reports should be able to provide managers with early warnings of foreseeable problems. The reports the managers receive must be transparent, accurate and verifiable and presented in a simple and understandable way with facts, figures and variations at each stage. They should have clear figures and variations should be clear at each stage.

Teamwork is necessary for the budget managers in order for them to reach a mutual agreement and a working financial plan. Accountability and authority for budget managers is important for financial management as part of the delegation process with the overall goal of improving performance.

Budget management has both advantages and disadvantages. A budget coordinates activities across all departments of an organization. It also helps managers to translate their strategic plans into action. Good budget management helps managers to keep records, which help them to organize well their activities.

It improves resource allocation due to the process of clarification and justification of all requests. Good budget management also improves communication between employers and employees as well as providing a means for corrective action through resource reallocation (Barnat, Para. 1).

It helps maximize profits of enterprises. To achieve this, the managers have to undertake proper control over all expenses and revenues. Budget management enables managers to put available resources into the best possible use. It is a good tool for measuring performance of the management. The top management in big organizations gives targets to their departments and expects them to control their budget to meet their specified goals.

The departments compare the budgeted targets with the actual results and determine deviations from the budget. They then communicate this to the top management of their performance at departmental level. The performance, derived from the deviations, help the management to determine the weaknesses and strengths in the implementation of the budget towards achieving the specified goals.

This helps the management to direct their efforts to the areas where performance is less and thus improving the general performance. It also helps the management to take corrective action whenever there is a deviation thus reducing the costs of operation. Without the corrective action, the management may run into loss and sometimes lead to decreased efficiency in their work.

Budget management on the other hand can create problems. This mainly occurs in the process of budget control. Problems are likely to occur when the management applies budgets mechanically and rigidly.

This can lead to decline of motivation of the employers in the case of organizations or governments and thus lead to more problems due to lack of proper participation of all employees. If the employees are not fully involved in the process of budget management, they may not sometimes understand the importance or reason of the budgeted expenditures and thus will not commit themselves to them (Barnat, Para. 2). There can be resource competition due to implementation and management of budgets.

A rigid budget management may reduce initiative and innovation making it difficult to obtain money for new ideas especially at lower levels of an enterprise. These aspects can make organizations or individuals fail to achieve their goals. Therefore, budget management should be as flexible as possible for it to achieve the set goals.

In the case of a project, the management or the project finance committee prepare a budget and submit it to the donor or source of funding of the project for approval. The project budget prepared reflects all the money allocated for specific purposes for a specified period (“The Project Budget”, Para.1). Budget management in this context ensures that those involved control all the costs of the project to ensure that they are within the approved budget and that the budget yields the expected outcome.

The project budget manager is involved in monitoring and controlling the operations of the budget and ensures that only relevant and important changes are included in the budget baseline. The budget managers in the field level must communicate any changes they see necessary to be made to the budget to the management who then authorize the corrective actions.

In project management, the finance department is responsible for budget management. The general management expects the finance department to “record, track and monitor the budget from a cost accounting perspective” (“The Project Budget”, Para.17) and prepare reports for the management and the donor agency. In projects, “budget management is the process by which costs or expenses incurred on the project are formally identified, approved and paid” (Para.18).

Like many other organizations, the project budget management may have various authorization levels. If the authority is centralized, the central management before any adjustment or payment must approve all budget reports. A good managed project budget ensures that the managers achieve the project goals within the required time and without many deviations from the stipulated expenses.

Budget management in health and social care ensures that the cost incurred achieves the maximum level of service delivery possible (Bryans, pg. 3). Managers work to reduce the amount of expenses they can use to achieve successful health and social care without reducing the quality of service offered. They also monitor the budgets to eliminate all sorts of losses of funds through carelessness, fraud, corruption, collusion and other professional malpractices.

To achieve this, the managers have to come up with an implementation plan for the budget and use tactical interventions to avert wastage of budget funds and resources. They prioritize the activities and organize their implementation in such a way as to eliminate all the additional expenses that may arise due to disorganized operations. Inflation and changes in the economic climate of a place can affect the functionality and applicability of a budget.

In this case, the management under approval of the funding authority makes necessary adjustments to the budget to make it operational. “The main purpose of budget management in health and social care is to provide an early indication of resource performance within the limits of time and money so that, if necessary, appropriate intervention is possible.” (pg. 31). Best managers who are known to maintain discipline in spending are preferred in the post of budget managers in health and social care.

The management then gives them full authority and responsibility of spending in order for them to run smoothly the budget management exercise. Budget management in this case has its benefits. It enables the institutions to work within the stipulated limits, makes it easy for the budget manager and the institution to coordinate their activities as well as helping the institution to make realistic, tactical, and strategic decisions. Reporting is also an important component of budget management in health and social care.

Another example is the academic budget management. In large institutions of learning like colleges and universities with a few to many campuses or branches, the budget management process is sometimes complex and requires complex computer programs to effect. The chief academic officer is responsible for all the expenditure in the academic institutions (Ferren & Stanton, pg. 107).

He or she gives the budget managers authority to effect expenditure and corrections to the budget after submitting reports to him or her. This requires honest budget managers who are true and committed to the aim and objectives of the learning institution.

The budget management strategies in institutions of learning vary greatly from highly centralized to highly decentralized systems. If the chief academic officer has vast knowledge about budgeting and budget management, it makes it easier for the budget managers to perform effectively their management activities, especially, in a highly centralized management system. The major aim of budget management in this area is to align the budget with the requirements and priorities of academic work.

Budget managers ensure that the funds are used for the specified functions. They also encourage spending for the budgeted functions and discourage laziness among the academic staff in executing their duties. The academic budget management employs the internal audit systems to indentify the effectiveness of the budget implementation and to check the weak points thus giving recommendations and room for corrective action for improved performance.

Another example is the management of a personal budget. Individuals make budgets to enable them live within the limits of their income. Mismanagement of these budgets can create serious deficits an issue that will increase loans and debts, further leading to bankruptcy. Management of personal budgets involve the comparison of the budgeted values relative to the actual expenditure and making necessary changes to enable one live within the budget constraint.

An individual can make adjustments by cutting costs on unnecessary expenditures or on those expenditures that are not urgent. Inflation and other economic factors can alter the actual prices of the commodities or services budgeted for and therefore individuals normally adjust their budgets from time to time to ensure that it represents the most current value of what they budget for.

Different people use various methods and tools of personal budget management. This, like any other type of budget, depends on the complexity of the budget. This ranges from the use of simple diary records to use of computer programs.

Most people prefer the use of Microsoft Excel spreadsheets to analyze their budgets and see where they need adjustments. The software enables an individual to identify easily the areas he or she is overspending in and thus gives room for adjustments. Like any other type of budget management, personal budget management also requires a lot of flexibility in order to achieve success.

In conclusion, budget management is an important component of financial management. It enables managers to compare the values in the budget to the values in the actual expenditure and allows them to make necessary adjustments to the budget. The level of management in a budget depends on the complexity of that budget. Complex budgets in complex organizations require more attention and a high level of budget management to achieve success.

It is important to note that the financial environment differs from time to time and therefore it is important to adjust the budget to be in agreement with the current financial standards. Budget managers need to be highly skilled in the issues of financial management in order for them to achieve efficiency in their work. In order for a budget to be effective in achieving its goals, its management requires a lot of flexibility.

Managers need to be skilled on the best methods of budget management in order for them to employ the relevant management tools to achieve departmental and organizational goals. A good budget manager is supposed to identify and eliminate all forms of mismanagement of budget firms through careless spending, corruption, collusion or other professional malpractices.

Taking good records and reporting is an important practice in any type of budget management. The success of a budget is when it achieves the intentions of the budgeters and in the period stipulated. This is likely to produce books that balance and is an indication of good budget management. Good budget management is also a good tool for organization and management of an institution, a firm or a country.

Works Cited

Barnat, Ryszard. Advantages and Disadvantages of Budget Control. N.d. Web.

Bryans, William. Practical Budget management and social care . Oxford. New York. Radcliffe Publishing. 2007. Print.

Ferren, S. Ann & Stanton W. Wilbur. Leadership through collaboration: the role of the chief academic officer . Westport, CT 06881. Praeger Publishers. 2004.

QFinance Dictionary. Budget management. Bloomsbury Information Ltd, 2009-10. N.d. Web.

Sennewald, A. Charles. Effective Security Management . Fourth Edition. Elsevier science (USA). Butterworth-Heinemann.2003. Print.

“The Project Budget”, Docstoc 2010 . N.d. Web.

• Chicago (A-D)
• Chicago (N-B)

IvyPanda. (2022, December 2). Concept of the Budget Management. https://ivypanda.com/essays/budget-management/

"Concept of the Budget Management." IvyPanda , 2 Dec. 2022, ivypanda.com/essays/budget-management/.

IvyPanda . (2022) 'Concept of the Budget Management'. 2 December.

IvyPanda . 2022. "Concept of the Budget Management." December 2, 2022. https://ivypanda.com/essays/budget-management/.

1. IvyPanda . "Concept of the Budget Management." December 2, 2022. https://ivypanda.com/essays/budget-management/.

Bibliography

IvyPanda . "Concept of the Budget Management." December 2, 2022. https://ivypanda.com/essays/budget-management/.

• Corrective Advertising and Its Effectiveness
• Corrective Action for Employees Who Are Late
• US Government Budget: Sources and Expenditures
• Florida Healthcare System: Policy Planning, Assessment, Evaluation, and Corrective Measures
• The European Union's Budget Expenditures
• Nightingale Community Hospital: Corrective Action Plan
• Oklahoma City's Capital Budget and Expenditure
• State Expenditure: Texas and Massachusetts Comparison
• Determinants of Local and State spending
• The California’s Budget Process
• Budgeting Preparation in Economics Sector
• Concepts of Budget and Cash Flow Analysis
• Obama's Speech on 2012 Budget Cuts
• Trade of Coffee and Gold
• A Peacock in The Land of Penguins

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• PMC10645357

Impact of financial literacy, mental budgeting and self control on financial wellbeing: Mediating impact of investment decision making

School of Accountancy, Henan Institute of Economics and Trade, Zhengzhou, Henan, China

Associated Data

All relevant data are within the paper and its Supporting Information files.

The topic of financial wellbeing is a current concern within the realm of personal and household finance. This study aims to examine the influence of cognitive factors, specifically financial literacy, mental budgeting, and self-control, on subjective financial wellbeing. While there exist multiple determinants of financial wellbeing, this research focuses on these particular cognitive factors. The present study aims to examine the mediating role of investment decision-making behavior in the association between cognitive factors and financial well-being. The study employed Partial Least Squares Structural Equation Modeling (PLS-SEM) to analyze the data collected from a sample of 449 Chinese university students, with the aim of assessing the empirical associations. The results indicate that financial literacy, mental budgeting, and self-control exert a favorable and noteworthy influence on an individual’s financial well-being. The results indicate that individuals with a greater degree of financial literacy are more prone to achieving superior financial well-being. Moreover, individuals who practice mental budgeting, a technique that entails mentally classifying and monitoring their expenditures, demonstrate elevated levels of financial well-being. Likewise, the exercise of self-regulation is identified as a pivotal element that impacts an individual’s financial wellbeing. The findings indicate that there is evidence to support the mediator, investment decision-making behavior. This mediator partially mediates the association between the independent variables, namely financial literacy, mental budgeting, and self-control, and financial well-being. The results suggest that individuals with elevated levels of financial literacy, proficient mental budgeting skills, and self-regulatory abilities are inclined towards demonstrating favorable investment decision-making conduct. Consequently, this contributes to their general financial welfare. In general, the study’s theoretical implications augment the current knowledge repository, while its practical implications provide feasible perspectives for policymakers, financial institutions, and individuals to foster financial wellness and enhance financial results.

1. Introduction

The world’s biggest public health issues are depression, anxiety, and stress. Mental health issues affect 84 million Europeans, or 17.3% of the population, according to the Global Health Data Exchange [ 1 ]. Depression and anxiety are the most common mental health problems in society. Public health concerns include anxiety and mood disorder increase [ 2 ]. In 2017, Fiksenbaum et al. [ 3 ] discovered that 4.4 percent of people worldwide have anxiety disorders, with 3.6 percent exhibiting symptoms. Poor mental health is caused by psychological stress, employment issues [ 4 ], and socioeconomic causes [ 5 ]. Financial hardship is rising, according to WHO data [ 6 ]. The UK survey [ 7 ] and PwC’s Employee Financial Wellness Survey [ 8 ] in the US reached similar conclusions. Employees reported financial stress higher than any other type of stress in the poll. The Chinese social structure has similar issues. HSBC found that 64% of Chinese are satisfied with their finances in 2019, up from 57% in 2016. The poll found that 36% of Chinese people worry about saving for retirement and 29% about paying unexpected costs [ 9 ]. Researching a person’s money management, spending, saving, and investing habits is called "financial well-being" [ 10 ]. Lack of financial wellbeing causes financial distress, which lowers physical and mental health and workplace productivity [ 11 – 14 ]. If they think their salary isn’t enough to meet their basic needs, people feel disadvantaged financially [ 15 ].

Several things affect and improve financial well-being. Financial literacy helps people make informed and responsible financial decisions, boosting financial stability and reducing financial worries [ 16 ]. Financial literacy gives people the information, skills, attitudes, and behaviors to manage their money and reach their goals [ 17 ]. It educates people about financial ideas, risks, and decisions [ 18 ]. Financial literacy encourages budgeting, saving, and investing, which improves financial health. They can handle complex financial decisions and avoid financial hazards better. Financial literacy helps people manage their income at difficult times like the COVID-19 epidemic [ 19 ]. Mental budgeting is also crucial to financial health. Individuals and households utilize cognitive operations to arrange and control their finances [ 20 ]. It entails budgeting for several expenditure categories and mentally dividing the monies [ 21 ]. Mental budgeting aids in spending tracking, goal setting, and financial decision-making [ 20 ]. Many research have shown the benefits of mental budgeting for financial health. According to Chun & Johnson [ 22 ], consumers with superior mental budgeting skills are more resistant to store promotions and price fluctuations. This implies that mental budgeting can help people avoid impulse purchases and stay to their budgets. Financial well-being also depends on self-control. Many research have examined the relationship between self-control and financial outcomes like financial assets and financial management behavior. Self-control is the ability to manage ideas, emotions, and actions to attain long-term goals and avoid temptation [ 23 ]. It requires the ability to think rationally, control impulses, and manage money [ 23 , 24 ]. Higher self-control has been linked to improved financial outcomes. Better self-control leads to increased financial assets [ 24 ]. They are also more likely to budget, save, and regulate spending [ 25 ]. Self-control improves financial planning and saving [ 26 ]. Greater self-control is a key predictor of financial security, as persons with it tend to save and avoid debt [ 27 ].

Investment decisions are vital to financial well-being. Several elements increase financial well-being through investing decision-making. Financial literacy matters. According to Kamakia et al. [ 28 ], financially literate people make better investment decisions and have higher financial stability and well-being. Financial literacy improves investment decisions by helping people understand and analyze information [ 29 ]. Investment decision-making mediates mental budgeting and financial well-being [ 22 ]. Financial decision-making is influenced by mental budgeting. Credit cards can mix expenditures across budgeted categories and increase temporal distance between purchases and payments, making it harder to remember how much was spent on each [ 22 ]. This may lead to overspending or bad budget management, affecting finances. Self-control affects financial well-being through investment decisions. Self-control is the ability to manage behavior and make decisions that support long-term goals [ 30 ]. Research shows that self-control improves financial decisions. Higher self-control leads to more wise investment decisions and improved financial wellbeing [ 31 ].

Amid the Great Recession and COVID-19 pandemic, individuals, families, legislators, financial service providers, and financial educators need more understanding about financial well-being and how to improve it. This study makes significant literary contributions. First, this study examines the complex interaction between financial literacy, mental budgeting, self-control, and investment decision making, adding to financial wellbeing research. Examination of these structures together provides a more complete knowledge of financial wellbeing variables. Second, study examines mental budgeting and self-control in financial decision making to connect psychological and economic aspects. This integrated approach adds depth to the research by acknowledging that cognitive and behavioral processes affect financial wellbeing as well as economic considerations. Third, investment decision making as a mediator between financial literacy, mental budgeting, self-control, and financial health is another theoretical contribution. This mediation model shows how various factors affect financial well-being. It explains how financial knowledge, mental budgeting, and self-control affect financial outcomes. Financial educators, counselors, and policymakers can apply the study’s conclusions. By recognizing investment decision making as a mediator, it suggests interventions and education to improve financial literacy, mental budgeting, self-control, and financial health. The study emphasizes the need to evaluate many financial wellbeing elements at once. It promotes a holistic approach that emphasizes the interdependence of financial literacy, cognitive processes (mental budgeting), behavioral attributes (self-control), and investment decisions in financial well-being.

Rest of the paper is distributed among four sections: literature and hypotheses, methodology, results and conclusions.

2. Literature and hypotheses

The body of research that is now available on the topic of financial well-being hints that the concept of financial well-being is a subjective evaluation of one’s present and future financial situation [ 32 – 35 ]. The relevance of objective economic measurements, such as a consumer’s income, savings, and investments, credit score, credit card debt, regular mortgage payment, and tax payments, was stressed in much early academic research in the financial wellbeing field [ 36 – 38 ]. The subjective evaluation of financial wellbeing, on the other hand, focuses on the consumer’s self-assessment of his or her disposition, attitude, belief, and behaviors linked to money management [ 32 , 35 ]. According to this subjective interpretation of financial wellbeing, two people with comparable salaries or debt loads may regard their own financial wellbeing very differently. Due to importance of subjective financial wellbeing for researchers studying consumer behavior, financial institutions (FIs), non-profit organizations, businesses, and decision-makers in the government, study choose to investigate subjective side of this contrast. The relationships described in the study, which examines the impact of financial literacy, mental budgeting, and self-control on financial wellbeing with the mediating role of investment decision making, can be supported by several theories from the fields of economics, psychology, and behavioral economics, this study uses cognitive dissonance theory. Cognitive Dissonance Theory suggests that individuals strive for consistency in their beliefs and behaviors [ 39 ]. Financial literacy, mental budgeting, and self-control can influence the alignment of an individual’s financial decisions with their overall financial goals and values, reducing cognitive dissonance and enhancing financial wellbeing.

2.1. Financial literacy

Financial literacy refers to the knowledge of basic financial concepts, the ability to apply financial knowledge and skills in managing financial resources effectively, and the ability to make informed financial decisions to achieve financial welfare over a lifetime [ 40 – 44 ]. It involves understanding of financial matters, the ability to make conscious choice of financial products and services, and techniques for making appropriate financial decisions. Financial literacy translates into prosperity and sustainable development and helps in ensuring the financial sustainability of individuals, families, enterprises, and national economies [ 45 ]. It also includes a capacity and confidence to handle personal funds appropriately, short-term decision making and solid long-term financial thinking [ 46 ]. Moreover, being familiar with finance-related issues and making rational financial decisions based on basic financial knowledge are also crucial components of financial literacy [ 45 , 47 ]. Subjective financial knowledge, which refers to individuals’ self-evaluation of their financial knowledge, has been found to be a stronger predictor of financial behavior and subjective financial wellbeing than objective financial knowledge [ 48 ]. This indicates that individuals who perceive themselves to have higher financial knowledge tend to have higher levels of financial satisfaction and overall financial wellbeing. However, Balasubramnian and Sargent [ 49 ] investigate gaps between objective financial literacy and self-reported (perceived) financial literacy and report that individuals with high objective financial literacy make better financial decisions. A study by Joo and Grable [ 50 ] sought to identify the variables that affect financial contentment. According to the survey’s findings, financial contentment is directly influenced by factors including education level, financial literacy, risk, financial capability, financial activity, and financial demands. The findings demonstrated that improving financial behaviors increases levels of financial happiness at high knowledge and skill levels. As a result, their research suggested that financial literacy affected financial well-being directly. Another study [ 51 ] looked at the connections between 3,121 clients of a financial consulting firm’s financial activity, financial well-being, and health. According to their findings, those who have a greater level of financial well-being are less stressed, more motivated to manage their money, have better family relationships, and are physically and mentally healthier. Due to their advanced age and high level of vulnerability, retirees place a high priority on their financial well-being. They might experience physical or mental health effects from certain financial stress. In a research measuring financial literacy [ 52 ], authors found that even those with the information and skills to use that knowledge may not always behave as expected or experience advances in financial well-being due to a variety of factors. Such effects might be caused by cognitive biases, issues with self-control, family, economic, and institutional factors. However, another research [ 53 ] discovered that students’ perceptions of their financial well-being were significantly influenced by their financial literacy. Higher financial literacy correlates with greater financial well-being, according to a study [ 16 ] on financial literacy, financial well-being, and financial concerns. As a result, financial literacy is required to achieve financial well-being.

2.2. Mental budgeting

Mental budgeting is the cognitive process that people use to organize, evaluate, and keep track of financial activities [ 54 ]. It is a financial management technique that involves categorizing and monitoring expenses and income on a mental level [ 20 ]. Mental budgeting has an essential role to play in improving financial well-being because it can positively influence personal financial management [ 21 ] and consumer budgeting behavior [ 22 ]. Studies have shown that mental accounting can aid in monitoring personal spending, consumption, and investments and improve financial self-efficacy and control [ 55 ]. It can help socially excluded individuals make better financial decisions [ 56 ]. Mental accounting also affects budgeting, investing, and spending decisions [ 57 ]. Thus, it plays a central role in improving financial health and helps individuals, communities, and governments in managing their finances [ 58 ]. Mental budgeting helps individuals manage their finances better, make informed financial decisions, reducing financial stress, and improving financial self-efficacy. According to [ 59 ], financial literacy empowers individuals with knowledge and skills to manage their money effectively. Studies have shown that mental budgeting motivates and positively affects personal financial management [ 20 ] and reduces unduly risky personal investment behavior by triggering mental budgeting thoughts [ 21 ]. The impact of financial wellbeing and mental health are interlinked, and financial stress is a significant source of stress for many individuals, leading to mental health challenges [ 22 ]. Mental budgeting has been identified as a key factor in promoting financial wellbeing and reducing the risk of financial stress impacting an individual’s mental health. Multiple studies have been conducted to explore the relationship between mental budgeting and financial wellbeing in recent years. A systematic review by [ 60 ] identified the importance of proactive prevention, such as financial education and literacy, in reducing the burden of mental depression caused by financial stress. Similarly, mental budgeting was highlighted as a significant factor in promoting positive financial management behaviors, reducing financial stress, and improving financial wellbeing [ 61 ].

2.3. Self-control

Self-control, often called self-regulation, is the ability to control one’s conduct and reduce impulsivity [ 62 ]. Research shows that self-control and financial knowledge improve financial well-being [ 63 ]. Self-control, financial understanding, and financial literacy affect financial behavior and decision-making [ 64 ]. Self-control is needed to manage finances and prioritize goals in personal financial planning programs. A study on self-control, money attitude, and personal financial planning indicated that self-control affects financial planning [ 65 ]. Other research have linked self-control to occupational stress [ 66 ], self-directed learning readiness [ 67 ], and self-disgust [ 68 ].

The financial conduct of all different kinds of economic actors can be influenced by one’s level of self-control. According to Thaler and Shefrin [ 69 ], the concept of self-control may be applied to the individual as if they were an organization. According to Baumeister [ 70 ], people have a tendency to get confused as a result of conflicts between their behaviors and feelings; yet, inner strength creates self-control. The research conducted by [ 71 ] utilized three aspects of self-control: planning, monitoring, and commitment. The researchers came to the conclusion that self-control has a significant correlation with household net wealth and financial hardship. Self-control is beneficial for making decisions, having a strong will, and achieving success in the future, whether that achievement be being wealthy or prominent. The inability to exercise self-control can result in illogical decision making, a lack of confidence, and disastrous behavioral outcomes. The ability of a person to exercise self-control in the present and make sound choices will determine their potential financial well-being in the future. People tend to put their goals off till later, and when they want to improve their performance, they will sometimes try to restrict their behavior by placing stringent restrictions and deadlines on themselves.

According to [ 72 ], people who have deadlines that are too stringent tend to have less self-control than those who have deadlines that are not stringent enough. The difficulty of exercising self-control may also be understood through Shefrin and Thaler’s [ 73 ] Behavioral Life-Cycle (BLC). According to the BLC theory, the majority of individuals are preoccupied with the challenges and rewards of the now rather than the advantages of the long term. People create mental accounts in order to employ the resources that are accessible to them by categorizing their wealth into three categories, such as their present income, their current assets, and their future income [ 74 ]. According to Moffitt et al. [ 75 ], individuals lack control over their income and as a result spend more money on their immediate need rather than putting away more money for retirement and other future needs. People who have higher self-control also have better financial conduct and are able to take excellent care of their financial resources. Self-control is a key factor in both of these areas. They invest their resources in the most effective way possible [ 76 ]. They do not waste money on activities or products that are not important to their lives. People who have mastered the art of self-control have been at the forefront of society for eons, and they continue to do so now. This is due to the fact that self-control is a prerequisite for making sage choices and enjoying improved material circumstances. Households who have established saving guidelines save significantly more money than households that lack self-control. According to Kahneman [ 77 ], people who have cognitive capacities always manage their money in a way that allows them to attain their objectives and pay for their predictable costs. Planners and doers are the two types of people that Thaler and Shefrin [ 69 ] have determined people to be based on how well they exercise self-control over their finances. To them, planners are concerned with the utility across a lifetime, whereas doers are self-centered, shortsighted, and only exist for a short period of time. To live a prosperous and healthy life, both financially and emotionally, one of the goals that one must achieve is to have good financial well-being. This can only be accomplished via exercising self-control. Most of the studies measured self-control using Brief Self-Control Scale [ 78 ] and Short-Term Future Orientation Scale [ 59 ].

2.4. Investment decision making

Investment decision-making behavior refers to the process of making decisions related to finances and investments by individuals, which are influenced by various factors such as financial knowledge, financial attitude, financial behavior, self-control, psychological biases, and external environment. Financial knowledge plays an important role in making informed financial decisions, while financial behavior refers to the habits and behavior of individuals when managing finances. Self-control enables individuals to make rational and informed decisions while managing their finances. Psychological biases such as herding, heuristics, and prospect also affect the financial decision-making behavior of individuals. In summary, financial decision-making behavior is a complex process influenced by various rational and psychological factors that impact an individual’s financial wellbeing [ 79 – 82 ].

Financial or investment decision making behavior is a crucial determinant of financial well-being. It has been established that this behavior has a positive influence on financial well-being [ 83 ]. Moreover, financial well-being is directly and indirectly related to financial behavior [ 83 ]. Financial behavior is the result of putting expectations and values into action, and it is the link between expectations and financial well-being. Hence, better financial behavior translates to better financial well-being.

Several studies have shown that financial literacy and self-control are significant determinants of financial behavior and financial well-being. Research has found that financial literacy has a significant direct impact on financial well-being, and it affects financial well-being through financial behavior [ 84 ]. Similarly, financial self-efficacy and financial literacy positively influence financial well-being through financial behavior mediation [ 63 ].

Furthermore, the research has shown a positive relationship between parental financial socialization and financial literacy, financial behavior, and financial well-being. Delafrooz and Paim [ 85 ] found that higher levels of financial literacy led to better financial behavior, which in turn resulted in higher financial well-being. Studies have also explored the relationships between financial behavior, financial knowledge, and financial well-being. For instance, research [ 86 , 87 ] showed that subjective knowledge had stronger relationships with both financial behavior and financial well-being than objective knowledge. Further, it was established that money attitudes and financial knowledge significantly influenced financial behavior. Money attitudes have also been found to have a positive influence on financial management behavior, which in turn impacts financial well-being.

In conclusion, financial decision making behavior has a significant impact on financial well-being. Financial literacy, self-control, parental financial socialization, financial knowledge, and money attitude have been shown to influence financial behavior and thus impact financial well-being. It is crucial, therefore, to educate individuals on the importance of financial behavior and its role in achieving financial security.

Based on previous discussion, following hypotheses are developed:

H1: financial literacy has a significant direct impact on financial wellbeing.

H2: Mental budgeting has a significant direct impact on financial wellbeing.

H3: Self-control has a significant direct impact on financial wellbeing.

H4: Investment decision making has a significant direct impact on financial well-being.

H5: Investment decision making has a significant mediating effect between mental budgeting and financial well-being.

H6: Investment decision making has a significant mediating effect between financial literacy and financial well-being.

H7: Investment decision making has a significant mediating effect between self-control and financial well-being.

The conceptual model represents the selections of the variables from the critical review of the literature, and we expect their relationship in shape of figure. Moreover, our conceptual model of the study is given in Fig 1 .

3. Methodology

Sample was chosen using the criteria based on number of items. Convenience sampling was used to collect the data. Data was collected from Chinese university students using both physical and electronic channels which resulted in a set of 449 useable observations. Respondents included 245 male (55%) and 204 female (45%) students. 270 (60%) of these respondents belonged to business major. Table 1 shows the distribution of collected data.

3.2. Measures

We employed two separate measures to capture the diverse aspects of one’s financial well-being: one, the extent to which one suffered from financial anxiety, and the other is the degree to which one felt financially secure. For the purpose of quantifying anxiety caused by financial concerns, four items from [ 88 ] were selected. When calculating the level of financial security, [ 14 ] takes into account three different factors. The respondent was asked to rate how strongly they agreed or disagreed on a scale from 1 (strongly disagree) to 5 (strongly agree).

Seven items for measuring financial literacy have been adopted from a study [ 89 ].

Four items were adopted from a past study of mental budgeting andmanagement of household finance [ 59 ].

Self-control is quantified through a general measure which is a smaller version of the Brief Self-Control Scale [ 78 ]. It consists of five items, and the four items from the Short-Term Future Orientation Scale [ 59 ].

Scale for financial management or investment decision making behavior is adopted [ 90 ] and contains four components: overall financial management or decision making behavior, savings and investment, cash management and credit management.

List of the items used for measurement is given in S1 File .

3.3. Ethical statement

The present investigation pertains to the participation of human subjects, and therefore, ethical clearance was obtained subsequent to its evaluation by the research council of Henan Institute of Economics and Trade, located in Zhengzhou, Henan, China. The study was conducted in accordance with the research ethics guidelines of Henan Institute of Economics and Trade. Participants were accurately informed what is being studied, the benefits and risks of the study. Participants were also aware of their right to withdraw from the study at any point, all respondent gave their verbal informed consent for inclusion before they participated in the study.

3.4. Analysis

Path analysis and regression are two areas in which Structural Equation Modeling (SEM) excels. SEM is particularly useful when dealing with several variables. The PLS-SEM approach is being utilized throughout this investigation so that Path analysis may be performed. The benefits of utilizing PLS-SEM include the fact that it is more flexible with the sample sizes and is also less vulnerable to the violations of the multivariate data assumptions, such as normality of data. These are only few of the advantages of utilizing PLS-SEM. [ 91 ].

4.1. Measurement model

Stage one in the estimation of the measurement model included indicator reliability measurement through factor (outer) loadings, internal reliability measurement through composite reliability, convergent validity measurement through average variance extracted. The table shows that all of the indicators have loadings of more than 0.50 (range: 0.637–1.000), which is the value recommended by Nunnally [ 92 ] and Hair et al. [ 93 ]. All of the constructs obtained composite reliability values (range: 0.714 to 0.845) greater than 0.70, which is the value recommended by [ 94 – 96 ]. Table 2 shows that the Cronbach’s alpha ranges from 0.743 to 0.821; the statistically acceptable minimum value is 0.70 [ 94 – 96 ]. AVE values should be greater than 0.50 [ 93 , 97 ]. Our results meet these criteria.

4.2. Structural model

The path coefficients were assessed in order to test the hypotheses and determine the association between the psychological characteristics of the young people and their financial conduct as well as their overall financial well-being. The value of a variable’s path coefficient indicates the extent to which that variable was directly influenced by another variable. A value that is closer to 1 indicates that there is a stronger correlation, while a value that is closer to 0 indicates that there is a weaker relationship. Values close to zero are not statistically significant. Path coefficients are listed in the Table 3 . Results indicate that all three independent variable (financial literacy, mental budgeting and self-control) are positively affect the dependent variable (financial-wellbeing).

4.3. Mediation

Baron and Kenny [ 98 ] argued for simultaneously considering direct and indirect effects to conclude mediation tests. We found that the direct effects of the independent variables (financial literacy and investment decision making behavior) on the dependent variable (financial well-being) were positive and statistically significant. Similar is the case for other two paths i.e. mental budgeting and investment decision making behavior and self-control and investment decision making behavior. The indirect effects in the presence of the mediator (investment decision making behavior) is also statistically significant. This concludes into partial mediation. The mediation results are summarized in Table 4 .

5. Conclusion

Based on this investigation, it is evident that financial literacy, mental budgeting, and self-control have a positive and significant impact on subjective financial well-being. The findings suggest that individuals who possess a higher level of financial literacy are more likely to experience better financial well-being. This implies that having a strong understanding of financial concepts, such as budgeting, saving, and investing, can contribute to improved financial outcomes. These findings are consistent to previous literature [ 45 – 49 ]. Furthermore, individuals who engage in mental budgeting, which involves mentally categorizing and tracking their expenses, exhibit higher levels of financial well-being. This practice enables them to have a better grasp of their financial situation and make informed decisions regarding their spending habits and financial goals. Previous literature support this finding [ 22 , 56 , 60 , 61 ]. Similarly, self-control emerges as a crucial factor influencing financial well-being. Individuals who exercise self-control, such as resisting impulsive purchases and sticking to their financial plans, are more likely to achieve better financial outcomes. This finding suggests that maintaining discipline and self-restraint in financial matters can significantly contribute to one’s financial well-being. This outcome is also in line with the existing empirical evidence [ 63 , 64 , 69 ]. Results reveal support for the mediator, investment decision-making behavior, which partially mediates the relationship between the independent variables (financial literacy, mental budgeting, and self-control) and financial well-being. The findings indicate that individuals who possess higher levels of financial literacy, engage in effective mental budgeting, and exercise self-control are more likely to exhibit positive investment decision-making behavior. This, in turn, contributes to their overall financial well-being. The partial mediation suggests that investment decision-making behavior accounts for a portion of the relationship between the independent variables and financial well-being, while other factors may also be involved. These results have important implications for understanding the pathways through which financial literacy, mental budgeting, and self-control influence financial well-being. The presence of mediation indicates that investment decision-making behavior plays a role in translating the effects of these independent variables into improved financial outcomes. It highlights the significance of making informed investment decisions and aligning them with one’s financial goals [ 79 – 82 ]. Overall, the results of this investigation underscore the importance of financial literacy, mental budgeting, and self-control in shaping an individual’s financial well-being. To enhance financial well-being, individuals should strive to improve their financial knowledge, develop effective mental budgeting strategies, and cultivate self-control in their financial decision-making processes.

This study has several theoretical and practical implications.

5.1. Theoretical implications

Enriching the understanding of financial well-being: This study contributes to the existing body of knowledge by providing empirical evidence on the impact of financial literacy, mental budgeting, and self-control on financial well-being. It enhances our theoretical understanding of the factors that influence individuals’ financial well-being and highlights the importance of these variables in achieving positive financial outcomes.

Supporting the importance of financial education: The findings underscore the significance of financial literacy in promoting financial well-being. This emphasizes the need for educational institutions, policymakers, and financial institutions to prioritize and promote financial education programs. It highlights the potential benefits of equipping individuals with the necessary knowledge and skills to make informed financial decisions and improve their financial well-being.

Emphasizing the role of behavioral factors: This study highlights the role of behavioral factors, such as mental budgeting and self-control, in shaping financial well-being. It supports the growing body of research that recognizes the impact of psychological and behavioral aspects on financial outcomes. These findings can contribute to the development of theories and frameworks that integrate behavioral economics and finance, providing a more comprehensive understanding of individuals’ financial well-being.

5.2. Practical implications

Policy interventions and financial education programs: Policymakers can utilize these findings to design and implement effective financial education initiatives that focus on improving financial literacy, promoting mental budgeting practices, and enhancing self-control. These programs can be targeted towards various age groups and socio-economic backgrounds to ensure wider accessibility and inclusivity.

Financial counseling and guidance: Financial institutions and professionals can leverage the insights from this study to provide personalized financial counseling and guidance to their clients. By addressing specific areas of financial literacy, mental budgeting, and self-control, individuals can receive tailored support to enhance their financial well-being and achieve their financial goals.

Development of digital tools and resources: Technology can play a crucial role in improving financial well-being. Based on the findings of this study, the development of digital tools, mobile applications, and online platforms can be tailored to provide financial education, facilitate mental budgeting, and encourage self-control. These resources can provide real-time feedback, personalized recommendations, and practical tips to help individuals manage their finances effectively.

Overall, the theoretical implications of this study contribute to the existing knowledge base, while the practical implications offer actionable insights for policymakers, financial institutions, and individuals to promote financial well-being and improve financial outcomes.

5.3. Limitations

The study’s findings may be limited by the characteristics of the sample used. The investigation has focused on a specific demographic and geographic sample (i.e. students), which could limit the generalizability of the results to a broader population. Future research could consider using larger and more diverse samples to enhance the external validity of the findings. The study employed a cross-sectional design, which captures data at a specific point in time. This design limitation prevents establishing causal relationships between the variables investigated. To address this limitation, future research could employ longitudinal or experimental designs to assess the causal effects of financial literacy, mental budgeting, self-control, and investment decision-making behavior on financial well-being. The study relied on self-reported measures, which may introduce response biases and social desirability effects. Participants might have provided answers that they believed were expected or socially acceptable rather than reflecting their true behaviors or beliefs. Future studies could consider incorporating objective measures or alternative data sources to enhance the validity of the findings.

5.4. Further research directions

Investigating additional mediating and moderating variables could provide a more comprehensive understanding of the relationships between financial literacy, mental budgeting, self-control, investment decision-making behavior, and financial well-being. Factors such as risk tolerance, financial attitudes, social influences, and psychological factors could be explored to uncover their potential impact on the relationships of interest. Future research could explore the long-term effects of financial literacy, mental budgeting, and self-control on financial well-being. Assessing the sustainability and durability of these effects over time could shed light on the long-term benefits of cultivating these skills and behaviors. Investigating the effectiveness of interventions aimed at improving financial literacy, mental budgeting, and self-control could provide valuable insights. Assessing the impact of educational programs, financial counseling, and interventions on individuals’ financial well-being and investment decision-making behavior would help identify the most effective strategies for promoting positive financial outcomes. Exploring the role of cultural and contextual factors in the relationships of interest could offer valuable insights. Different cultures and socio-economic contexts may influence the impact of financial literacy, mental budgeting, self-control, and investment decision-making behavior on financial well-being. Examining these factors would allow for a more nuanced understanding of how these relationships manifest across diverse populations. Addressing these limitations and pursuing these research directions can further advance the knowledge and understanding of the impact of financial literacy, mental budgeting, self-control, investment decision-making behavior, and their interrelationships on financial well-being.

Supporting information

Acknowledgments.

This paper is a general project of 2021 Henan Higher Education Teaching Reform Research and Practice Project (Research and Practice of "Integration of Competition and Teaching" in Accounting major under the background of National Vocational College Skills Competition 2021SJGLX826)

Funding Statement

The author(s) received no specific funding for this work.

Data Availability

• PLoS One. 2023; 18(11): e0294466.

Decision Letter 0

17 Jul 2023

PONE-D-23-18334Impact of Financial Literacy, Mental Budgeting and Self Control on Financial Wellbeing: Mediating Impact of Investment Decision MakingPLOS ONE

Dear Dr. Ruofan Bai,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

The paper investigate the Impact of Financial Literacy, Mental Budgeting and Self Control on Financial Wellbeing: Mediating Impact of Investment Decision Making". Its findings are interesting but requires major revisions before it can be considered. My comments are as follows:

• You need state clearly the contributions of the paper. For example, "Consequently, the current paper seeks to make the following contributions to the existing literature. First,…, Second,…., Third, …, Fourth,… and so on". The description of the contribution needs to be more forensic, needs to be more focussed.
• The authors should discuss the relevant theories in detail and relate their findings to of financial literacy, mental budgeting, and self-control on Financial Wellbeing.
• Highlight their economic and research and policy implications. In the discussion of the results please focus on the novel findings and insights vis-à-vis the existing literature
• Theoretical framework may increase its implication, Read the below related paper for methodology.

R. M. Ammar Zahid.,Rafique., S. Khurshid., M. Khan., W. Ikram Ullah (2023). Does women’s Financial Literacy accelerate Financial Inclusion? Evidence from Pakistan. Journal of the Knowledge Economy , DOI: https://doi.org/10.1007/s13132-023-01272-2

I recommend Major REVISIONS for publication after the author/s addressing the above queries and suggestions.

Please submit your revised manuscript by Aug 31 2023 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at  gro.solp@enosolp . When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

• A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols . Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols .

We look forward to receiving your revised manuscript.

Kind regards,

Academic Editor

Journal Requirements:

When submitting your revision, we need you to address these additional requirements.

1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at 

https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and 

https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf

2. Please provide additional details regarding participant consent. In the ethics statement in the Methods and online submission information, please ensure that you have specified (1) whether consent was informed and (2) what type you obtained (for instance, written or verbal, and if verbal, how it was documented and witnessed). If your study included minors, state whether you obtained consent from parents or guardians. If the need for consent was waived by the ethics committee, please include this information.

If you are reporting a retrospective study of medical records or archived samples, please ensure that you have discussed whether all data were fully anonymized before you accessed them and/or whether the IRB or ethics committee waived the requirement for informed consent. If patients provided informed written consent to have data from their medical records used in research, please include this information.

3. We note that you have stated that you will provide repository information for your data at acceptance. Should your manuscript be accepted for publication, we will hold it until you provide the relevant accession numbers or DOIs necessary to access your data. If you wish to make changes to your Data Availability statement, please describe these changes in your cover letter and we will update your Data Availability statement to reflect the information you provide.

4. PLOS requires an ORCID iD for the corresponding author in Editorial Manager on papers submitted after December 6th, 2016. Please ensure that you have an ORCID iD and that it is validated in Editorial Manager. To do this, go to ‘Update my Information’ (in the upper left-hand corner of the main menu), and click on the Fetch/Validate link next to the ORCID field. This will take you to the ORCID site and allow you to create a new iD or authenticate a pre-existing iD in Editorial Manager. Please see the following video for instructions on linking an ORCID iD to your Editorial Manager account: https://www.youtube.com/watch?v=_xcclfuvtxQ

5. Please amend either the abstract on the online submission form (via Edit Submission) or the abstract in the manuscript so that they are identical.

6. Please include captions for your Supporting Information files at the end of your manuscript, and update any in-text citations to match accordingly. Please see our Supporting Information guidelines for more information: http://journals.plos.org/plosone/s/supporting-information. 

[Note: HTML markup is below. Please do not edit.]

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: No

Reviewer #2: Yes

Reviewer #3: Partly

2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: No

Reviewer #3: Yes

3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Overall: I think this is a major world problem and a significant research topic. I would like to see more than perception self-report measures to make the claims in this paper. Improving actual financial literacy vs. perceived financial literacy (self-report impressions that you have here) may lead to different recommendations. You lack important covariates. You may be able to rework this to be about perceptions influencing other perceptions and that might work. After all, you make the point that perceived FWB is more about the individual’s interpretation, not actual financial status. You have a specific population (students) that may not have had extensive experience with financial decisions. That is a limitation (at least acknowledge it).

Introduction

You may be over playing the contribution to mental health. It is enough to indicate that financial stress is an important stressor. This can be shortened, perhaps substantially. You do not build up to your research questions (such that they are a logical next step in addressing financial well-being). For instance, you never mention mental budgeting or investment decisions prior to line 161 where they appear as a surprise. You have explained the problem but then you need to show how your work will address it. That link needs strengthening. You mention that many studies do not include a full array of variables, which is true, then you drop that aspect and have RQs that are lean (single variable), the very thing you criticize. You then have a paragraph about the importance of increasing FWB with factors not in your RQs (like retirement planning). Create a more concise organization: describe the problem (which is done extensively), how you address the problem (missing, RQs are not really doing the job here), the major findings and the implications given the findings. The specific RQs usually come after hypothesis.

Literature and Hypothesis

Just listing your variables and the literature for that variable is good but needs some introduction prior to jumping into them. Why start with FL? Is this for perceived and actual (measured) FL or just actual FL? In many models they have similar correlations on financial behaviors but mean slightly different things. Not sure what you mean here: “Managing finances for personal needs aligns with

financial literacy from a practical perspective.” (Line 193). Your comment: Financial literacy and financial well-being have been the subjects of separate research up until this point is unclear.” (Line 198) Most of the literature on FL is impact on financial habits or financial outcomes, which you argue leads to FWB. Then you start discussing FWB, leaving FL. This seems like the place to put your RQ about FL.

In the second paragraph about mental budgeting you pivot to FL, (Line 230) and then back to mental budgeting. In line 235 you say mental budgeting has the “most” influence on financial behavior – more than any other variable – with one citation given. I do not agree as I look at Xiao & O’Neill (2018). The beta for that variable is much smaller than several other significant variables in the OLS on financial well-being. Further, other studies have found it to be significant but not with a higher effect size over other variables such as education and income. The discussion on self-control does not mention how it was measured in these studies that found it correlated with positive financial outcomes. Is self-control nudgeable (vs. FL)?

Line 324: FL and self-control are significant in financial behavior and well-being. Seems to be leaving off some major variables (e.g., education, income, demographics). The discussion needs tighter organization. You then pivot to financial education and subjective FL in the mental budgeting section. Then parental education comes in (before individual’s education?) and money attitudes.

I might introduce the full family of variables that link to financial behaviors and FWB and then one at a time discuss them, including how they are measured in the literature, leading to each RQ.

Method and Findings

Please put the results on Fig 1.

Wonder if students are typical of the national studies done in the literature? Most have not even started their careers or thought about emergency savings. I wonder about the ability to generalize from this.

Actual FL has been measured by the same 5 questions for decades and include, for example, the ability to figure compounding interest at 2% for one year. See Lusardi’s line of research. I believe you have measure “perceived financial literacy,” not actual FL. Perceived is the person’s belief about financial competency. This differs from actual competency. For instance, for a discussion of the difference of these two, see:

Balasubramnian, Bhanu, and Carol Springer Sargent. “Impact of Inflated Perceptions of Financial Literacy on Financial Decision Making.” Journal of Economic Psychology, vol. 80, 2020. https://doi.org/10.1016/j.joep.2020.102306 .

You have failed to control for very important demographic information, especially education and income. Further, your FL variable, normally measured by an actual “test” of financial comprehension, is a FL perception self-report. Highly educated individuals may have better self-control and so you cannot tell which is giving you the result without controlling for these important covariates. You rightly criticize the literature for not including all the variables and then you do it too.

You may have a finding here but not the one you discuss. You have found that one’s view about financial competence correlates with financial behaviors and financial well-being. And how do we know the direction? Maybe strong financial behaviors (paying things on line for instance) makes the individual feel more able (PFL) and in control (self-control). Could it be the perceptions follow from good habits and perceptions lead to FWB? You mention that two different individuals with the same financial circumstances can have different SWB perceptions. This would be a different paper but may be possible with this dataset.

Going forward, consider a more diverse sample, measuring AFL, and including covariates.

Small items to address:

• I would not characterize the cognitive aspects as a “personality” type. (line 155)

• Line 161: Remove “to”

Reviewer #2: Dear Authors

Why financial literacy and financial knowledge are not operationalized as multi-dimensional constructs.

Financial literacy is measured by both subjective and objective approaches. Why authors adopted subjective approach only.

Why Baron and Kenny's approach of mediation was adopted. Baron and Kenny's approach is outdated an primitive approach of mediation.

Reviewer #3: The paper entitled” Impact of Financial Literacy, Mental Budgeting and Self Control on Financial Wellbeing: Mediating Impact of Investment Decision Making” deals with a very interesting topic and it included interesting ideas. In general, I appreciate the aims of this work; it is quite interesting and informative to most readers of this field.

However, I have the following comments that hopefully help the authors improve their paper:

• The introduction section is too long. The reader is lost with the overwhelming amount of background information that relates to the topic but is not necessarily relevant for your research. It may be wise to remove some paragraphs if they are not strongly related to the main issue.

• The structure (outline) of the paper could be given at the end of the introductory chapter.

• I suggest that the authors add a research method diagram. This will provide a snapshot of the research steps followed and will help the reader in a clearer understanding of the paper.

• In relation to literature review, I would strongly encourage authors to provide a summary table of comprehensive literature review that will not only identify the gaps in the literature but also strengthen the contribution of this work.

• What are the limitations of the study in terms of the proposed method, data used, approaches, and/or analysis?

• How the results of this study can be generalized to other regions?

• The authors should convince the readers, that their contribution is so important. These issues deserve a deeper discussion: What are the managerial implications from this research? How does this understanding help people to make better decisions? How decision or policy makers could benefit from this study.

• As usual a final thorough proof-reading is recommended.

I wish the author(s) all the best for their research and that these comments will be useful to them in improving the paper.

6. PLOS authors have the option to publish the peer review history of their article ( what does this mean? ). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy .

Reviewer #2:  Yes:  Suhail Ahmad Bhat

Reviewer #3: No

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool,  https://pacev2.apexcovantage.com/ . PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at  gro.solp@serugif . Please note that Supporting Information files do not need this step.

Submitted filename: PLOS ONE-D-23-18334_review SARGENT Financial Literacy Self Control.pdf.pdf

Author response to Decision Letter 0

18 Sep 2023

RESPONSE TO EDITOR

Contributions are rewritten clearly.

Relevant theory is added.

Implications of the findings are added.

RESPONSE TO REVIEWER 1

Concerns about objectives and subjective financial wellbeing are addressed and it is mentioned that author is interested in the later.

Introduction is shortened.

After discussing the problem, solution (i.e. role of selected factors) is also discussed.

Comments which were not matched as indicated by the reviewer are either removed or adjusted.

Education, income and demographics are ignored because of the sample, as respondents do not have very diverse characteristics.

RESPONSE TO REVIEWER 2

Item 1: Why financial literacy and financial knowledge are not operationalized as multi-dimensional constructs?

Operationalizing "financial literacy" as a uni-dimensional construct can have some advantages. Here are some reasons why author choose to operationalize financial literacy as a uni-dimensional construct:

Simplicity: A uni-dimensional approach simplifies measurement and analysis. It reduces the complexity associated with measuring multiple dimensions of financial literacy, making it easier to administer surveys, collect data, and analyze results.

Ease of Communication: Communicating and interpreting the results of a uni-dimensional financial literacy measure is straightforward. It allows for clearer communication of findings to policymakers, educators, and the general public.

Comparison: Uni-dimensional measures make it easier to compare individuals or groups based on a single scale, facilitating straightforward comparisons between different demographics, regions, or time periods.

Policy Implications: A uni-dimensional measure can be more effective for guiding policy decisions, as it provides a clear overall picture of financial literacy levels within a population. Policymakers may find it easier to target interventions when working with a single metric.

Apart from these reasons, the items chosen to measure financial literacy are broad and fulfill the researcher’s objective.

Item 2: Financial literacy is measured by both subjective and objective approaches. Why authors adopted subjective approach only?

Here's why author choose subjective approach:

Self-assessment and self-awareness: Subjective measures allow individuals to assess their own financial knowledge, skills, and confidence in managing their finances. This self-awareness can be valuable because it helps individuals recognize their own areas of weakness and take steps to improve their financial literacy. It can also serve as a motivation for individuals to seek out financial education and make positive changes in their financial behaviors.

Practicality and cost-effectiveness: Subjective measures are often easier and more cost-effective to implement than objective measures, which may require standardized tests or evaluations by financial experts. Subjective assessments can be administered through surveys or questionnaires, making them accessible to a wider range of people and organizations, including schools, employers, and financial institutions.

Cultural and contextual sensitivity: Financial literacy is not a one-size-fits-all concept. It can vary based on cultural, socioeconomic, and personal factors. Subjective assessments can capture the nuances of an individual's financial knowledge and attitudes, allowing for a more context-specific understanding of their financial literacy.

Focus on behavior and decision-making: Subjective measures often include questions about financial attitudes, behaviors, and decision-making, which are critical components of financial literacy. Understanding how individuals perceive and approach financial choices can provide valuable insights for designing targeted financial education programs and interventions.

Item 3: Why Baron and Kenny's approach of mediation was adopted?

Baron and Kenny's approach to mediation analysis is a widely used and influential method in the field of psychology and social sciences for investigating the mechanisms by which an independent variable affects a dependent variable through an intermediate variable (i.e., the mediator).

Clarity and Transparency: Baron and Kenny's approach provides a clear and step-by-step framework for conducting mediation analysis. It helps researchers systematically test the hypothesized mediation model, making the process more transparent and accessible.

Causal Inference: The approach emphasizes the establishment of causality in mediation relationships. It requires researchers to demonstrate that three conditions are met: (a) the independent variable significantly predicts the mediator, (b) the mediator significantly predicts the dependent variable while controlling for the independent variable, and (c) the direct effect of the independent variable on the dependent variable is reduced or becomes non-significant when the mediator is included in the model. This helps researchers make stronger claims about causality.

Practicality: Baron and Kenny's approach is relatively straightforward to implement. It does not require advanced statistical techniques or specialized software, making it accessible to a wide range of researchers.

Interpretability: The approach provides coefficients that are easily interpretable. Researchers can directly assess the size and significance of the indirect (mediation) effect, which is often of primary interest in mediation analysis.

In summary, Baron and Kenny's approach to mediation analysis is preferred for its simplicity, clarity, and emphasis on causality.

RESPONSE TO REVIEWER 3

The structure of the paper is given.

Limitations are identified.

Implications are discussed.

Submitted filename: Response to Reviewers.docx

Decision Letter 1

Impact of Financial Literacy, Mental Budgeting and Self Control on Financial Wellbeing: Mediating Impact of Investment Decision Making

PONE-D-23-18334R1

Dear Dr. Bai,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/ , click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at gro.solp@gnillibrohtua .

If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact gro.solp@sserpeno .

Additional Editor Comments (optional):

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #2: All comments have been addressed

Reviewer #3: (No Response)

2. Is the manuscript technically sound, and do the data support the conclusions?

3. Has the statistical analysis been performed appropriately and rigorously?

4. Have the authors made all data underlying the findings in their manuscript fully available?

5. Is the manuscript presented in an intelligible fashion and written in standard English?

6. Review Comments to the Author

Reviewer #2: All the issues raised have been addressed by the author/s. the paper is now in a position to be published in the journal

Reviewer #3: The paper has significantly improved as compared to the previous version. Indeed, the authors tried to improve it, and the main the weaknesses are solved.

Thus, in my opinion, the paper is on the borderline recommendable for publication.

7. PLOS authors have the option to publish the peer review history of their article ( what does this mean? ). If published, this will include your full peer review and any attached files.

Acceptance letter

Dear Dr. Bai:

I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department.

If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact gro.solp@sserpeno .

If we can help with anything else, please email us at gro.solp@enosolp .

Thank you for submitting your work to PLOS ONE and supporting open access.

PLOS ONE Editorial Office Staff

on behalf of

Dr. Wajid Khan

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

• View all journals
• My Account Login
• Explore content
• About the journal
• Publish with us
• Sign up for alerts
• Open access
• Published: 08 April 2024

A case study on the relationship between risk assessment of scientific research projects and related factors under the Naive Bayesian algorithm

• Xuying Dong 1 &
• Wanlin Qiu 1  

Scientific Reports volume  14 , Article number:  8244 ( 2024 ) Cite this article

39 Accesses

Metrics details

• Computer science
• Mathematics and computing

This paper delves into the nuanced dynamics influencing the outcomes of risk assessment (RA) in scientific research projects (SRPs), employing the Naive Bayes algorithm. The methodology involves the selection of diverse SRPs cases, gathering data encompassing project scale, budget investment, team experience, and other pertinent factors. The paper advances the application of the Naive Bayes algorithm by introducing enhancements, specifically integrating the Tree-augmented Naive Bayes (TANB) model. This augmentation serves to estimate risk probabilities for different research projects, shedding light on the intricate interplay and contributions of various factors to the RA process. The findings underscore the efficacy of the TANB algorithm, demonstrating commendable accuracy (average accuracy 89.2%) in RA for SRPs. Notably, budget investment (regression coefficient: 0.68, P < 0.05) and team experience (regression coefficient: 0.51, P < 0.05) emerge as significant determinants obviously influencing RA outcomes. Conversely, the impact of project size (regression coefficient: 0.31, P < 0.05) is relatively modest. This paper furnishes a concrete reference framework for project managers, facilitating informed decision-making in SRPs. By comprehensively analyzing the influence of various factors on RA, the paper not only contributes empirical insights to project decision-making but also elucidates the intricate relationships between different factors. The research advocates for heightened attention to budget investment and team experience when formulating risk management strategies. This strategic focus is posited to enhance the precision of RAs and the scientific foundation of decision-making processes.

Similar content being viewed by others

Prediction of SMEs’ R&D performances by machine learning for project selection

Hyoung Sun Yoo, Ye Lim Jung & Seung-Pyo Jun

Machine learning in project analytics: a data-driven framework and case study

Shahadat Uddin, Stephen Ong & Haohui Lu

Bayesian Analysis Reporting Guidelines

John K. Kruschke

Introduction

Scientific research projects (SRPs) stand as pivotal drivers of technological advancement and societal progress in the contemporary landscape 1 , 2 , 3 . The dynamism of SRP success hinges on a multitude of internal and external factors 4 . Central to effective project management, Risk assessment (RA) in SRPs plays a critical role in identifying and quantifying potential risks. This process not only aids project managers in formulating strategic decision-making approaches but also enhances the overall success rate and benefits of projects. In a recent contribution, Salahuddin 5 provides essential numerical techniques indispensable for conducting RAs in SRPs. Building on this foundation, Awais and Salahuddin 6 delve into the assessment of risk factors within SRPs, notably introducing the consideration of activation energy through an exploration of the radioactive magnetohydrodynamic model. Further expanding the scope, Awais and Salahuddin 7 undertake a study on the natural convection of coupled stress fluids. However, RA of SRPs confronts a myriad of challenges, underscoring the critical need for novel methodologies 8 . Primarily, the intricate nature of SRPs renders precise RA exceptionally complex and challenging. The project’s multifaceted dimensions, encompassing technology, resources, and personnel, are intricately interwoven, posing a formidable challenge for traditional assessment methods to comprehensively capture all potential risks 9 . Furthermore, the intricate and diverse interdependencies among various project factors contribute to the complexity of these relationships, thereby limiting the efficacy of conventional methods 10 , 11 , 12 . Traditional approaches often focus solely on the individual impact of diverse factors, overlooking the nuanced relationships that exist between them—an inherent limitation in the realm of RA for SRPs 13 , 14 , 15 .

The pursuit of a methodology capable of effectively assessing project risks while elucidating the intricate interplay of different factors has emerged as a focal point in SRPs management 16 , 17 , 18 . This approach necessitates a holistic consideration of multiple factors, their quantification in contributing to project risks, and the revelation of their correlations. Such an approach enables project managers to more precisely predict and respond to risks. Marx-Stoelting et al. 19 , current approaches for the assessment of environmental and human health risks due to exposure to chemical substances have served their purpose reasonably well. Additionally, Awais et al. 20 highlights the significance of enthalpy changes in SRPs risk considerations, while Awais et al. 21 delve into the comprehensive exploration of risk factors in Eyring-Powell fluid flow in magnetohydrodynamics, particularly addressing viscous dissipation and activation energy effects. The Naive Bayesian algorithm, recognized for its prowess in probability and statistics, has yielded substantial results in information retrieval and data mining in recent years 22 . Leveraging its advantages in classification and probability estimation, the algorithm presents a novel approach for RA of SRPs 23 . Integrating probability analysis into RA enables a more precise estimation of project risks by utilizing existing project data and harnessing the capabilities of the Naive Bayesian algorithms. This method facilitates a quantitative, statistical analysis of various factors, effectively navigating the intricate relationships between them, thereby enhancing the comprehensiveness and accuracy of RA for SRPs.

This paper seeks to employ the Naive Bayesian algorithm to estimate the probability of risks by carefully selecting distinct research project cases and analyzing multidimensional data, encompassing project scale, budget investment, and team experience. Concurrently, Multiple Linear Regression (MLR) analysis is applied to quantify the influence of these factors on the assessment results. The paper places particular emphasis on exploring the intricate interrelationships between different factors, aiming to provide a more specific and accurate reference framework for decision-making in SRPs management.

This paper introduces several innovations and contributions to the field of RA for SRPs:

Comprehensive Consideration of Key Factors: Unlike traditional research that focuses on a single factor, this paper comprehensively considers multiple key factors, such as project size, budget investment, and team experience. This holistic analysis enhances the realism and thoroughness of RA for SRPs.

Introduction of Tree-Enhanced Naive Bayes Model: The naive Bayes algorithm is introduced and further improved through the proposal of a tree-enhanced naive Bayes model. This algorithm exhibits unique advantages in handling uncertainty and complexity, thereby enhancing its applicability and accuracy in the RA of scientific and technological projects.

Empirical Validation: The effectiveness of the proposed method is not only discussed theoretically but also validated through empirical cases. The analysis of actual cases provides practical support and verification, enhancing the credibility of the research results.

Application of MLR Analysis: The paper employs MLR analysis to delve into the impact of various factors on RA. This quantitative analysis method adds specificity and operability to the research, offering a practical decision-making basis for scientific and technological project management.

Discovery of New Connections and Interactions: The paper uncovers novel connections and interactions, such as the compensatory role of team experience for budget-related risks and the impact of the interaction between project size and budget investment on RA results. These insights provide new perspectives for decision-making in technology projects, contributing significantly to the field of RA for SRPs in terms of both importance and practical value.

The paper is structured as follows: “ Introduction ” briefly outlines the significance of RA for SRPs. Existing challenges within current research are addressed, and the paper’s core objectives are elucidated. A distinct emphasis is placed on the innovative aspects of this research compared to similar studies. The organizational structure of the paper is succinctly introduced, providing a brief overview of each section’s content. “ Literature review ” provides a comprehensive review of relevant theories and methodologies in the domain of RA for SRPs. The current research landscape is systematically examined, highlighting the existing status and potential gaps. Shortcomings in previous research are analyzed, laying the groundwork for the paper’s motivation and unique contributions. “ Research methodology ” delves into the detailed methodologies employed in the paper, encompassing data collection, screening criteria, preprocessing steps, and more. The tree-enhanced naive Bayes model is introduced, elucidating specific steps and the purpose behind MLR analysis. “ Results and discussion ” unfolds the results and discussions based on selected empirical cases. The representativeness and diversity of these cases are expounded upon. An in-depth analysis of each factor’s impact and interaction in the context of RA is presented, offering valuable insights. “ Discussion ” succinctly summarizes the entire research endeavor. Potential directions for further research and suggestions for improvement are proposed, providing a thoughtful conclusion to the paper.

Literature review

A review of ra for srps.

In recent years, the advancement of SRPs management has led to the evolution of various RA methods tailored for SRPs. The escalating complexity of these projects poses a challenge for traditional methods, often falling short in comprehensively considering the intricate interplay among multiple factors and yielding incomplete assessment outcomes. Scholars, recognizing the pivotal role of factors such as project scale, budget investment, and team experience in influencing project risks, have endeavored to explore these dynamics from diverse perspectives. Siyal et al. 24 pioneered the development and testing of a model geared towards detecting SRPs risks. Chen et al. 25 underscored the significance of visual management in SRPs risk management, emphasizing its importance in understanding and mitigating project risks. Zhao et al. 26 introduced a classic approach based on cumulative prospect theory, offering an optional method to elucidate researchers’ psychological behaviors. Their study demonstrated the enhanced rationality achieved by utilizing the entropy weight method to derive attribute weight information under Pythagorean fuzzy sets. This approach was then applied to RA for SRPs, showcasing a model grounded in the proposed methodology. Suresh and Dillibabu 27 proposed an innovative hybrid fuzzy-based machine learning mechanism tailored for RA in software projects. This hybrid scheme facilitated the identification and ranking of major software project risks, thereby supporting decision-making throughout the software project lifecycle. Akhavan et al. 28 introduced a Bayesian network modeling framework adept at capturing project risks by calculating the uncertainty of project net present value. This model provided an effective means for analyzing risk scenarios and their impact on project success, particularly applicable in evaluating risks for innovative projects that had undergone feasibility studies.

A review of factors affecting SRPs

Within the realm of SRPs management, the assessment and proficient management of project risks stand as imperative components. Consequently, a range of studies has been conducted to explore diverse methods and models aimed at enhancing the comprehension and decision support associated with project risks. Guan et al. 29 introduced a new risk interdependence network model based on Monte Carlo simulation to support decision-makers in more effectively assessing project risks and planning risk management actions. They integrated interpretive structural modeling methods into the model to develop a hierarchical project risk interdependence network based on identified risks and their causal relationships. Vujović et al. 30 provided a new method for research in project management through careful analysis of risk management in SRPs. To confirm the hypothesis, the study focused on educational organizations and outlined specific project management solutions in business systems, thereby improving the business and achieving positive business outcomes. Muñoz-La Rivera et al. 31 described and classified the 100 identified factors based on the dimensions and aspects of the project, assessed their impact, and determined whether they were shaping or directly affecting the occurrence of research project accidents. These factors and their descriptions and classifications made significant contributions to improving the security creation of the system and generating training and awareness materials, fostering the development of a robust security culture within organizations. Nguyen et al. concentrated on the pivotal risk factors inherent in design-build projects within the construction industry. Effective identification and management of these factors enhanced project success and foster confidence among owners and contractors in adopting the design-build approach 32 . Their study offers valuable insights into RA in project management and the adoption of new contract forms. Nguyen and Le delineated risk factors influencing the quality of 20 civil engineering projects during the construction phase 33 . The top five risks identified encompass poor raw material quality, insufficient worker skills, deficient design documents and drawings, geographical challenges at construction sites, and inadequate capabilities of main contractors and subcontractors. Meanwhile, Nguyen and Phu Pham concentrated on office building projects in Ho Chi Minh City, Vietnam, to pinpoint key risk factors during the construction phase 34 . These factors were classified into five groups based on their likelihood and impact: financial, management, schedule, construction, and environmental. Findings revealed that critical factors affecting office building projects encompassed both natural elements (e.g., prolonged rainfall, storms, and climate impacts) and human factors (e.g., unstable soil, safety behavior, owner-initiated design changes), with schedule-related risks exerting the most significant influence during the construction phase of Ho Chi Minh City’s office building projects. This provides construction and project management practitioners with fresh insights into risk management, aiding in the comprehensive identification, mitigation, and management of risk factors in office building projects.

While existing research has made notable strides in RA for SRPs, certain limitations persist. These studies limitations in quantifying the degree of influence of various factors and analyzing their interrelationships, thereby falling short of offering specific and actionable recommendations. Traditional methods, due to their inherent limitations, struggle to precisely quantify risk degrees and often overlook the intricate interplay among multiple factors. Consequently, there is an urgent need for a comprehensive method capable of quantifying the impact of diverse factors and revealing their correlations. In response to this exigency, this paper introduces the TANB model. The unique advantages of this algorithm in the RA of scientific and technological projects have been fully realized. Tailored to address the characteristics of uncertainty and complexity, the model represents a significant leap forward in enhancing applicability and accuracy. In comparison with traditional methods, the TANB model exhibits greater flexibility and a heightened ability to capture dependencies between features, thereby elevating the overall performance of RA. This innovative method emerges as a more potent and reliable tool in the realm of scientific and technological project management, furnishing decision-makers with more comprehensive and accurate support for RA.

Research methodology

This paper centers on the latest iteration of ISO 31000, delving into the project risk management process and scrutinizing the RA for SRPs and their intricate interplay with associated factors. ISO 31000, an international risk management standard, endeavors to furnish businesses, organizations, and individuals with a standardized set of risk management principles and guidelines, defining best practices and establishing a common framework. The paper unfolds in distinct phases aligned with ISO 31000:

Risk Identification: Employing data collection and preparation, a spectrum of factors related to project size, budget investment, team member experience, project duration, and technical difficulty were identified.

RA: Utilizing the Naive Bayes algorithm, the paper conducts RA for SRPs, estimating the probability distribution of various factors influencing RA results.

Risk Response: The application of the Naive Bayes model is positioned as a means to respond to risks, facilitating the formulation of apt risk response strategies based on calculated probabilities.

Monitoring and Control: Through meticulous data collection, model training, and verification, the paper illustrates the steps involved in monitoring and controlling both data and models. Regular monitoring of identified risks and responses allows for adjustments when necessary.

Communication and Reporting: Maintaining effective communication throughout the project lifecycle ensures that stakeholders comprehend the status of project risks. Transparent reporting on discussions and outcomes contributes to an informed project environment.

Data collection and preparation

In this paper, a meticulous approach is undertaken to select representative research project cases, adhering to stringent screening criteria. Additionally, a thorough review of existing literature is conducted and tailored to the practical requirements of SRPs management. According to Nguyen et al., these factors play a pivotal role in influencing the RA outcomes of SRPs 35 . Furthermore, research by He et al. underscored the significant impact of team members’ experience on project success 36 . Therefore, in alignment with our research objectives and supported by the literature, this paper identifies variables such as project scale, budget investment, team member experience, project duration, and technical difficulty as the focal themes. To ensure the universality and scientific rigor of our findings, the paper adheres to stringent selection criteria during the project case selection process. After preliminary screening of SRPs completed in the past 5 years, considering factors such as project diversity, implementation scales, and achieved outcomes, five representative projects spanning diverse fields, including engineering, medicine, and information technology, are ultimately selected. These project cases are chosen based on their capacity to represent various scales and types of SRPs, each possessing a typical risk management process, thereby offering robust and comprehensive data support for our study. The subsequent phase involves detailed data collection on each chosen project, encompassing diverse dimensions such as project scale, budget investment, team member experience, project cycle, and technical difficulty. The collected data undergo meticulous preprocessing to ensure data quality and reliability. The preprocessing steps comprised data cleaning, addressing missing values, handling outliers, culminating in the creation of a self-constructed dataset. The dataset encompasses over 500 SRPs across diverse disciplines and fields, ensuring statistically significant and universal outcomes. Particular emphasis is placed on ensuring dataset diversity, incorporating projects of varying scales, budgets, and team experience levels. This comprehensive coverage ensures the representativeness and credibility of the study on RA in SRPs. New influencing factors are introduced to expand the research scope, including project management quality (such as time management and communication efficiency), historical success rate, industry dynamics, and market demand. Detailed definitions and quantifications are provided for each new variable to facilitate comprehensive data processing and analysis. For project management quality, consideration is given to time management accuracy and communication frequency and quality among team members. Historical success rate is determined by reviewing past project records and outcomes. Industry dynamics are assessed by consulting the latest scientific literature and patent information. Market demand is gauged through market research and user demand surveys. The introduction of these variables enriches the understanding of RA in SRPs and opens up avenues for further research exploration.

At the same time, the collected data are integrated and coded in order to apply Naive Bayes algorithm and MLR analysis. For cases involving qualitative data, this paper uses appropriate coding methods to convert it into quantitative data for processing in the model. For example, for the qualitative feature of team member experience, numerical values are used to represent different experience levels, such as 0 representing beginners, 0 representing intermediate, and 2 representing advanced. The following is a specific sample data set example (Table 1 ). It shows the processed structured data, and the values in the table represent the specific characteristics of each project.

Establishment of naive Bayesian model

The Naive Bayesian algorithm, a probabilistic and statistical classification method renowned for its effectiveness in analyzing and predicting multi-dimensional data, is employed in this paper to conduct the RA for SRPs. The application of the Naive Bayesian algorithm to RA for SRPs aims to discern the influence of various factors on the outcomes of RA. The Naive Bayesian algorithm, depicted in Fig.  1 , operates on the principles of Bayesian theorem, utilizing posterior probability calculations for classification tasks. The fundamental concept of this algorithm hinges on the assumption of independence among different features, embodying the “naivety” hypothesis. In the context of RA for SRPs, the Naive Bayesian algorithm is instrumental in estimating the probability distribution of diverse factors affecting the RA results, thereby enhancing the precision of risk estimates. In the Naive Bayesian model, the initial step involves the computation of posterior probabilities for each factor, considering the given RA result conditions. Subsequently, the category with the highest posterior probability is selected as the predictive outcome.

Naive Bayesian algorithm process.

In Fig.  1 , the data collection process encompasses vital project details such as project scale, budget investment, team member experience, project cycle, technical difficulty, and RA results. This meticulous collection ensures the integrity and precision of the dataset. Subsequently, the gathered data undergoes integration and encoding to convert qualitative data into quantitative form, facilitating model processing and analysis. Tailored to specific requirements, relevant features are chosen for model construction, accompanied by essential preprocessing steps like standardization and normalization. The dataset is then partitioned into training and testing sets, with the model trained on the former and its performance verified on the latter. Leveraging the training data, a Naive Bayesian model is developed to estimate probability distribution parameters for various features across distinct categories. Ultimately, the trained model is employed to predict new project features, yielding RA results.

Naive Bayesian models, in this context, are deployed to forecast diverse project risk levels. Let X symbolize the feature vector, encompassing project scale, budget investment, team member experience, project cycle, and technical difficulty. The objective is to predict the project’s risk level, denoted as Y. Y assumes discrete values representing distinct risk levels. Applying the Bayesian theorem, the posterior probability P(Y|X) is computed, signifying the probability distribution of projects falling into different risk levels given the feature vector X. The fundamental equation governing the Naive Bayesian model is expressed as:

In Eq. ( 1 ), P(Y|X) represents the posterior probability, denoting the likelihood of the project belonging to a specific risk level. P(X|Y) signifies the class conditional probability, portraying the likelihood of the feature vector X occurring under known risk level conditions. P(Y) is the prior probability, reflecting the antecedent likelihood of the project pertaining to a particular risk level. P(X) acts as the evidence factor, encapsulating the likelihood of the feature vector X occurring.

The Naive Bayes, serving as the most elementary Bayesian network classifier, operates under the assumption of attribute independence given the class label c , as expressed in Eq. ( 2 ):

The classification decision formula for Naive Bayes is articulated in Eq. ( 3 ):

The Naive Bayes model, rooted in the assumption of conditional independence among attributes, often encounters deviations from reality. To address this limitation, the Tree-Augmented Naive Bayes (TANB) model extends the independence assumption by incorporating a first-order dependency maximum-weight spanning tree. TANB introduces a tree structure that more comprehensively models relationships between features, easing the constraints of the independence assumption and concurrently mitigating issues associated with multicollinearity. This extension bolsters its efficacy in handling intricate real-world data scenarios. TANB employs conditional mutual information \(I(X_{i} ;X_{j} |C)\) to gauge the dependency between attributes \(X_{j}\) and \(X_{i}\) , thereby constructing the maximum weighted spanning tree. In TANB, any attribute variable \(X_{i}\) is permitted to have at most one other attribute variable as its parent node, expressed as \(Pa\left( {X_{i} } \right) \le 2\) . The joint probability \(P_{con} \left( {x,c} \right)\) undergoes transformation using Eq. ( 4 ):

In Eq. ( 4 ), \(x_{r}\) refers to the root node, which can be expressed as Eq. ( 5 ):

TANB classification decision equation is presented below:

In the RA of SRPs, normal distribution parameters, such as mean (μ) and standard deviation (σ), are estimated for each characteristic dimension (project scale, budget investment, team member experience, project cycle, and technical difficulty). This estimation allows the calculation of posterior probabilities for projects belonging to different risk levels under given feature vector conditions. For each feature dimension \({X}_{i}\) , the mean \({mu}_{i,j}\) and standard deviation \({{\text{sigma}}}_{i,j}\) under each risk level are computed, where i represents the feature dimension, and j denotes the risk level. Parameter estimation employs the maximum likelihood method, and the specific calculations are as follows.

In Eqs. ( 7 ) and ( 8 ), \({N}_{j}\) represents the number of projects belonging to risk level j . \({x}_{i,k}\) denotes the value of the k -th item in the feature dimension i . Finally, under a given feature vector, the posterior probability of a project with risk level j is calculated as Eq. ( 9 ).

In Eq. ( 9 ), d represents the number of feature dimensions, and Z is the normalization factor. \(P(Y=j)\) represents the prior probability of category j . \(P({X}_{i}\mid Y=j)\) represents the normal distribution probability density function of feature dimension i under category j . The risk level of a project can be predicted by calculating the posterior probabilities of different risk levels to achieve RA for SRPs.

This paper integrates the probability estimation of the Naive Bayes model with actual project risk response strategies, enabling a more flexible and targeted response to various risk scenarios. Such integration offers decision support to project managers, enhancing their ability to address potential challenges effectively and ultimately improving the overall success rate of the project. This underscores the notion that risk management is not solely about problem prevention but stands as a pivotal factor contributing to project success.

MLR analysis

MLR analysis is used to validate the hypothesis to deeply explore the impact of various factors on RA of SRPs. Based on the previous research status, the following research hypotheses are proposed.

Hypothesis 1: There is a positive relationship among project scale, budget investment, and team member experience and RA results. As the project scale, budget investment, and team member experience increase, the RA results also increase.

Hypothesis 2: There is a negative relationship between the project cycle and the RA results. Projects with shorter cycles may have higher RA results.

Hypothesis 3: There is a complex relationship between technical difficulty and RA results, which may be positive, negative, or bidirectional in some cases. Based on these hypotheses, an MLR model is established to analyze the impact of factors, such as project scale, budget investment, team member experience, project cycle, and technical difficulty, on RA results. The form of an MLR model is as follows.

In Eq. ( 10 ), Y represents the RA result (dependent variable). \({X}_{1}\) to \({X}_{5}\) represent factors, such as project scale, budget investment, team member experience, project cycle, and technical difficulty (independent variables). \({\beta }_{0}\) to \({\beta }_{5}\) are the regression coefficients, which represent the impact of various factors on the RA results. \(\epsilon\) represents a random error term. The model structure is shown in Fig.  2 .

Schematic diagram of an MLR model.

In Fig.  2 , the MLR model is employed to scrutinize the influence of various independent variables on the outcomes of RA. In this specific context, the independent variables encompass project size, budget investment, team member experience, project cycle, and technical difficulty, all presumed to impact the project’s RA results. Each independent variable is denoted as a node in the model, with arrows depicting the relationships between these factors. In an MLR model, the arrow direction signifies causality, illustrating the influence of an independent variable on the dependent variable.

When conducting MLR analysis, it is necessary to estimate the parameter \(\upbeta\) in the regression model. These parameters determine the relationship between the independent and dependent variables. Here, the Ordinary Least Squares (OLS) method is applied to estimate these parameters. The OLS method is a commonly used parameter estimation method aimed at finding parameter values that minimize the sum of squared residuals between model predictions and actual observations. The steps are as follows. Firstly, based on the general form of an MLR model, it is assumed that there is a linear relationship between the independent and dependent variables. It can be represented by a linear equation, which includes regression coefficients β and the independent variable X. For each observation value, the difference between its predicted and actual values is calculated, which is called the residual. Residual \({e}_{i}\) can be expressed as:

In Eq. ( 11 ), \({Y}_{i}\) is the actual observation value, and \({\widehat{Y}}_{i}\) is the value predicted by the model. The goal of the OLS method is to adjust the regression coefficients \(\upbeta\) to minimize the sum of squared residuals of all observations. This can be achieved by solving an optimization problem, and the objective function is the sum of squared residuals.

Then, the estimated value of the regression coefficient \(\upbeta\) that minimizes the sum of squared residuals can be obtained by taking the derivative of the objective function and making the derivative zero. The estimated values of the parameters can be obtained by solving this system of equations. The final estimated regression coefficient can be expressed as:

In Eq. ( 13 ), X represents the independent variable matrix. Y represents the dependent variable vector. \(({X}^{T}X{)}^{-1}\) is the inverse of a matrix, and \(\widehat{\beta }\) is a parameter estimation vector.

Specifically, solving for the estimated value of regression coefficient \(\upbeta\) requires matrix operation and statistical analysis. Based on the collected project data, substitute it into the model and calculate the residual. Then, the steps of the OLS method are used to obtain parameter estimates. These parameter estimates are used to establish an MLR model to predict RA results and further analyze the influence of different factors.

The degree of influence of different factors on the RA results can be determined by analyzing the value of the regression coefficient β. A positive \(\upbeta\) value indicates that the factor has a positive impact on the RA results, while a negative \(\upbeta\) value indicates that the factor has a negative impact on the RA results. Additionally, hypothesis testing can determine whether each factor is significant in the RA results.

The TANB model proposed in this paper extends the traditional naive Bayes model by incorporating conditional dependencies between attributes to enhance the representation of feature interactions. While the traditional naive Bayes model assumes feature independence, real-world scenarios often involve interdependencies among features. To address this, the TANB model is introduced. The TANB model introduces a tree structure atop the naive Bayes model to more accurately model feature relationships, overcoming the limitation of assuming feature independence. Specifically, the TANB model constructs a maximum weight spanning tree to uncover conditional dependencies between features, thereby enabling the model to better capture feature interactions.

Assessment indicators

To comprehensively assess the efficacy of the proposed TANB model in the RA for SRPs, a self-constructed dataset serves as the data source for this experimental evaluation, as outlined in Table 1 . The dataset is segregated into training (80%) and test sets (20%). These indicators cover the accuracy, precision, recall rate, F1 value, and Area Under the Curve (AUC) Receiver Operating Characteristic (ROC) of the model. The following are the definitions and equations for each assessment indicator. Accuracy is the proportion of correctly predicted samples to the total number of samples. Precision is the proportion of Predicted Positive (PP) samples to actual positive samples. The recall rate is the proportion of correctly PP samples among the actual positive samples. The F1 value is the harmonic average of precision and recall, considering the precision and comprehensiveness of the model. The area under the ROC curve measures the classification performance of the model, and a larger AUC value indicates better model performance. The ROC curve suggests the relationship between True Positive Rate and False Positive Rate under different thresholds. The AUC value can be obtained by accumulating the area of each small rectangle under the ROC curve. The confusion matrix is used to display the prediction property of the model in different categories, including True Positive (TP), True Negative (TN), False Positive (FP), and False Negative (FN).

The performance of TANB in RA for SRPs can be comprehensively assessed to understand the advantages, disadvantages, and applicability of the model more comprehensively by calculating the above assessment indicators.

Results and discussion

Accuracy analysis of naive bayesian algorithm.

On the dataset of this paper, Fig.  3 reveals the performance of TANB algorithm under different assessment indicators.

Performance assessment of TANB algorithm on different projects.

From Fig.  3 , the TANB algorithm performs well in various projects, ranging from 0.87 to 0.911 in accuracy. This means that the overall accuracy of the model in predicting project risks is quite high. The precision also maintains a high level in various projects, ranging from 0.881 to 0.923, indicating that the model performs well in classifying high-risk categories. The recall rate ranges from 0.872 to 0.908, indicating that the model can effectively capture high-risk samples. Meanwhile, the AUC values in each project are relatively high, ranging from 0.905 to 0.931, which once again emphasizes the effectiveness of the model in risk prediction. From multiple assessment indicators, such as accuracy, precision, recall, F1 value, and AUC, the TANB algorithm has shown good risk prediction performance in representative projects. The performance assessment results of the TANB algorithm under different feature dimensions are plotted in Figs.  4 , 5 , 6 and 7 .

Prediction accuracy of TANB algorithm on different budget investments.

Prediction accuracy of TANB algorithm on different team experiences.

Prediction accuracy of TANB algorithm at different risk levels.

Prediction accuracy of TANB algorithm on different project scales.

From Figs.  4 , 5 , 6 and 7 , as the level of budget investment increases, the accuracy of most projects also shows an increasing trend. Especially in cases of high budget investment, the accuracy of the project is generally high. This may mean that a higher budget investment helps to reduce project risks, thereby improving the prediction accuracy of the TANB algorithm. It can be observed that team experience also affects the accuracy of the model. Projects with high team experience exhibit higher accuracy in TANB algorithms. This may indicate that experienced teams can better cope with project risks to improve the performance of the model. When budget investment and team experience are low, accuracy is relatively low. This may imply that budget investment and team experience can complement each other to affect the model performance.

There are certain differences in the accuracy of projects under different risk levels. Generally speaking, the accuracy of high-risk and medium-risk projects is relatively high, while the accuracy of low-risk projects is relatively low. This may be because high-risk and medium-risk projects require more accurate predictions, resulting in higher accuracy. Similarly, project scale also affects the performance of the model. Large-scale and medium-scale projects exhibit high accuracy in TANB algorithms, while small-scale projects have relatively low accuracy. This may be because the risks of large-scale and medium-scale projects are easier to identify and predict to promote the performance of the model. In high-risk and large-scale projects, accuracy is relatively high. This may indicate that the impact of project scale is more significant in specific risk scenarios.

Figure  8 further compares the performance of the TANB algorithm proposed here with other similar algorithms.

Performance comparison of different algorithms in RA of SRPs.

As depicted in Fig.  8 , the TANB algorithm attains an accuracy and precision of 0.912 and 0.920, respectively, surpassing other algorithms. It excels in recall rate and F1 value, registering 0.905 and 0.915, respectively, outperforming alternative algorithms. These findings underscore the proficiency of the TANB algorithm in comprehensively identifying high-risk projects while sustaining high classification accuracy. Moreover, the algorithm achieves an AUC of 0.930, indicative of its exceptional predictive prowess in sample classification. Thus, the TANB algorithm exhibits notable potential for application, particularly in scenarios demanding the recognition and comprehensiveness requisite for high-risk project identification. The evaluation results of the TANB model in predicting project risk levels are presented in Table 2 :

Table 2 demonstrates that the TANB model surpasses the traditional Naive Bayes model across multiple evaluation metrics, including accuracy, precision, and recall. This signifies that, by accounting for feature interdependence, the TANB model can more precisely forecast project risk levels. Furthermore, leveraging the model’s predictive outcomes, project managers can devise tailored risk mitigation strategies corresponding to various risk scenarios. For example, in high-risk projects, more assertive measures can be implemented to address risks, while in low-risk projects, risks can be managed more cautiously. This targeted risk management approach contributes to enhancing project success rates, thereby ensuring the seamless advancement of SRPs.

The exceptional performance of the TANB model in specific scenarios derives from its distinctive characteristics and capabilities. Firstly, compared to traditional Naive Bayes models, the TANB model can better capture the dependencies between attributes. In project RA, project features often exhibit complex interactions. The TANB model introduces first-order dependencies between attributes, allowing features to influence each other, thereby more accurately reflecting real-world situations and improving risk prediction precision. Secondly, the TANB model demonstrates strong adaptability and generalization ability in handling multidimensional data. SRPs typically involve data from multiple dimensions, such as project scale, budget investment, and team experience. The TANB model effectively processes these multidimensional data, extracts key information, and achieves accurate RA for projects. Furthermore, the paper explores the potential of using hybrid models or ensemble learning methods to further enhance model performance. By combining other machine learning algorithms, such as random forests and support vector regressors with sigmoid kernel, through ensemble learning, the shortcomings of individual models in specific scenarios can be overcome, thus improving the accuracy and robustness of RA. For example, in the study, we compared the performance of the TANB model with other algorithms in RA, as shown in Table 3 .

Table 3 illustrates that the TANB model surpasses other models in terms of accuracy, precision, recall, F1 value, and AUC value, further confirming its superiority and practicality in RA. Therefore, the TANB model holds significant application potential in SRPs, offering effective decision support for project managers to better evaluate and manage project risks, thereby enhancing the likelihood of project success.

Analysis of the degree of influence of different factors

Table 4 analyzes the degree of influence and interaction of different factors.

In Table 4 , the regression analysis results reveal that budget investment and team experience exert a significantly positive impact on RA outcomes. This suggests that increasing budget allocation and assembling a team with extensive experience can enhance project RA outcomes. Specifically, the regression coefficient for budget investment is 0.68, and for team experience, it is 0.51, both demonstrating significant positive effects (P < 0.05). The P-values are all significantly less than 0.05, indicating a significant impact. The impact of project scale is relatively small, at 0.31, and its P-value is also much less than 0.05. The degree of interaction influence is as follows. The impact of interaction terms is also significant, especially the interaction between budget investment and team experience and the interaction between budget investment and project scale. The P value of the interaction between budget investment and project scale is 0.002, and the P value of the interaction between team experience and project scale is 0.003. The P value of the interaction among budget investment, team experience, and project scale is 0.005. So, there are complex relationships and interactions among different factors, and budget investment and team experience significantly affect the RA results. However, the budget investment and project scale slightly affect the RA results. Project managers should comprehensively consider the interactive effects of different factors when making decisions to more accurately assess the risks of SRPs.

The interaction between team experience and budget investment

The results of the interaction between team experience and budget investment are demonstrated in Table 5 .

From Table 5 , the degree of interaction impact can be obtained. Budget investment and team experience, along with the interaction between project scale and technical difficulty, are critical factors in risk mitigation. Particularly in scenarios characterized by large project scales and high technical difficulties, adequate budget allocation and a skilled team can substantially reduce project risks. As depicted in Table 5 , under conditions of high team experience and sufficient budget investment, the average RA outcome is 0.895 with a standard deviation of 0.012, significantly lower than assessment outcomes under other conditions. This highlights the synergistic effects of budget investment and team experience in effectively mitigating risks in complex project scenarios. The interaction between team experience and budget investment has a significant impact on RA results. Under high team experience, the impact of different budget investment levels on RA results is not significant, but under medium and low team experience, the impact of different budget investment levels on RA results is significantly different. The joint impact of team experience and budget investment is as follows. Under high team experience, the impact of budget investment is relatively small, possibly because high-level team experience can compensate for the risks brought by insufficient budget to some extent. Under medium and low team experience, the impact of budget investment is more significant, possibly because the lack of team experience makes budget investment play a more important role in RA. Therefore, team experience and budget investment interact in RA of SRPs. They need to be comprehensively considered in project decision-making. High team experience can compensate for the risks brought by insufficient budget to some extent, but in the case of low team experience, the impact of budget investment on RA is more significant. An exhaustive consideration of these factors and their interplay is imperative for effectively assessing the risks inherent in SRPs. Merely focusing on budget allocation or team expertise may not yield a thorough risk evaluation. Project managers must scrutinize the project’s scale, technical complexity, and team proficiency, integrating these aspects with budget allocation and team experience. This holistic approach fosters a more precise RA and facilitates the development of tailored risk management strategies, thereby augmenting the project’s likelihood of success. In conclusion, acknowledging the synergy between budget allocation and team expertise, in conjunction with other pertinent factors, is pivotal in the RA of SRPs. Project managers should adopt a comprehensive outlook to ensure sound decision-making and successful project execution.

Risk mitigation strategies

To enhance the discourse on project risk management in this paper, a dedicated section on risk mitigation strategies has been included. Leveraging the insights gleaned from the predictive model regarding identified risk factors and their corresponding risk levels, targeted risk mitigation measures are proposed.

Primarily, given the significant influence of budget investment and team experience on project RA outcomes, project managers are advised to prioritize these factors and devise pertinent risk management strategies.

For risks stemming from budget constraints, the adoption of flexible budget allocation strategies is advocated. This may involve optimizing project expenditures, establishing financial reserves, or seeking additional funding avenues.

In addressing risks attributed to inadequate team experience, measures such as enhanced training initiatives, engagement of seasoned project advisors, or collaboration with experienced teams can be employed to mitigate the shortfall in expertise.

Furthermore, recognizing the impact of project scale, duration, and technical complexity on RA outcomes, project managers are advised to holistically consider these factors during project planning. This entails adjusting project scale as necessary, establishing realistic project timelines, and conducting thorough assessments of technical challenges prior to project commencement.

These risk mitigation strategies aim to equip project managers with a comprehensive toolkit for effectively identifying, assessing, and mitigating risks inherent in SRPs.

This paper delves into the efficacy of the TANB algorithm in project risk prediction. The findings indicate that the algorithm demonstrates commendable performance across diverse projects, boasting high precision, recall rates, and AUC values, thereby outperforming analogous algorithms. This aligns with the perspectives espoused by Asadullah et al. 37 . Particular emphasis was placed on assessing the impact of variables such as budget investment levels, team experience, and project size on algorithmic performance. Notably, heightened budget investment and extensive team experience positively influenced the results, with project size exerting a comparatively minor impact. Regression analysis elucidates the magnitude and interplay of these factors, underscoring the predominant influence of budget investment and team experience on RA outcomes, whereas project size assumes a relatively marginal role. This underscores the imperative for decision-makers in projects to meticulously consider the interrelationships between these factors for a more precise assessment of project risks, echoing the sentiments expressed by Testorelli et al. 38 .

In sum, this paper furnishes a holistic comprehension of the Naive Bayes algorithm’s application in project risk prediction, offering robust guidance for practical project management. The paper’s tangible applications are chiefly concentrated in the realm of RA and management for SRPs. Such insights empower managers in SRPs to navigate risks with scientific acumen, thereby enhancing project success rates and performance. The paper advocates several strategic measures for SRPs management: prioritizing resource adjustments and team training to elevate the professional skill set of team members in coping with the impact of team experience on risks; implementing project scale management strategies to mitigate potential risks by detailed project stage division and stringent project planning; addressing technical difficulty as a pivotal risk factor through assessment and solution development strategies; incorporating project cycle adjustment and flexibility management to accommodate fluctuations and mitigate associated risks; and ensuring the integration of data quality management strategies to bolster data reliability and enhance model accuracy. These targeted risk responses aim to improve the likelihood of project success and ensure the seamless realization of project objectives.

Achievements

In this paper, the application of Naive Bayesian algorithm in RA of SRPs is deeply explored, and the influence of various factors on RA results and their relationship is comprehensively investigated. The research results fully prove the good accuracy and applicability of Naive Bayesian algorithm in RA of science and technology projects. Through probability estimation, the risk level of the project can be estimated more accurately, which provides a new decision support tool for the project manager. It is found that budget input and team experience are the most significant factors affecting the RA results, and their regression coefficients are 0.68 and 0.51 respectively. However, the influence of project scale on the RA results is relatively small, and its regression coefficient is 0.31. Especially in the case of low team experience, the budget input has a more significant impact on the RA results. However, it should also be admitted that there are some limitations in the paper. First, the case data used is limited and the sample size is relatively small, which may affect the generalization ability of the research results. Second, the factors concerned may not be comprehensive, and other factors that may affect RA, such as market changes and policies and regulations, are not considered.

The paper makes several key contributions. Firstly, it applies the Naive Bayes algorithm to assess the risks associated with SRPs, proposing the TANB and validating its effectiveness empirically. The introduction of the TANB model broadens the application scope of the Naive Bayes algorithm in scientific research risk management, offering novel methodologies for project RA. Secondly, the study delves into the impact of various factors on RA for SRPs through MLR analysis, highlighting the significance of budget investment and team experience. The results underscore the positive influence of budget investment and team experience on RA outcomes, offering valuable insights for project decision-making. Additionally, the paper examines the interaction between team experience and budget investment, revealing a nuanced relationship between the two in RA. This finding underscores the importance of comprehensively considering factors such as team experience and budget investment in project decision-making to achieve more accurate RA. In summary, the paper provides crucial theoretical foundations and empirical analyses for SRPs risk management by investigating RA and its influencing factors in depth. The research findings offer valuable guidance for project decision-making and risk management, bolstering efforts to enhance the success rate and efficiency of SRPs.

This paper distinguishes itself from existing research by conducting an in-depth analysis of the intricate interactions among various factors, offering more nuanced and specific RA outcomes. The primary objective extends beyond problem exploration, aiming to broaden the scope of scientific evaluation and research practice through the application of statistical language. This research goal endows the paper with considerable significance in the realm of science and technology project management. In comparison to traditional methods, this paper scrutinizes project risk with greater granularity, furnishing project managers with more actionable suggestions. The empirical analysis validates the effectiveness of the proposed method, introducing a fresh perspective for decision-making in science and technology projects. Future research endeavors will involve expanding the sample size and accumulating a more extensive dataset of SRPs to enhance the stability and generalizability of results. Furthermore, additional factors such as market demand and technological changes will be incorporated to comprehensively analyze elements influencing the risks of SRPs. Through these endeavors, the aim is to provide more precise and comprehensive decision support to the field of science and technology project management, propelling both research and practice in this domain to new heights.

Limitations and prospects

This paper, while employing advanced methodologies like TANB models, acknowledges inherent limitations that warrant consideration. Firstly, like any model, TANB has its constraints, and predictions in specific scenarios may be subject to these limitations. Subsequent research endeavors should explore alternative advanced machine learning and statistical models to enhance the precision and applicability of RA. Secondly, the focus of this paper predominantly centers on the RA for SRPs. Given the unique characteristics and risk factors prevalent in projects across diverse fields and industries, the generalizability of the paper results may be limited. Future research can broaden the scope of applicability by validating the model across various fields and industries. The robustness and generalizability of the model can be further ascertained through the incorporation of extensive real project data in subsequent research. Furthermore, future studies can delve into additional data preprocessing and feature engineering methods to optimize model performance. In practical applications, the integration of research outcomes into SRPs management systems could provide more intuitive and practical support for project decision-making. These avenues represent valuable directions for refining and expanding the contributions of this research in subsequent studies.

Data availability

All data generated or analysed during this study are included in this published article [and its Supplementary Information files].

Moshtaghian, F., Golabchi, M. & Noorzai, E. A framework to dynamic identification of project risks. Smart and sustain. Built. Environ. 9 (4), 375–393 (2020).

Google Scholar  

Nunes, M. & Abreu, A. Managing open innovation project risks based on a social network analysis perspective. Sustainability 12 (8), 3132 (2020).

Article   Google Scholar  

Elkhatib, M. et al. Agile project management and project risks improvements: Pros and cons. Mod. Econ. 13 (9), 1157–1176 (2022).

Fridgeirsson, T. V. et al. The VUCAlity of projects: A new approach to assess a project risk in a complex world. Sustainability 13 (7), 3808 (2021).

Salahuddin, T. Numerical Techniques in MATLAB: Fundamental to Advanced Concepts (CRC Press, 2023).

Book   Google Scholar  

Awais, M. & Salahuddin, T. Radiative magnetohydrodynamic cross fluid thermophysical model passing on parabola surface with activation energy. Ain Shams Eng. J. 15 (1), 102282 (2024).

Awais, M. & Salahuddin, T. Natural convection with variable fluid properties of couple stress fluid with Cattaneo-Christov model and enthalpy process. Heliyon 9 (8), e18546 (2023).

Article   CAS   PubMed   PubMed Central   Google Scholar  

Guan, L., Abbasi, A. & Ryan, M. J. Analyzing green building project risk interdependencies using Interpretive Structural Modeling. J. Clean. Prod. 256 , 120372 (2020).

Gaudenzi, B. & Qazi, A. Assessing project risks from a supply chain quality management (SCQM) perspective. Int. J. Qual. Reliab. Manag. 38 (4), 908–931 (2021).

Lee, K. T., Park, S. J. & Kim, J. H. Comparative analysis of managers’ perception in overseas construction project risks and cost overrun in actual cases: A perspective of the Republic of Korea. J. Asian Archit. Build. Eng. 22 (4), 2291–2308 (2023).

Garai-Fodor, M., Szemere, T. P. & Csiszárik-Kocsir, Á. Investor segments by perceived project risk and their characteristics based on primary research results. Risks 10 (8), 159 (2022).

Senova, A., Tobisova, A. & Rozenberg, R. New approaches to project risk assessment utilizing the Monte Carlo method. Sustainability 15 (2), 1006 (2023).

Tiwari, P. & Suresha, B. Moderating role of project innovativeness on project flexibility, project risk, project performance, and business success in financial services. Glob. J. Flex. Syst. Manag. 22 (3), 179–196 (2021).

de Araújo, F., Lima, P., Marcelino-Sadaba, S. & Verbano, C. Successful implementation of project risk management in small and medium enterprises: A cross-case analysis. Int. J. Manag. Proj. Bus. 14 (4), 1023–1045 (2021).

Obondi, K. The utilization of project risk monitoring and control practices and their relationship with project success in construction projects. J. Proj. Manag. 7 (1), 35–52 (2022).

Atasoy, G. et al. Empowering risk communication: Use of visualizations to describe project risks. J. Constr. Eng. Manage. 148 (5), 04022015 (2022).

Dandage, R. V., Rane, S. B. & Mantha, S. S. Modelling human resource dimension of international project risk management. J. Global Oper. Strateg. Sourcing 14 (2), 261–290 (2021).

Wang, L. et al. Applying social network analysis to genetic algorithm in optimizing project risk response decisions. Inf. Sci. 512 , 1024–1042 (2020).

Marx-Stoelting, P. et al. A walk in the PARC: developing and implementing 21st century chemical risk assessment in Europe. Arch. Toxicol. 97 (3), 893–908 (2023).

Awais, M., Salahuddin, T. & Muhammad, S. Evaluating the thermo-physical characteristics of non-Newtonian Casson fluid with enthalpy change. Thermal Sci. Eng. Prog. 42 , 101948 (2023).

Article   CAS   Google Scholar  

Awais, M., Salahuddin, T. & Muhammad, S. Effects of viscous dissipation and activation energy for the MHD Eyring-Powell fluid flow with Darcy-Forchheimer and variable fluid properties. Ain Shams Eng. J. 15 (2), 102422 (2024).

Yang, L., Lou, J. & Zhao, X. Risk response of complex projects: Risk association network method. J. Manage. Eng. 37 (4), 05021004 (2021).

Acebes, F. et al. Project risk management from the bottom-up: Activity Risk Index. Cent. Eur. J. Oper. Res. 29 (4), 1375–1396 (2021).

Siyal, S. et al. They can’t treat you well under abusive supervision: Investigating the impact of job satisfaction and extrinsic motivation on healthcare employees. Rationality Society 33 (4), 401–423 (2021).

Chen, D., Wawrzynski, P. & Lv, Z. Cyber security in smart cities: A review of deep learning-based applications and case studies. Sustain. Cities Soc. 66 , 102655 (2021).

Zhao, M. et al. Pythagorean fuzzy TODIM method based on the cumulative prospect theory for MAGDM and its application on risk assessment of science and technology projects. Int. J. Fuzzy Syst. 23 , 1027–1041 (2021).

Suresh, K. & Dillibabu, R. A novel fuzzy mechanism for risk assessment in software projects. Soft Comput. 24 , 1683–1705 (2020).

Akhavan, M., Sebt, M. V. & Ameli, M. Risk assessment modeling for knowledge based and startup projects based on feasibility studies: A Bayesian network approach. Knowl.-Based Syst. 222 , 106992 (2021).

Guan, L., Abbasi, A. & Ryan, M. J. A simulation-based risk interdependency network model for project risk assessment. Decis. Support Syst. 148 , 113602 (2021).

Vujović, V. et al. Project planning and risk management as a success factor for IT projects in agricultural schools in Serbia. Technol. Soc. 63 , 101371 (2020).

Muñoz-La Rivera, F., Mora-Serrano, J. & Oñate, E. Factors influencing safety on construction projects (FSCPs): Types and categories. Int. J. Environ. Res. Public Health 18 (20), 10884 (2021).

Article   PubMed   PubMed Central   Google Scholar  

Nguyen, P. T. & Nguyen, P. C. Risk management in engineering and construction: A case study in design-build projects in Vietnam. Eng. Technol. Appl. Sci. Res 10 , 5237–5241 (2020).

Nguyen PT, Le TT. Risks on quality of civil engineering projects-an additive probability formula approach//AIP Conference Proceedings. AIP Publishing, 2798(1) (2023).

Nguyen, P.T., Phu, P.C., Thanh, P.P., et al . Exploring critical risk factors of office building projects. 8 (2), 0309–0315 (2020).

Nguyen, H. D. & Macchion, L. Risk management in green building: A review of the current state of research and future directions. Environ. Develop. Sustain. 25 (3), 2136–2172 (2023).

He, S. et al. Risk assessment of oil and gas pipelines hot work based on AHP-FCE. Petroleum 9 (1), 94–100 (2023).

Asadullah, M. et al. Evaluation of machine learning techniques for hypertension risk prediction based on medical data in Bangladesh. Indones. J. Electr. Eng. Comput. Sci. 31 (3), 1794–1802 (2023).

Testorelli, R., de Araujo, F., Lima, P. & Verbano, C. Fostering project risk management in SMEs: An emergent framework from a literature review. Prod. Plan. Control 33 (13), 1304–1318 (2022).

Download references

Author information

Authors and affiliations.

Institute of Policy Studies, Lingnan University, Tuen Mun, 999077, Hong Kong, China

Xuying Dong & Wanlin Qiu

You can also search for this author in PubMed   Google Scholar

Contributions

Xuying Dong and Wanlin Qiu played a key role in the writing of Risk Assessment of Scientific Research Projects and the Relationship between Related Factors Based on Naive Bayes Algorithm. First, they jointly developed clearly defined research questions and methods for risk assessment using the naive Bayes algorithm at the beginning of the research project. Secondly, Xuying Dong and Wanlin Qiu were responsible for data collection and preparation, respectively, to ensure the quality and accuracy of the data used in the research. They worked together to develop a naive Bayes algorithm model, gain a deep understanding of the algorithm, ensure the effectiveness and performance of the model, and successfully apply the model in practical research. In the experimental and data analysis phase, the collaborative work of Xuying Dong and Wanlin Qiu played a key role in verifying the validity of the model and accurately assessing the risks of the research project. They also collaborated on research papers, including detailed descriptions of methods, experiments and results, and actively participated in the review and revision process, ensuring the accuracy and completeness of the findings. In general, the joint contribution of Xuying Dong and Wanlin Qiu has provided a solid foundation for the success of this research and the publication of high-quality papers, promoted the research on the risk assessment of scientific research projects and the relationship between related factors, and made a positive contribution to the progress of the field.

Corresponding author

Correspondence to Wanlin Qiu .

Ethics declarations

Competing interests.

The authors declare no competing interests.

Additional information

Publisher's note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Supplementary information., rights and permissions.

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ .

Reprints and permissions

About this article

Cite this article.

Dong, X., Qiu, W. A case study on the relationship between risk assessment of scientific research projects and related factors under the Naive Bayesian algorithm. Sci Rep 14 , 8244 (2024). https://doi.org/10.1038/s41598-024-58341-y

Download citation

Received : 30 October 2023

Accepted : 27 March 2024

Published : 08 April 2024

DOI : https://doi.org/10.1038/s41598-024-58341-y

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Naive Bayesian algorithm
• Scientific research projects
• Risk assessment
• Factor analysis
• Probability estimation
• Decision support
• Data-driven decision-making

By submitting a comment you agree to abide by our Terms and Community Guidelines . If you find something abusive or that does not comply with our terms or guidelines please flag it as inappropriate.

Quick links

• Explore articles by subject
• Guide to authors
• Editorial policies

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

This paper is in the following e-collection/theme issue:

Published on 11.4.2024 in Vol 26 (2024)

This is a member publication of Imperial College London (Jisc)

Regulatory Standards and Guidance for the Use of Health Apps for Self-Management in Sub-Saharan Africa: Scoping Review

Authors of this article:

• Benard Ayaka Bene 1, 2 , MBBS, MPH   ; 
• Sunny Ibeneme 3 , MD, PhD   ; 
• Kayode Philip Fadahunsi 1 , MBBS, MPH   ; 
• Bala Isa Harri 4 , MBBS, MPH, MSc   ; 
• Nkiruka Ukor 5 , MSc   ; 
• Nikolaos Mastellos 1 , BSc, PhD   ; 
• Azeem Majeed 1 , MD   ; 
• Josip Car 1, 6 , MSc, MD, PhD  

1 Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom

2 Department of Public Health, Federal Ministry of Health, Abuja, Nigeria

3 Digital Health Specialist, UNICEF East Asia Pacific Regional Office, Bangkok, Thailand

4 Department of Health Planning, Research and Statistics, Federal Ministry of Health, Abuja, Nigeria

5 Strategic Health Information Cluster, World Health Organization, Abuja, Nigeria

6 School of Life Course & Population Sciences, King’s College London, London, United Kingdom

Corresponding Author:

Benard Ayaka Bene, MBBS, MPH

Department of Primary Care and Public Health

School of Public Health

Imperial College London

The Reynolds Building

St Dunstan’s Road

London, W6 8RP

United Kingdom

Phone: 44 7598439185

Email: [email protected]

Background: Health apps are increasingly recognized as crucial tools for enhancing health care delivery. Many countries, particularly those in sub-Saharan Africa, can substantially benefit from using health apps to support self-management and thus help to achieve universal health coverage and the third sustainable development goal. However, most health apps published in app stores are of unknown or poor quality, which poses a risk to patient safety. Regulatory standards and guidance can help address this risk and promote patient safety.

Objective: This review aims to assess the regulatory standards and guidance for health apps supporting evidence-based best practices in sub-Saharan Africa with a focus on self-management.

Methods: A methodological framework for scoping reviews was applied. A search strategy was built and applied across the following databases, gray literature sources, and institutional websites: PubMed, Scopus, World Health Organization (WHO) African Index Medicus, OpenGrey, WHO Regional Office for Africa Library, ICTworks, WHO Directory of eHealth policies, HIS Strengthening Resource Center, International Telecommunication Union, Ministry of Health websites, and Google. The search covered the period between January 2005 and January 2024. The findings were analyzed using a deductive descriptive content analysis. The policy analysis framework was adapted and used to organize the findings. The Reporting Items for Stakeholder Analysis tool guided the identification and mapping of key stakeholders based on their roles in regulating health apps for self-management.

Results: The study included 49 documents from 31 sub-Saharan African countries. While all the documents were relevant for stakeholder identification and mapping, only 3 regulatory standards and guidance contained relevant information on regulation of health apps. These standards and guidance primarily aimed to build mutual trust; promote integration, inclusion, and equitable access to services; and address implementation issues and poor coordination. They provided guidance on systems quality, software acquisition and maintenance, security measures, data exchange, interoperability and integration, involvement of relevant stakeholders, and equitable access to services. To enhance implementation, the standards highlight that legal authority, coordination of activities, building capacity, and monitoring and evaluation are required. A number of stakeholders, including governments, regulatory bodies, funders, intergovernmental and nongovernmental organizations, academia, and the health care community, were identified to play key roles in regulating health apps.

Conclusions: Health apps have huge potential to support self-management in sub-Saharan Africa, but the lack of regulatory standards and guidance constitutes a major barrier. Hence, for these apps to be safely and effectively integrated into health care, more attention should be given to regulation. Learning from countries with effective regulations can help sub-Saharan Africa build a more robust and responsive regulatory system, ensuring the safe and beneficial use of health apps across the region.

International Registered Report Identifier (IRRID): RR2-10.1136/bmjopen-2018-025714

Introduction

Health apps are the most widely used digital health products globally [ 1 , 2 ]. Harnessing the potential of health apps creates a huge opportunity in providing support for health care delivery, including patient communication, patient education, and decision support for self-management [ 3 - 8 ]. Health apps can be an effective tool to strengthen health systems worldwide, especially in low- and middle-income countries including those in sub-Saharan Africa [ 4 , 5 , 9 ]. As a result, the attainment of universal health coverage (UHC) and sustainable development goal (SDG) 3, good health and well-being, can be accelerated [ 8 , 10 ].

Many health apps fall below the expected quality threshold [ 11 ]. Several studies have found that widely used health apps are often technically unreliable and clinically unsafe [ 12 - 14 ] and do not comply with ethical standards and the principles of confidentiality of information and data privacy [ 15 , 16 ]. In addition, many commercially available health apps were not developed using interoperability standards that are widely accepted in sub-Saharan Africa (eg, Fast Healthcare Interoperability Resources [FHIR]) [ 17 - 20 ]. Consequently, it becomes difficult to integrate these apps into a clinical workflow.

Hence, regulation through robust mechanisms is crucial to enhance the development, implementation, and adoption of health apps. Regulatory standards and guidance are essential for the safety of patients as they ensure quality assurance of any new technology in health care and contribute to building mutual trust while promoting the optimal use of the technology [ 21 - 23 ]. Therefore, to ensure that health apps that are used to support the self-management of patients are technically reliable and clinically safe, interoperable across systems, and compliant with the principles of confidentiality of information and data privacy, there is a need for effective regulatory standards. Furthermore, effective regulation can help ensure that health apps for self-management are culturally functional and competent and are accessible to those who need them regardless of gender, ethnicity, geographical location, or financial status [ 24 - 31 ].

Since 2005, there have been ongoing efforts to strengthen digital health governance at both the national and international levels [ 32 , 33 ]. In 2018, the World Health Organization (WHO) member states renewed their commitment to using digital health technologies (DHTs) to advance UHC and SDG 3 [ 33 ]. However, to date, the extent to which the use of health apps for self-management is regulated across countries within the WHO African Region (also known as sub-Saharan Africa) remains unclear. Therefore, this review was conducted to identify available regulatory standards and guidance and assess the extent to which they regulate health apps for self-management in sub-Saharan Africa. The review also mapped out the key stakeholders and their roles in regulating health apps for self-management across sub-Saharan Africa.

Review Questions

The review attempted to answer the following questions: (1) What regulatory standards and guidance are available for regulating health apps for self-management across sub-Saharan Africa? (2) To what extent do regulatory standards and guidance regulate health apps for self-management in terms of what aspects are regulated; why, how, and for whom; and what aspects are not regulated? (3) Who are the key stakeholders and what are their roles in regulating health apps for self-management?

Study Design

The process of this scoping review followed the methodological framework for conducting a scoping study originally described by Arksey and O’Malley [ 34 ] and the updated methodological guidance for conducting a Joanna Briggs Institute scoping review [ 34 - 37 ]. The reporting of the review was guided by the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist [ 38 ]. A completed PRISMA-ScR checklist is provided in Multimedia Appendix 1 . The protocol of this scoping review was published in BMJ Open [ 30 ].

Identifying Relevant Documents

Two reviewers (BAB and SI) developed the search strategy with the assistance of a librarian and in consultation with other research team members (KPF, BIH, NU, NM, AM, and JC). The following key terms were included: policy, legislation, strategy, regulation, standard, criterion, framework, guidance, guideline, digital health, eHealth, app, WHO African Region, and sub-Saharan Africa, and the names of all sub-Saharan African countries.

Owing to the absence of regulatory standards and guidance in scientific databases, the search focus was narrowed down to gray literature sources and institutional websites, including OpenGrey, WHO Regional Office for Africa (AFRO) Library, repositories for digital health policies (ICTworks, WHO’s Directory of eHealth Policies, and Health Information System Strengthening Resource Center), as well as the websites of WHO, International Telecommunication Union (ITU), and Ministries of Health (MOHs). The only scientific databases searched were PubMed, Scopus, and WHO AIM. PubMed was not included in the protocol. We also conducted a systematic search on Google. We used truncation to increase the yield of the results. The search strategy was then applied across PubMed, Scopus, and WHO AIM databases using Boolean terms (mainly OR and AND ) to combine search results. Gray literature sources and institutional websites were searched using phrases containing ≥2 keywords such as “eHealth regulation,” “digital health regulatory standard,” “eHealth regulatory standard,” “digital health regulation,” “digital health policy,” “eHealth policy,” “digital health strategy,” and “eHealth strategy.” For Google search, we added the names of the country to the phrases (eg, “digital health regulation Nigeria”). The reference lists of the included documents were also searched, and key individuals at the MOHs, WHO Country Offices, and the WHO AFRO were contacted for related documents. When our search was conducted, the WHO Directory of eHealth policies website was unavailable, and the WHO AFRO Library was undergoing reconstruction. The search strategies for PubMed, Scopus, and WHO AIM are provided in Multimedia Appendix 2 . The search was conducted between 2005 and January 2024.

Study Selection

The search results obtained from PubMed, Scopus, and WHO AIM were imported into Mendeley (Elsevier) [ 39 ] to remove duplicates. The search conducted on OpenGrey did not yield any results, whereas relevant records obtained from institutional websites, repositories, and Google were downloaded as PDF copies and uploaded to Mendeley. After removing duplicates, the remaining results were imported into Covidence (Veritas Health Innovation) [ 40 ] for screening. Two reviewers (BAB and SI) applied the predefined eligibility criteria ( Textbox 1 ) to screen the documents in 2 stages (title and abstract or executive summary). All discrepancies were discussed until the reviewers reached agreement.

Inclusion criteria

• Type of document: Regulatory standards, guidance, policies, strategies, and committee or government reports that address regulatory issues related to the use of health apps for self-management
• Location: Documents developed and implemented in countries within sub-Saharan Africa
• Date of publication: Documents developed since 2005; the global efforts toward promoting standards to minimize variability and potential harms that could arise from poorly regulated use of digital health began in 2005 [ 33 ]
• Language: Documents written in English language and other official languages of sub-Saharan African countries (Portuguese and French)

Exclusion criteria

• Type of document: Standards, guidance, policies, strategies, and reports not related to regulation of health apps
• Location: Documents from countries outside sub-Saharan Africa
• Date of publication: Documents developed before 2005
• Language: None

Data Charting (Extraction)

Two reviewers (BAB and SI), in consultation with the other members of the research team, developed the data extraction forms using an iterative process that included piloting data extraction and refinement until a consensus was reached.

We proposed in the study protocol [ 30 ] that data extraction would be conducted by the 2 reviewers independently. However, owing to the approach adopted for data extraction (deductive qualitative content analysis), 1 reviewer, rather than 2, initially extracted data from the included documents, and any concerns were discussed with a second reviewer [ 41 ]. Unresolved issues were then discussed and resolved with a third reviewer in a steering group meeting.

Collating, Summarizing, and Reporting Results

To address the research questions (particularly question 2), we adopted a deductive descriptive qualitative content analysis method to analyze and report the key findings. The policy analysis framework by Walt and Gilson [ 42 ] was adapted and applied to ensure that there was a consistent way of organizing the key findings: (1) Content (which aspects are regulated and which aspects are not?)—these are the components that directly or indirectly address regulatory issues related to the use of health apps for self-management, including areas that have not been addressed. (2) Context (why are those aspects regulated?)—this characterizes the rationale indicated for addressing regulatory issues related to the use of health apps for self-management. (3) Process (how are the regulatory standards developed and implemented?)—this describes the methods or approaches used to develop and implement regulatory standards. (4) Actors (who are the regulatory standards targeted toward?)—these are the key actors targeted by the standards.

Using a deductive descriptive qualitative content analysis approach, we examined each included document to systematically identify texts for concepts, patterns, and other relevant information. We then categorized them under content, context, process, or actors in relation to regulating health apps for self-management. The findings under content and context were further organized based on 4 predefined regulatory categories or themes as documented in the literature, namely (1) technical and clinical safety [ 12 - 14 ], (2) data protection and security [ 15 , 16 ], (3) standards and interoperability [ 28 , 31 ], and (4) inclusion and equitable access [ 24 - 29 ].

To address the third research question, the Reporting Items for Stakeholder Analysis (RISA) tool [ 41 ] was used as a guide to group key stakeholders based on role categorization as recognized globally by the WHO, the ITU, and UNESCO [ 32 , 33 , 43 ].

Ethical Considerations

Primary data were not collected in this study. Therefore, no ethics approval was required.

Search Results

A total of 2900 records were obtained after removing duplicates. Although the literature search was conducted in English, the search also yielded documents written in French and Portuguese from the ICTworks repository [ 44 ]. Following the initial screening of the title and abstract (or executive summaries), 73 documents were retrieved for full-text assessment. After applying the inclusion criteria for the full-text assessment, 49 documents were found eligible for inclusion in the review.

The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow diagram [ 45 ] showing the study selection process is presented in Figure 1 .

Types of Documents

On the basis of the inclusion criteria, 3 categories of documents were considered for this review, namely “stand-alone regulatory standards and guidance that potentially regulate health apps for self-management,” “national policies and strategies on digital health,” and “other national documents that relate to the regulation of health apps for self-management.” Table 1 presents the types of documents obtained for each country within sub-Saharan Africa.

Characteristics of the Included Documents

Stand-alone regulatory standards and guidance.

We identified and included 6 stand-alone regulatory standards [ 18 , 19 , 46 - 49 ] from 3 countries (Ethiopia, Kenya, and Nigeria). All 6 documents were written in English. The years of development ranged between 2013 and 2021, as indicated in Multimedia Appendix 3 . The years of implementation were not specifically stated.

Although none of the included regulatory standards were exclusively developed to regulate health apps for self-management, 3 of them (Kenya Standards and Guidelines for mHealth Systems [ 18 ], Kenya Standards and Guidelines for E-Health Systems Interoperability [ 47 ], and Health Sector Information and Communications Technology Standards and Guidelines [ 48 ]) provided concept and information relevant to the regulation of health apps and were included in the qualitative content analysis. The Kenya Standards and Guidelines for mHealth Systems [ 18 ] provides standards and guidelines on the design, development, and implementation of mobile health (mHealth) solutions to ensure they are interoperable, scalable, and sustainable. The Kenya Standards and Guidelines for E-Health Systems Interoperability [ 47 ] outlines the principles, requirements, and standards for eHealth systems interoperability in Kenya. The Health Sector Information and Communications Technology Standards and Guidelines [ 48 ] provide guidance and a consistent approach across the health sector in Kenya for establishing, acquiring, and maintaining current and future information systems and information and communications technology (ICT) infrastructure that foster interoperability across systems. These 3 documents are a good combination of regulatory standards and guidance that provide content and context relevant to the regulation of health apps in sub-Saharan Africa.

The remaining 3 standards (standard for electronic health record [EHR] system in Ethiopia [ 19 ], standards and guidelines for electronic medical record systems in Kenya [ 46 ], and the health information exchange standard operating procedure and guideline [ 49 ]) were exclusively developed for EHRs or electronic medical records. However, they contain information relevant for mapping stakeholders with potential roles in regulating health apps for supporting self-management.

National Policies and Strategies on Digital Health

This review includes 35 national policies and strategies that are related to digital health (potentially covering health apps) [ 50 - 84 ] from 31 countries written in English, French, and Portuguese (Benin, Botswana, Burkina Faso, Burundi, Cameroon, Comoros, Côte d’Ivoire [Ivory Coast], Democratic Republic of the Congo, Eswatini, Ethiopia, Gabon, Ghana, Kenya, Liberia, Madagascar, Malawi, Mali, Mauritius, Mozambique, Namibia, Niger, Nigeria, Rwanda, Senegal, Sierra Leone, South Africa, Tanzania, Togo, Uganda, Zambia, and Zimbabwe). Although the literature search was conducted in English, it also yielded documents written in French and Portuguese from the ICTworks repository. The years of development and implementation range between 2005 and 2030. Policies and strategies written in French and Portuguese were translated into English using Google Translate. Documents labeled as national development plans, strategic plans, and strategic development plans were considered as national strategies.

National policies and strategies do not offer specific standards or guidance, but rather outline the country’s vision, policy directions, and strategies for using digital technologies in health care. They provide useful information for identifying digital health stakeholders who can play a role in regulating health apps for self-management. For example, Nigeria has a separate National Digital Health Policy [ 72 ] and a National Digital Health Strategy [ 71 ]. Both documents were developed by building on the lessons learned from the end-term evaluation of the previous National Health ICT Strategic Framework [ 85 ]. They describe Nigeria’s renewed vision, mission, goals, objectives, and strategies for the development and implementation of digital health with the aim to improve the quality, efficiency, and effectiveness of health service delivery and health outcomes.

It is worth noting that for countries with >1 policy or strategy, we included only the most recent versions. For instance, as mentioned earlier, Nigeria now has both a national digital health policy and a national digital health strategy. These 2 documents supersede and thus replace the old National Health ICT Strategic Framework [ 86 ]. Details of included documents are presented in Multimedia Appendix 3 .

Other Related National Documents

We included 8 other documents [ 20 , 85 , 87 - 92 ] from 6 countries (Ethiopia, Kenya, Liberia, Nigeria, South Africa, and Tanzania) that did not fall under either stand-alone regulatory standards and guidance or national policies and strategies. These were mostly frameworks, road maps, and reports that potentially provide information relevant to the use of health apps. The years of development and implementation range from 2016 to 2025. These documents do not provide standards or guidance, but they contain information that can help map the digital health stakeholders that potentially play a role in regulating health apps for self-management. When multiple versions of a document exist, only the latest version was taken into consideration. Multimedia Appendix 3 provides details of the included documents.

Content: Aspects That Are Regulated and Aspects That Are Not

Technical and clinical safety.

Technical and clinical safety standards are required to prevent or minimize the harm that may arise from the use of the health ICT systems (including mHealth systems) as well as to improve the health outcomes and user satisfaction. As shown in Figure 2 , two subthemes were generated from included standards [ 18 , 47 , 48 ] as content under technical and clinical safety: v(1) guidance on system quality and (2) guidance on software or app development, acquisition, support, and maintenance.

Notably, 2 of the included standards [ 18 , 47 ] provide guidance on system quality to ensure the quality, security, reliability, performance, and maintenance of eHealth and mHealth systems. The Kenya Standards and Guidelines for E-Health Systems Interoperability [ 47 ] recommend the implementation of a data quality protocol to ensure that the data collection, collation, analysis, interpretation, dissemination, and use are managed in accordance with the quality standards. Similarly, the Kenya Standards and Guidelines for mHealth Systems [ 18 ] recommends the inclusion of the following requirements in the technical manual: (1) minimum hardware requirements that should incorporate the preferred hardware architecture, (2) minimum software requirements that should include the minimum version of the underlying operating system as well as acceptable versions of related software, and (3) a detailed list of software dependencies (external libraries) necessary for the system to function properly.

The included standards [ 18 , 48 ] cover guidance on software or app development, acquisition, support, and maintenance, which aim to ensure the efficiency and effectiveness of eHealth and mHealth systems. The Kenya Standards and Guidelines for mHealth Systems [ 18 ] recommends a technical manual to provide a detailed description of the system’s installation and maintenance processes for system administrators and implementers; a developer’s guide for software developers and programmers to provide them with an overview of the system, description of the software design methodologies, description of the system architecture, and technical design diagrams; and a user manual to aid users in understanding how the system works and how each feature operates; in addition, the technical manual contains instructions for operating the software; entering and updating data; and generating, saving, and printing reports.

Although the contents generated here provide guidance that is relevant to health apps, they are not specific to health apps. Moreover, there are no clear measures to enable individuals or organizations that use health apps to manage clinical risk appropriately.

Data Protection and Security

Data protection and security are crucial aspects of managing patient information, thus ensuring the confidentiality, integrity, and availability of data as well as the rights and interests of the patient. Two subthemes related to data protection and security are (1) security measures for adequate protection of patients’ digital records and (2) guidance on data exchange.

The included standards [ 18 , 48 ] provide security measures for eHealth or mHealth systems to ensure the adequate protection of digitally accessible patient records. These measures include authentication, accountability, identification, authorization, integrity, confidentiality, availability, security, administration, and audit. This will help to achieve confidentiality, integrity, availability, and nonrepudiation of patient data or health records. Additional levels of security such as data encryption are required when there is a need to store sensitive information on removable devices or media or outside the MOH premises.

The Kenya Standards and Guidelines for mHealth Systems [ 18 ] provide the following guidance on data exchange to ensure privacy: (1) anonymize client data as much as possible before they can be shared; (2) where possible, use pseudonyms for the client data before they can be shared; (3) aggregate client data before they can be shared to reduce possibilities of tracing the data back to the client; and (4) minimize data so that access is available only to the data set required for that particular use. With regard to privacy rules, the Kenya Standards and Guidelines for E-Health Systems Interoperability [ 47 ] propose that a notice of privacy practices should be given to patients describing how their information may be used or shared while also specifying their legal rights.

Standards and Interoperability

Standards and interoperability are essential concepts in the field of IT, especially for systems that need to communicate and exchange data, as seen in the use of health apps for self-management. Two subthemes related to standards and interoperability are (1) interoperability as a basic requirement and (2) minimum standards to enable integration.

All the regulatory standards [ 18 , 47 , 48 ] highlight the importance of having interoperability as a basic requirement when selecting software products or services for use within the health system. This facilitates interaction across systems. For instance, to facilitate seamless interaction between mHealth systems and primary information systems for data capture, reporting, and decision support in various domains of the health system, the Kenya Standards and Guidelines for mHealth Systems [ 18 ] recommends the incorporation of at least 3 types of interoperability, namely, technical interoperability, semantic interoperability, and process interoperability.

Furthermore, 2 regulatory standards [ 18 , 47 ] proposed minimum interoperability standards to enable the integration of services and data exchange between various systems in health care. For instance, the Kenya Standards and Guidelines for mHealth Systems [ 18 ] suggests standards (for interoperability) for mHealth systems that are consistent with the recommendations in internationally accepted standards. They include the following: (1) clinical messaging—ensuring mHealth systems conform to Health Level 7 (HL7) version 3 standards and corresponding implementation guideline; (2) clinical terminology—ensuring terminologies and classifications for clinical concepts (eg, International Classification of Diseases, tenth revision—for diseases; Systemized Nomenclature of Medicine—for clinical data coding; Logical Observation Identifiers Names and Codes—for laboratories; and RxNorm—for Pharmacies); (3) the mHealth system must use the latest versions of international standards, such as HL7 Clinical Document Architecture for electronic sharing of clinical documents; (4) concepts—mHealth systems will use the idea of “concepts” so that information can be transmitted between systems without losing meaning or context, and HL7 Reference Implementation Model or other appropriate standards are recommended for implementing concepts; (5) architecture—to develop mHealth systems, developers should define the system architecture that should include data elements and business logic. Furthermore, to define how mHealth systems interact with other systems, developers of mHealth solutions must provide application programming interfaces. FHIR is the preferred application programming interface interoperability standard.

Inclusion and Equitable Access

Inclusion and equitable access are essential principles to ensure that health apps are culturally appropriate and relevant and accessible to everyone, regardless of gender, ethnicity, location, or economic status.

All the included regulatory standards [ 18 , 47 , 48 ] indicate that they were developed based on a combination of participatory and consultative approaches involving multiple actors or stakeholders, thus promoting inclusion. However, there are no specific measures or guidance to ensure adequate engagement and representation of all the relevant stakeholders and to sustain that engagement.

The Kenya Standards and Guidelines for mHealth Systems [ 18 ] proposes the following systems attributes to ensure equitable access to mHealth services at all times and from anywhere: (1) allocation of adequate storage and bandwidth capacity; (2) fast response time; (3) fast recovery capabilities; (4) performance monitoring; (5) business continuity processes, for example, backups; and (6) redundant sites and links. Furthermore, the Kenya Standards and Guidelines for mHealth Systems [ 18 ] prescribes the following metrics for measuring system availability: (1) downtime per year, (2) mean time between failure, (3) mean time to repair, and (4) failure in time.

Although the abovementioned systems attributes and metrics for measuring system availability are important, the included standards do not offer any concrete guidance or model for achieving a sustainable funding mechanism for health apps to ensure that they are readily available and accessible to those who need them.

Context: Reasons Why Those Aspects Are Regulated

The 3 standards [ 18 , 47 , 48 ] were developed to address unsafe, isolated, and inconsistent implementation. The Health Sector ICT Standards and Guidelines [ 48 ] suggest that although there has been a lot of ICT investment in the health sector leading to improvement in service delivery and information exchange, there remains the challenge of inconsistency in ICT implementation and harmonization of the health sector system requirements. Hence, there is a need to adopt global best practices for software development, acquisition, support, and maintenance by the MOH. In addition, the Kenya Standards and Guidelines for mHealth Systems [ 18 ] indicates that standards and guidelines are necessary to ensure a consistent approach to the development of ICT systems. Similarly, the Kenya Standards and Guidelines for E-Health Systems Interoperability [ 47 ] recognize the need to ensure that the processes of collecting, collating, analyzing, interpreting, disseminating, and using data are consistent with data quality standards.

To build mutual trust and maximize the benefits of eHealth information exchange, the Kenya Standards and Guidelines for E-Health Systems Interoperability [ 47 ] reiterate that as health data are constantly being exchanged across health information systems, robust security standards are required to maintain their integrity and confidentiality. This will build the trust of service users and consequently help to maximize the benefits of eHealth information exchange such as in self-management.

Two of the included regulatory standards [ 47 , 48 ] indicate that the context for standards and interoperability was (1) to address poor coordination, duplication of efforts, and inefficient use of resources and (2) to promote the integration of ICT systems.

The Kenya Standards and Guidelines for E-Health Systems Interoperability [ 47 ] acknowledge that the absence of interoperability standards over the years has led to the duplication of efforts and the inefficient use of ICT resources in health care. Now that ICT has become increasingly relevant in improving efficiency in health service delivery, the Kenya MOH recognizes the need to adopt a standardized approach, hence the development of interoperability standards for eHealth systems. In addition, the Health Sector ICT Standards and Guidelines [ 48 ] emphasize the relevance of interoperability as a requirement for addressing the inconsistency in implementing ICT in the health sector.

The Health Sector ICT Standards and Guidelines [ 48 ] consider “integration of ICT systems” as one of its key guiding principles, acknowledging the lack of information systems integration as a challenge experienced by ICT services across Kenya.

The contexts for inclusion and equitable access as generated from included standards [ 18 , 47 , 48 ] were (1) to promote inclusion and (2) to promote equitable access to services.

To promote inclusion, the standards [ 18 , 47 , 48 ] highlight the importance of involving and engaging multiple actors and stakeholders during the development process. However, no emphasis was placed on the need to sustain stakeholder engagement during the implementation process.

Pertaining to equitable access, the Kenya Standards and Guidelines for mHealth Systems [ 18 ] acknowledges that the public health care system is largely unavailable to most of the population in many developing countries because of geographical location, resource constraints, inefficiencies, and lack of awareness. Hence, it recognizes the importance of ensuring that mHealth services are always accessible by users and from anywhere as well as the need to put in place mechanisms to make this happen.

Process: How the Regulations Are Developed and Implemented

Two themes were generated from the included standards: development and implementation processes [ 18 , 47 , 48 ].

Development Process

All the included standards [ 18 , 47 , 48 ] indicate that they were developed through a participatory process and in consultation with a range of subject experts and interest groups. In addition, the standards [ 18 , 47 , 48 ] adopted a multisectoral approach to engage health-related stakeholders from government ministries or agencies and development partners and a range of subject experts and interest groups. It has also been reported that these standards [ 18 , 47 , 48 ] were developed based on international best practices and with reference to international standards. However, there is no indication that a stakeholder engagement strategy was adopted to sustain the engagement of stakeholders through the entire development and implementation process.

Implementation Process

The 3 regulatory standards [ 18 , 47 , 48 ] identify the key requirements to ensure effective implementation of IT services in the health sector. These are (1) legal authority, (2) coordination, (3) building capacity, and (4) monitoring and evaluation.

The included standards [ 18 , 47 , 48 ] were established based on the legal provisions enshrined in the health and other related acts and laws of Kenya as well as the relevant policies and strategies. Hence, it is expected that their implementation will comply with and be backed by those legal provisions. For example, the Health Sector ICT Standards and Guidelines [ 48 ] indicate that its implementation will be supported by the authority from the Kenya Communications Act 2009, E-Government Strategy, and National ICT Policy. Similarly, the Kenya Standards and Guidelines for mHealth Systems [ 18 ] asserts that it will be implemented by complying with existing and relevant national policies, legal frameworks, strategies, and standards, including the Health Information Policy, ICT Standards, and System Interoperability Principles.

The included standards [ 18 , 47 , 48 ] report that the implementation of regulations will require robust coordination mechanisms. For instance, the Health Sector ICT Standards and Guidelines [ 48 ] indicate that, as the Ministry’s ICT resource manager, the principal secretary (also the head of ICT), in collaboration with the ICT Governance Committee, is responsible for coordinating the implementation of the standard. The ICT Governance Committee comprises representatives from the heads of departments and ICT development partners in the health sector. The committee’s responsibilities include overseeing, enforcing, and reviewing standards as well as initiating ICT projects.

The Health Sector ICT Standards and Guidelines [ 48 ] highlight the need for capacity building or training of the MOH staff and stakeholders who are the primary users of the Ministry’s ICT services. This will enhance their capacity to implement the guidelines provided in the document in line with the ministry’s human resource development policies, regulations, and rules. However, it is acknowledged that building capacity for health ICT is a challenge given that there is low adoption of ICT among health providers, and ICT is not routinely included in the course content of most training programs. The Kenya Standards and Guidelines for mHealth Systems [ 18 ] listed the “number of mHealth practitioners trained on the standards and guidelines” as one of the indicators for monitoring and evaluating mHealth interventions.

The Health Sector ICT Standards and Guidelines [ 48 ] assert that monitoring and evaluation is an essential role of the MOH to ensure efficiency, accountability, and transparency throughout the implementation period. It further stresses that all those who use the Ministry’s ICT services are required to adhere to the provisions in the standard as the MOH will carry out quarterly monitoring exercises on the use of the standard to ensure compliance based on clear indicators. Furthermore, the ICT Governance Committee will periodically review and amend the standard to keep it relevant and effective. Similarly, the Kenya Standards and Guidelines for mHealth Systems [ 18 ] establishes the following key indicators for effectively monitoring and evaluating the implementation of the standards and guidelines: (1) the number of counties in which the MOH has disseminated the standards and guidelines, (2) the number of counties successfully implementing the standards and guidelines, (3) the number of mHealth practitioners trained on the standards and guidelines, (4) the number of mHealth practitioners accessing the standards and guidelines, (5) the number of mHealth practitioners who correctly understand the standards and guidelines, (6) the number of stakeholders who adhere to the standards and guidelines, (7) the number of mHealth systems that follow the required development steps, and (8) the number of mHealth practitioners who have implemented their systems by using the standards and guidelines. In addition, the Kenya Standards and Guidelines for mHealth Systems [ 18 ] indicates that the outlined standards will be reviewed every 3 years to ensure they are up to date with new changes including the changes in policies and systems upgrades.

Although all the abovementioned indicators are relevant, the implementation process is not explicit on the approach for regulating health apps and ensuring compliance with regulatory standards and guidance.

Actors: Those the Regulations Are Targeted at

The included standards [ 18 , 47 , 48 ] identified 2 main groups of actors for whom the regulations and guidance were targeted. They included (1) those who provide digital health services and (2) those who use the ICT infrastructure of the MOH.

Two of the standards [ 47 , 48 ] indicated that the regulations should be implemented by all individuals and organizations that provide ICT-related health care services to the public. Similarly, the Health Sector ICT Standards and Guidelines [ 48 ] state that all those who access or use the MOH ICT infrastructure are expected to adhere to the guidelines outlined in the document.

Mapping of Stakeholders

To address the third research question, we conducted a stakeholder mapping guided by the RISA tool [ 41 ].

A total of 11 categories of key stakeholders were identified from all 49 included documents (6 stand-alone regulatory standards and guidance, 35 national policies or strategies, and 8 other related documents). These categories are consistent with the digital health stakeholders recognized by the WHO, ITU, and UNESCO [ 32 , 33 , 43 ]. Table 2 presents the mapping of stakeholders according to their role categorization. A more detailed table with a potential role description with regard to regulating health apps for self-management is presented in Multimedia Appendix 4 .

a WHO: World Health Organization.

This paper presents the findings of a scoping review of regulatory standards and guidance for the use of health apps for self-management in sub-Saharan Africa. To the best of our knowledge, this is the first study that attempted to identify and assess the extent to which regulatory standards and guidance regulate and guide the use of health apps for self-management in sub-Saharan Africa as well as map out the key stakeholders and their potential roles.

Our findings reveal that only 1 country (Kenya) in sub-Saharan Africa currently has national regulatory standards that could potentially regulate the use of health apps for self-management. The included standards failed to adequately address adequate attention to inclusion and equitable access. This is concerning given the growing need to promote the adoption of culturally appropriate and relevant health apps and to ensure that they are available to those who need them regardless of gender, ethnicity, geographical location, or financial status [ 24 - 29 ]. Consequently, this review provides insights into the regulation of health apps for self-management in sub-Saharan Africa, which needs to be given more attention if the potential of these apps is to be harnessed in the region.

Principal Findings

We identified 49 documents from 31 countries in sub-Saharan Africa. Although none of the included standards provided a specific set of regulations on health apps for self-management, we identified 3 standards [ 18 , 47 , 48 ] that provided relevant information regarding the regulation of health apps. The included national policies and strategies, in contrast, only outline the goals and commitments made by national governments to promote the adoption of digital technologies in the health sector and the plans and paths set forth to achieve these goals. However, the information they provided was relevant for identifying and mapping digital health stakeholders who potentially have vital roles in regulating the use of health apps for self-management.

The policy analysis framework (content, context, process, and actors) [ 42 ] was adapted and applied to organize the key findings. The content covered the following areas: guidance on systems quality; guidance on software and app development, acquisition, support, and maintenance; security measures for adequate protection of patients’ digital records; guidance on data exchange; interoperability as a basic requirement; minimum standards to enable integration; involvement and engagement of relevant stakeholders; and system attributes for equitable access to services. Meanwhile, the context was to address unsafe, isolated, and inconsistent implementation; to build mutual trust and maximize the benefits of eHealth information exchange; to address poor coordination, duplication of efforts, and inefficient use of resources; to promote the integration of ICT systems; and to promote inclusion and equitable access to services. The process involved the development process (which covers participatory and consultative processes and multisectoral approach, with reference to international standards and best practices) and the implementation process (which covers legal authority, coordination, capacity building, and monitoring and evaluation). The targeted actors were those who provided digital health services and those who used the ICT infrastructure of the MOH.

Furthermore, key stakeholders with potential roles in regulating health apps for self-management were identified. They include the government, regulatory bodies, funders, intergovernmental and nongovernmental organizations, academia, and the health care community.

Implications of the Study Findings for Practice

Regulatory standards and guidance act as a bridge between technological innovation and its safe and effective use in health care. They ensure that while technology continues to advance, the safety and trust of patients are never compromised. Among the plethora of health apps on the market, the over-the-counter, nonregulated apps such as wellness and fitness apps are the most mainstream [ 93 - 95 ]. On the other side of the spectrum, there are regulated health apps that are classified under medical devices or software as medical device products [ 94 , 95 ]. Some of these are prescription-only apps, such as digital therapeutics (DTx) apps for managing substance dependence [ 95 , 96 ].

Although some high-income countries have made significant strides in ensuring the safety, effectiveness, and accessibility of health apps, the journey has indeed not been without challenges and hurdles. Sub-Saharan Africa, although dealing with its own unique set of challenges, has the opportunity to learn from the experiences of these high-income countries. This could potentially allow the region to bypass some of the hurdles encountered by high-income countries in their journeys.

Technical and clinical safety are essential requirements that health apps must meet before they can be considered for use for self-management to minimize the risk of harm to patients. It is well documented that health apps that function poorly pose a serious threat to the safety of patients. An example illustrating how health apps used for self-management can threaten patient safety is evident in a study [ 12 ]. This study [ 12 ] revealed that widely used health apps designed to calculate and estimate insulin doses could endanger patients by providing incorrect or inappropriate dose recommendations. Similarly, 2 successive studies that assessed the contents and tools of apps for asthma discovered that none of the apps in the first study offered comprehensive information or adequate tools for asthma self-management, whereas the follow-up study, which was conducted 2 years later, showed a 2-fold increase in the number of asthma apps, yet there was no improvement in the content and tools offered by the newer apps. In fact, many apps recommended self-management procedures that were not supported by evidence [ 13 , 14 ]. Accordingly, some health apps that support the self-management of long-term conditions do not adhere to evidence-based guidelines and are unresponsive to the evolving health needs of patients.

Although the context of included regulatory standards with regard to technical and clinical safety was to address unsafe, isolated, and inconsistent implementation, the guidance provided by these regulatory standards is not specific to health apps, and they do not provide appropriate guidance and standards for health organizations and other key stakeholders to establish a framework for managing the clinical risks associated with deploying and implementing self-management health apps. Considering the rapid advancements in digital health (including artificial intelligence [AI] or machine learning and big data), health apps will increasingly play a crucial role in supporting self-management through digitally enabled care pathways that will improve personalized care and health outcomes [ 97 , 98 ]. Therefore, it is imperative to ensure the technical reliability and clinical safety of health apps for self-management through robust regulatory standards and guidance. For instance, a guide on the criteria for health app assessment, developed by the UK government, includes technical stability and clinical safety as criteria for deciding whether health apps should be considered for use in the National Health Service (NHS) [ 99 ]. In addition, medical device apps are required to conform to the NHS clinical risk management standards as part of the clinical safety requirements [ 99 , 100 ]. In the event of any concerns regarding the safety of a medical device app, the Yellow Card reporting system can be used by a responsible clinical safety officer or any other individual to notify the Medicines and Healthcare products Regulatory Agency (MHRA) [ 101 , 102 ].

To adequately manage patient information when health apps are used for self-management, data protection and security standards and guidance are required. They guarantee that data are kept and handled safely and responsibly within the provisions of the law and that patients’ rights and interests are respected.

There have been ongoing concerns about compliance with ethical standards, the principles of confidentiality of information, and data privacy. For example, an assessment of apps that had previously been endorsed by the former UK NHS Apps Library revealed substantial gaps in compliance with data protection principles regarding the collection, storage, and transmission of personal information. This has raised a fundamental concern about the credibility of developer disclosures and whether these disclosures can be trusted by certification programs [ 15 ]. A study assessed the privacy practices of the 36 most popular apps for depression and smoking cessation for Android and iOS in the United States and Australia [ 16 ]. The findings revealed that although only 69% (25/36) of the apps included a privacy policy, 92% (33/36) of the apps shared data with a third party, and only 92% (23/25 with privacy policy) of the apps disclosed sharing data with a third party in their policy. Although 81% (29/36) of the apps shared data with Google and Facebook for the purposes of advertising, marketing, or analytics, only 43% (12/28) of the apps that shared data with Google and 50% (6/12) of the apps that shared data with Facebook disclosed this in their policy [ 16 ].

In this regard, health app developers and providers in the United Kingdom are required to conduct a data protection risk assessment before they launch or update their apps to ensure compliance with the United Kingdom General Data Protection Regulation (GDPR) and other relevant regulations, including the Data Protection Act 2018 [ 103 ]. By conducting a data protection risk assessment, health app developers and providers can demonstrate that they are accountable; they respect the privacy and dignity of their users; and that they deliver safe, effective, and ethical solutions [ 104 ].

Health apps are expected to play an increasingly important role in supporting self-management. However, this ambition can only be achieved if citizens trust that these apps are collecting and analyzing data safely and in accordance with robust regulatory standards and guidance. It is also crucial that these apps provide reliable information that clinicians can act on [ 98 ]. The context of the standards included in this study regarding data protection and security was to build mutual trust and maximize the benefits of eHealth information exchange. Trust is a key factor in the successful adoption and use of health apps, and transparency in data handling and clinical decision-making is essential to build and maintain that trust. This is also paramount for the widespread acceptance and impact of health apps on health care outcomes in sub-Saharan Africa.

We acknowledge the existence of numerous national laws related to data protection and security outside the health sector. Hence, guidelines that link these legislations together must be provided to ensure compliance with all relevant laws and guidance when using patient data. An example of how to achieve this is the United Kingdome’s guide to good practice for digital and data-driven health technologies that provides guidelines on how to abide by the laws and principles that govern data security and protection in the United Kingdom, including the GDPR, Data Protection Act 2018, and Caldicott Principles [ 105 ].

Standards and interoperability are essential for effectively developing, deploying, and implementing health apps to support self-management in sub-Saharan Africa. Interoperability is the ability of different systems, devices, or applications to communicate and exchange data with each other in a coordinated manner, thus providing timely and seamless portable information across organizational, regional, and national boundaries and optimizing both individual and population health [ 106 ]. In the same vein, standards enable interoperability between systems or devices through a common language and a common set of expectations [ 106 ].

Interoperability is crucial in improving the quality, safety, and efficiency of care delivery as well as empowering patients and providers with access to relevant and timely information [ 99 ]. One of the most widely used and accepted interoperability standards for health care data exchange is FHIR [ 106 , 107 ]. FHIR is a global industry standard developed by HL7 International. FHIR is designed to be quick to learn and implement and to support a variety of use cases, including self-management [ 108 ]. By using apps that are based on an FHIR standard, patients can benefit from data analytics that show how their health data relate to their chronic conditions or wellness goals [ 109 ]. They could also access all their health information from one place, even if they visit different health professionals who use different electronic medical records or EHR, thus promoting integrated care [ 28 , 31 , 33 , 109 - 115 ]. As a result, patient care can easily be coordinated.

The context of the included regulatory standards with regard to standards and interoperability was to address poor coordination, duplication of efforts, and inefficient use of resources and to promote the integration of ICT systems. However, in sub-Saharan Africa, there are many challenges and barriers to the adoption and implementation of interoperability standards, such as the lack of awareness or knowledge of the benefits and requirements of interoperability standards among stakeholders; lack of incentives or regulations to encourage or enforce the adoption of interoperability standards by app developers and vendors; lack of resources or capacity to implement interoperability standards, including technical expertise, infrastructure, funding, or governance; and lack of alignment or coordination among the different actors and initiatives involved in developing, deploying, and implementing the digital health interventions [ 30 , 116 - 119 ]. To address these challenges, some possible solutions may include raising awareness and education on the importance and value of interoperability standards for health apps among all relevant actors; developing and implementing policies and guidelines that promote or mandate the use of interoperability standards by app developers and vendors; providing technical assistance and support for app developers and vendors to adopt and implement interoperability standards, such as tools, frameworks, testing, certification, or accreditation; and establishing and strengthening collaboration and coordination among the different stakeholders and initiatives involved in health app development, deployment, and implementation in sub-Saharan Africa. In addition, the Digital Health Platform Handbook, a toolkit developed by the collaborative efforts of the WHO and ITU [ 120 ], can help countries in sub-Saharan Africa to develop and implement digital health platforms as the underlying infrastructure for interoperable and integrated national digital health systems. The digital health platform is a system-wide approach to developing digital health solutions with the aim to overcome the problems of siloed, vertical, and isolated applications and systems that hamper data management, innovation, efficiency, and impact in the health sector.

Inclusion and equitable access are crucial to ensuring that health apps and related services are culturally appropriate and relevant as well as accessible to all who need them, regardless of gender, ethnicity, geographical location, ability, or financial status [ 24 - 29 ]. This is the key to promoting a “sense of belonging” and “ownership” and thus underscoring the importance of stakeholder mapping and involvement or engagement through the development and implementation process [ 22 ].

In this study, the included regulatory standards demonstrate the importance of inclusion by adopting both a participatory and consultative approach involving multiple stakeholders from different sectors. However, the standards do not provide clear guidance to ensure the adequate participation and sustained engagement of all relevant stakeholders. The lack of concise guidance to ensure the adequate participation and engagement of all relevant stakeholders, especially the susceptible and disadvantaged groups, can increase the risk of tokenistic tendencies, which can undermine the cultural appropriateness of health apps [ 25 , 121 ]. Some susceptible groups, such as women and people with low socioeconomic status, may face additional barriers to accessing and using health apps, such as lack of digital literacy, privacy concerns, cultural norms, or stigma [ 25 ]. Similarly, the cost of developing, maintaining, and updating health apps may not be covered by public or private health insurance schemes, which could limit their affordability and availability for low-income or uninsured populations [ 95 ]. However, there is no specific guidance or model for an effective funding mechanism for health apps in the included regulatory standards.

To address these challenges and ensure equitable access to health apps for self-management in sub-Saharan Africa, possible measures may include developing policies and regulations that support integrating health app interventions into existing health systems and financing mechanisms and engaging with stakeholders from different sectors and backgrounds (including health professionals, patients, communities, governments, civil society, academia, and industry) to co-develop and co-implement frameworks or models that promote the use of health apps for self-management in ways that are responsive to the local context and needs. Moreover, establishing regulations that provide appropriate financing or reimbursement options will reduce the risk of developers of good quality health apps turning to data mining for revenue, thus increasing privacy concerns [ 95 ]. For instance, in Germany, the reimbursement of health apps classified as medical devices (Digitale Gesundheitsanwendungen) was introduced in 2021 under the statutory health insurance [ 122 , 123 ]. When a medical device is prescribed by a physician or a physiotherapist, the manufacturer must submit an application to the German Federal Institute for Drugs and Medical Devices (Bundesinstitut für Arzneimittel und Medizinprodukte) for approval [ 123 ]. The Federal Association of the Statutory Health Insurance Funds (Spitzenverband Bund der Krankenkassen) determines and negotiates the reimbursement thresholds following approval. However, the manufacturer must demonstrate that the app is safe, functional, and of good quality; complies with data protection requirements; and benefits patient care [ 123 ].

The process of regulating health apps essentially involves the development and implementation of regulatory standards and guidance. According to our study, the development process comprises a participatory and consultative process, a multisectoral approach, and a reference to international standards and best practices. In contrast, the implementation process is ongoing and requires appropriate legal authority, coordination, capacity building, and monitoring and evaluation.

We recognize that health apps can be accessed and used by patients from different parts of the world, and this means that countries need to carefully consider whether health apps that are accessed and used by their citizens meet the national or regional legal and ethical requirements, including their cultural and linguistic needs [ 23 ]. For countries in sub-Saharan Africa, a cross-border or regional collaboration between national legal authorities through the coordination of agencies such as the African Medicines Regulatory Harmonization (AMRH) may help to ensure that health apps built for the region are safe, effective, and user-friendly for everyone, considering the contextual differences of the countries [ 23 ]. For instance, all medical device companies that want to sell their products in the European market must obtain a Conformité Européenne (CE) mark for their devices, which indicates that they meet the legal requirements and can be freely circulated within the European Union [ 124 ]. Although the European Union member states regulate medical devices, the European Medicines Agency is involved in the regulatory process.

The regulation of health apps is extremely complex and involves a wide range of stakeholders. Therefore, a robust coordination mechanism is essential to reduce the risk of fragmentation and duplication of efforts and to promote the efficient use of resources. Most countries in sub-Saharan Africa have units in health ministries that coordinate and oversee the regulation of medical products. These units should be autonomous, full-fledged departments with legal authority (boards or commissions) to ensure independent, transparent, and accountable decision-making, but this is often not the case [ 125 ]. These units are recognized by the national authorities as regulators (eg, the National Medicines Regulatory Authority [NMRA]) [ 126 ]. Such organizational structures hinder the effectiveness of the national regulatory authorities in fulfilling their mandate and prevent the establishment of quality management systems to ensure transparent and accountable decision-making [ 125 ].

Furthermore, Essén et al [ 23 ] analyzed health app policy or regulation in 9 high-income countries (Sweden, Norway, Denmark, Netherlands, Belgium, Germany, England, the United States, and Singapore) and found that most of these countries adopted centralized approaches to app evaluation. Although centralized approaches might have advantages over self-evaluation, they may create bottlenecks and limit the availability of high-quality health apps for users. As suggested by Essén et al [ 23 ], a decentralized approach, such as the accreditation of evaluation agencies, maybe a worthwhile solution. However, this will require adequate coordination to ensure the consistency and reliability of the evaluation criteria and methods across different agencies as well as the transparency and accountability of the accreditation process. A possible way to achieve this is to adopt a common framework that can guide the evaluation and accreditation of health apps.

Similarly, the postmarket surveillance (PMS) system, which is a new regulation for medical devices in Europe, is a process of collecting and analyzing data on medical devices after they have been launched into the market to ensure their safety and performance and to identify any problems or need for improvements [ 127 , 128 ]. The PMS system is important because premarket data, which are obtained from testing a medical device before it is launched, have limitations in capturing the long-term performance and risks of the device [ 128 ]. Currently, the PMS system does not cover fitness and wellness apps, which are commonly used in self-management. Hence, Yu [ 93 ] proposed that the PMS system should also be applied to DHTs, such as fitness and wellness apps. They argue that the postmarket data would help regulators periodically review and adjust the regulatory standards for these groups of health apps based on their risks and benefits.

Drawing on the experience of the United Kingdom, it can be clearly demonstrated that the regulation of health apps is a complex, a multifaceted, and an evolving process that involves different regulators and criteria depending on the nature and function of the app. For instance, a centralized NHS Apps Library was launched as a beta site in April 2017 to provide patients with a collection of trusted and easy-to-use digital health tools [ 129 ]. The library provided access to a range of health apps that were reviewed and approved by the NHS, including apps that could help patients manage conditions such as diabetes, mental health, and chronic obstructive pulmonary disease [ 130 ]. However, the library was closed in December 2021 [ 131 ]. Although no reason for the closure was provided on the website, it is likely because of persistent concerns regarding the safety of patients and data privacy involving multiple apps including those listed in the library [ 12 , 14 - 16 , 131 , 132 ]. The NHS App was introduced in January 2019 before the closure of the NHS Apps Library to serve as the gateway for accessing NHS services including ordering repeat prescriptions and booking or managing appointments [ 133 ].

Furthermore, the United Kingdom Health Security Agency, formerly known as Public Health England, issued a guidance on criteria for health app assessment in October 2017 [ 99 ]. The purpose of this guidance was to ensure that all health apps built for the UK population work well and provide clear information about their functions, benefits, and intended outcomes for patients and health care professionals. On the basis of this guidance, those intending to build an app are required to conform to certain regulations before being considered for the app assessment process. The 2 main regulations are the medical device regulation and the Care Quality Commission (CQC) registration. Apps that are considered as medical devices must register with the MHRA and have a CE mark. Apps providing health or social care that fit into 1 of 14 regulated activities are required to register with the CQC before they can be assessed [ 134 ]. CQC is an independent regulator of health and social care services in England.

Similarly, the Organisation for the Review of Care and Health Apps (ORCHA) is a UK-based organization that independently evaluates and distributes health apps. It provides services such as app review, accreditation, curation, and recommendation within the United Kingdom and across the world [ 135 ]. ORCHA also enables organizations (including the NHS) to build a decentralized web-based digital health library of consumer-friendly over-the-counter apps [ 135 - 137 ]. These apps are continuously assessed by ORCHA against the standards and regulations in clinical and professional assurance, data quality and privacy, and usability and accessibility [ 137 ].

In addition, the Digital Technology Assessment Criteria (DTAC) were introduced in beta in October 2020, and its first official version was subsequently launched in February 2021 [ 138 ]. The DTAC plays a crucial role in ensuring that digital health tools meet the necessary standards in areas such as clinical safety, data protection, technical security, interoperability, usability, and accessibility. By serving as the national baseline criteria for DHTs in the NHS and social care, it provides a valuable framework for health care organizations during procurement. It also offers guidance for developers on the expectations for their digital technologies within the NHS and social care. This is an example of how a harmonized framework can help ensure the quality and safety of DHTs, including health apps.

In addition, the National Institute for Health and Care Excellence Evidence Standards Framework is a set of evidence standards for a wide range of DHTs designed to help evaluators and decision makers in the health care system to consistently identify DHTs that are likely to offer benefits to the users and the health care system [ 139 ]. The Evidence Standards Framework was first published in March 2019 and is ideally used before DHTs (including health apps) are considered for commissioning or procurement by the NHS [ 140 ]. It is a crucial tool for ensuring that DHTs are clinically effective and offer value to the health and care system in the United Kingdom. In August 2022, the framework was updated to include AI and data-driven technologies with adaptive algorithms [ 140 ].

Furthermore, DTx apps, which are a type of medical device, are not allowed into the UK market unless they comply with the UK GDPR and meet the requirements of DTAC. In addition, they must bear the CE or UK Conformity Assessed marks [ 141 ]. This means that DTx apps must demonstrate their safety and efficacy through clinical trials and comply with the relevant regulations for data protection and quality standards as regulated by the MHRA. DTx products are also recognized as DHTs under the National Institute for Health and Care Excellence Evidence Standards Framework [ 142 ]. DTx incorporates software to treat, prevent, or manage specific diseases or conditions [ 143 , 144 ]. The fact that DTx products typically focus on a narrow clinical indication and generate evidence of clinical efficacy underscores their potential to make a substantial contribution to self-management and health care delivery in general. The increasing recognition of the role of DTx in patient care by regulators is also noteworthy, and the creation of regulatory and reimbursement pathways for approved apps further enables DTx products to continue to play an important role in impacting health care delivery [ 1 , 143 ]. This is a testament to the potential of regulated health apps to revolutionize health care and improve patient outcomes.

Among the many lessons to learn from the experience of the United Kingdom is that the regulation of health apps must evolve to keep pace with advances in DHTs and adapt to the changing needs and demands of digital health. Moreover, efforts are being made to streamline the multifaceted approaches to simplify app regulation and access in the United Kingdom [ 23 ]. Therefore, a robust and dynamic coordination mechanism, along with political will, skilled personnel, reliable funding, and a robust framework for monitoring and evaluating progress and aligning key performance indicators, is essential for countries in sub-Saharan Africa to keep pace with the advancement in the regulation of health apps. There is also a need to strengthen collaboration and ensure regulatory harmonization among national regulatory authorities and continental bodies such as the regional economic communities, AMRH, and the WHO AFRO [ 126 ].

Capacity building and monitoring and evaluation are important factors for ensuring effective regulation of health apps given the complex nature of the process. The regulation of medical products (including health apps) in sub-Saharan Africa generally includes licensing and accreditation, evaluation, inspection, quality control, information dissemination and promotion, and monitoring of adverse events [ 125 ]. Therefore, high-level skills as well as effective monitoring and evaluation will be required to ensure the success of the process. For most countries in sub-Saharan Africa, the NMRA is responsible for coordinating and overseeing the regulatory system of medical products [ 125 , 126 ]. However, in most cases, NMRAs are unable to perform the core regulatory functions expected of them [ 145 ]. More than 90% of African countries have limited or no capacity to regulate medical products, with only 7% having moderately developed capabilities [ 145 ]. The lack of effective NMRAs in Africa exposes the citizens to potential harm by allowing unsafe, low-quality, and fake medical products to circulate and be used [ 145 ].

Although it is the responsibility of governments to establish functional regulatory systems and ensure effective monitoring and evaluation of the regulatory process, the involvement of international and continental organizations to support sub-Saharan African countries improve the regulatory capacity of their national regulatory agencies would be extremely beneficial. For instance, the African Medicines Agency (AMA) was established in November 2019 as a treaty adopted by the African Union Member States to help address the concerns arising from weak regulatory systems on the continent. At present, 37 countries have signed the AMA treaty, including 26 countries that have ratified it [ 146 ]. The main objective of the AMA is to enhance the capacity of States Parties and regional economic communities to regulate medical products to improve the quality, safety, and efficacy of medical products on the continent [ 147 ]. The AMA, in collaboration with other existing capacity building initiatives or organizations, such as the WHO Global Initiative on Digital Health, ITU, AMRH, WHO AFRO, and United Nations Children’s Fund, can assist sub-Saharan African countries in aligning their regulatory requirements with available resources and support them to acquire the necessary tools and skills to build effective and sustainable regulatory systems for health apps. This can be achieved by adopting a decentralized approach to engage a network of technical experts across the African Union similar to the model of the European Medicines Agency [ 148 ].

Actors or Stakeholders

The regulation of health apps often requires working with a wide range of actors or stakeholders. However, in this review, we identified only 2 main actor groups (those who provide digital health services and those who use the ICT infrastructure of the health ministry). These are the groups that are targeted by the included regulatory standards.

From a broader perspective, 12 categories of stakeholders according to their potential role in regulating health apps for the self-management were mapped in this study. The potential contribution of these stakeholders to the regulation of health apps for self-management in sub-Saharan Africa not only depends on their roles and responsibilities but also on their interests, needs, expectations, and influence [ 41 , 149 - 151 ]. Thus, a robust stakeholder analysis is paramount as it can help define the scope of the regulatory process, prioritize the requirements, manage the expectations, and ensure the engagement and participation of stakeholders throughout the regulatory process [ 41 , 152 - 156 ]. Our stakeholder mapping, as presented in Table 2 (refer to Multimedia Appendix 4 for more details), lays the foundation for national governments to conduct a robust stakeholder analysis and to adopt an all-inclusive stakeholder engagement strategy to manage and sustain the engagement and participation of all relevant stakeholders [ 157 , 158 ].

Recommendations

Our review found that the regulation of health apps in sub-Saharan Africa is especially poor and almost nonexistent, as only Kenya has national standards that could address some of the regulatory issues related to health apps. Therefore, we recommend the following actions to help sub-Saharan African countries improve the regulation of health apps to support self-management:

• Establish a clear and consistent definition of what constitutes a health app (considering AI or machine learning) and what level of regulation is required for different types of apps.
• Develop and implement criteria and guidelines that ensure the quality, safety, and usability of health apps.
• Engage with independent app evaluators, such as ORCHA, to adopt a common framework that can guide the evaluation and accreditation of health apps and use the framework to create and maintain decentralized and transparent platforms that showcase and evaluate health apps for users and health care professionals.
• Develop and implement policies and regulations that enable sustainable funding for health apps such as integrating the use of health apps for self-management into existing health systems and financing pathways or mechanisms.
• Support and facilitate innovation and collaboration across the sub-Saharan Africa region, especially in areas including but not limited to data security and privacy, interoperability standards, usability, accessibility, funding, capacity building, and monitoring and evaluation of the regulatory process.
• Manage and sustain the engagement, involvement, and participation of all relevant stakeholders in the regulatory process by conducting a robust stakeholder analysis and adopting an all-inclusive stakeholder engagement strategy.

Strengths and Limitations of the Study

This study has several strengths, which include an extensive search of gray literature and repositories, contact with key individuals, and the use of a systematic approach. Given that regulatory standards and guidance are unavailable in scientific databases, a wide range of gray literature and repositories were searched. In addition, contact was made with key staff members to obtain relevant documents, including those at the MOHs, the WHO country offices, and the WHO AFRO. Second, to enhance the strength of the study, a policy analysis framework was adapted and used to systematically organize the key study findings, whereas a deductive descriptive qualitative content analysis approach was used to identify and analyze texts that contained relevant concepts and other related information based on the 4 predefined themes. Third, the RISA tool was used to guide the mapping of key stakeholders. This has further increased the robustness of the study findings.

The limitations of this study include the fact that our literature search was conducted in English. Although the literature search was conducted in English, it yielded documents written in French and Portuguese from the ICTworks repository. Second, regulatory standards and guidance are not readily available on scientific databases; hence, it is possible that some relevant documents might have been missed. However, efforts were made to obtain these documents by contacting key stakeholders including key contact persons at the WHO AFRO, WHO country offices, and MOHs. In addition, contacting key individuals only for the purposes of requesting documents rather than conducting direct interviews was one of the limitations of this study. Interviewing key contact persons and stakeholders to obtain additional information could have strengthened the review; however, we did not interview any key individuals or stakeholders because it was beyond the scope of this review. Nonetheless, we recommend that future studies consider incorporating interviews to explore the perspectives of key stakeholders.

Conclusions

Health apps are increasingly being used by patients to manage their health, and sub-Saharan African countries can leverage these apps to advance their progress toward achieving SDG 3 (good health and well-being) and UHC, especially given the rapid advancement of AI and big data. However, our study has established that the regulation of health apps in sub-Saharan Africa is inadequate to ensure that health apps are technically reliable and clinically safe; interoperable across systems; compliant with the principles of confidentiality of information and data privacy; culturally appropriate and relevant; and accessible to everyone regardless of gender, ethnicity, location, or income. Therefore, the region can learn from the experiences of some high-income countries such as the United Kingdom and Germany to develop and implement a robust and responsive regulatory system that supports the widespread adoption of safe, effective, and beneficial health apps for its population.

Following the publication of this review, a summary of the findings will be disseminated to the relevant organizations. In addition, the key findings will be summarized and presented at national, regional, and international conferences.

Acknowledgments

The authors would like to thank Rebecca Jones, the Library Manager and Liaison Librarian at Charing Cross Library, who advised and assisted with the search strategy for this study. This work is part of the PhD research of BAB, which is sponsored by the government of Nigeria. AM and JC were supported by the National Institute for Health and Care Research (NIHR) Applied Research Collaboration Northwest London (NIHR200180). The views expressed in this publication are those of the authors and not necessarily those of the government of Nigeria or the NIHR or the Department of Health and Social Care. In the Results and Discussion sections, Microsoft Copilot in Bing [ 159 ] was used to help summarize and modify a few texts as well as suggest some citations.

Data Availability

The search strategy for PubMed, Scopus, and the World Health Organization AIM is presented in Multimedia Appendix 1 . All data generated or analyzed during this study are included in this published article (and its supplementary information files). The documents analyzed are available directly from the relevant institutional websites, ICTworks repository [ 44 ] or upon request from the relevant government departments in each country. Additionally, documents in the list of references that are not accessible on the web can be solicited from the corresponding author on reasonable request.

Authors' Contributions

BAB and JC conceived the study. BAB designed the study with contributions from JC and NM. BAB drafted the manuscript, and JC, NM, AM, SI, KPF, BIH, and NU read and contributed to it. AM was the clinical lead, and JC acted as a guarantor for this study. The final manuscript was read and approved by all the authors.

Conflicts of Interest

None declared.

PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist.

Database search strategy.

Details of included documents.

Mapping of the stakeholders according to their potential role in regulating health apps for self-management.

• Aitken M, Nass D. Digital health trends 2021: innovation, evidence, regulation, and adoption. IQVIA Institute for Human Data Science. 2021. URL: https:/​/www.​iqvia.com/​-/​media/​iqvia/​pdfs/​institute-reports/​digital-health-trends-2021/​iqvia-institute-digital-health-trends-2021.​pdf?&_=1669449368070 [accessed 2022-11-26]
• Mobile app threat landscape report. RiskIQ. 2020. URL: https://www.riskiq.com/2020-mobile-threat-landscape-report-thank-you/ [accessed 2021-07-19]
• El-Sappagh S, Ali F, Hendawi A, Jang JH, Kwak KS. A mobile health monitoring-and-treatment system based on integration of the SSN sensor ontology and the HL7 FHIR standard. BMC Med Inform Decis Mak. May 10, 2019;19(1):97. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Labrique AB, Vasudevan L, Kochi E, Fabricant R, Mehl G. mHealth innovations as health system strengthening tools: 12 common applications and a visual framework. Glob Health Sci Pract. Aug 06, 2013;1(2):160-171. [ FREE Full text ] [ CrossRef ]
• Adepoju IOO, Albersen BJA, De Brouwere V, van Roosmalen J, Zweekhorst M. mHealth for clinical decision-making in sub-Saharan Africa: a scoping review. JMIR Mhealth Uhealth. Mar 23, 2017;5(3):e38. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Vegesna A, Tran M, Angelaccio M, Arcona S. Remote patient monitoring via non-invasive digital technologies: a systematic review. Telemed J E Health. Jan 2017;23(1):3-17. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Use of appropriate digital technologies for public health: Report by the Director-General. World Health Organization. 2016. URL: https://iris.who.int/handle/10665/274134 [accessed 2023-05-06]
• El-Osta A, Rowe C, Majeed A. Developing a shared definition of self-driven healthcare to enhance the current healthcare delivery paradigm. J R Soc Med. Nov 2022;115(11):424-428. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Hussein R. A review of realizing the universal health coverage (UHC) goals by 2030: part 2- what is the role of eHealth and technology? J Med Syst. Jul 2015;39(7):72. [ CrossRef ] [ Medline ]
• Sustainable development goal 3: Ensure healthy lives and promote well-being for all at all ages. United Nations. URL: https://sdgs.un.org/goals/goal3 [accessed 2023-05-07]
• Coronavirus: apps to help the elderly. Organisation for the Review of Care and Health Apps. 2020. URL: https://orchahealth.com/coronavirus-apps-to-help-the-elderly/ [accessed 2021-07-19]
• Huckvale K, Adomaviciute S, Prieto JT, Leow MKS, Car J. Smartphone apps for calculating insulin dose: a systematic assessment. BMC Med. May 06, 2015;13:106. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Huckvale K, Car M, Morrison C, Car J. Apps for asthma self-management: a systematic assessment of content and tools. BMC Med. Nov 22, 2012;10:144. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Huckvale K, Morrison C, Ouyang J, Ghaghda A, Car J. The evolution of mobile apps for asthma: an updated systematic assessment of content and tools. BMC Med. Mar 23, 2015;13:58. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Huckvale K, Prieto JT, Tilney M, Benghozi PJ, Car J. Unaddressed privacy risks in accredited health and wellness apps: a cross-sectional systematic assessment. BMC Med. Sep 07, 2015;13:214. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Huckvale K, Torous J, Larsen ME. Assessment of the data sharing and privacy practices of smartphone apps for depression and smoking cessation. JAMA Netw Open. Apr 05, 2019;2(4):e192542. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Ndlovu K, Mars M, Scott RE. Interoperability frameworks linking mHealth applications to electronic record systems. BMC Health Serv Res. May 13, 2021;21(1):459. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Kenya standards and guidelines for mHealth systems. Kenya Ministry of Health. 2017. URL: https:/​/www.​health.go.ke/​wp-content/​uploads/​2020/​02/​Revised-Guidelines-For-Mhealth-Systems-May-Version.​pdf [accessed 2023-03-21]
• Standard for electronic health record system (EHRs) in Ethiopia. Ethiopia Minister of Health. 2021. URL: https:/​/registry.​betterehealth.eu/​ehealth-policies/​standard-electronic-health-record-system-ehrs-ethiopia [accessed 2023-04-21]
• National health normative standards framework for digital health interoperability in South Africa. South Africa Department of Health. 2021. URL: https://www.health.gov.za/wp-content/uploads/2022/10/HNSF_Gazette_21_October_2022.pdf [accessed 2023-05-15]
• Ferretti A, Ronchi E, Vayena E. From principles to practice: benchmarking government guidance on health apps. Lancet Digit Health. Jun 2019;1(2):e55-e57. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Diao JA, Venkatesh KP, Raza MM, Kvedar JC. Multinational landscape of health app policy: toward regulatory consensus on digital health. NPJ Digit Med. May 11, 2022;5(1):61. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Essén A, Stern AD, Haase CB, Car J, Greaves F, Paparova D, et al. Health app policy: international comparison of nine countries' approaches. NPJ Digit Med. Mar 18, 2022;5(1):31. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Brown SA, Garcia AA, Kouzekanani K, Hanis CL. Culturally competent diabetes self-management education for Mexican Americans: the Starr County border health initiative. Diabetes Care. Feb 2002;25(2):259-268. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Chaney SC, Mechael P. Self-Care Trailblazer Group. 2020. URL: https://media.psi.org/wp-content/uploads/2020/09/31000510/Digital-Self-Care-Final.pdf [accessed 2021-05-20]
• Kanzaveli T. Healthcare: shiftingfrom “one size fits all” to “one size fits one”. Medium. 2017. URL: https:/​/tkanzaveli.​medium.com/​healthcare-shifting-from-one-size-fits-all-to-one-size-fits-one-d56136ded705 [accessed 2022-03-04]
• Myth 1 – one app will fit all!. Organisation for the Review of Care and Health Apps. URL: https://orchahealth.com/myth-1-one-app-will-fit-all/ [accessed 2022-03-04]
• Aitken M, Lyle J. Patient adoption of mHealth: use, evidence and remaining barriers to mainstream acceptance. IQVIA Institute for Human Data Science. Sep 2015. URL: https://www.iqvia.com/-/media/iqvia/pdfs/institute-reports/patient-adoption-of-mhealth.pdf [accessed 2021-05-21]
• Mechael P, Batavia H, Kaonga N. Barriers and gaps affecting mhealth in low and middle income countries: policy white paper. Center for Global Health and Economic Development Earth Institute, Columbia University. 2010. URL: http://www.globalproblems-globalsolutions-files.org/pdfs/mHealth_Barriers_White_Paper.pdf [accessed 2021-03-24]
• Bene BA, Ibeneme S, Fadahunsi KP, Harri BI, Ukor N, Mastellos N, et al. Regulatory standards and guidance for the use of health applications for self-management in Africa: scoping review protocol. BMJ Open. Feb 11, 2022;12(2):e058067. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Aitken M, Gauntlett C. Patient apps for improved healthcare: from novelty to mainstream. IMS Institute for Healthcare Informatics. 2013. URL: https://ignacioriesgo.es/wp-content/uploads/2014/03/iihi_patient_apps_report_editora_39_2_1.pdf [accessed 2024-03-10]
• National eHealth Strategy Toolkit. World Health Organization, International Telecommunication Union. 2012. URL: https://www.itu.int/pub/D-STR-E_HEALTH.05-2012 [accessed 2021-06-28]
• Global strategy on digital health 2020-2025. World Health Organization. 2021. URL: https://www.who.int/docs/default-source/documents/gs4dhdaa2a9f352b0445bafbc79ca799dce4d.pdf [accessed 2021-06-23]
• Arksey H, O'Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. Feb 2005;8(1):19-32. [ FREE Full text ] [ CrossRef ]
• Anderson S, Allen P, Peckham S, Goodwin N. Asking the right questions: scoping studies in the commissioning of research on the organisation and delivery of health services. Health Res Policy Syst. Jul 09, 2008;6:7. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Levac D, Colquhoun H, O'Brien KK. Scoping studies: advancing the methodology. Implement Sci. Sep 20, 2010;5:69. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Peters MDJ, Marnie C, Tricco AC, Pollock D, Munn Z, Alexander L, et al. Updated methodological guidance for the conduct of scoping reviews. JBI Evid Synth. Oct 2020;18(10):2119-2126. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Tricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H, Levac D, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. Oct 02, 2018;169(7):467-473. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Leitner C, Potenziani D. Mendeley reference manager. Mendeley. 2022. URL: https://www.mendeley.com/reference-management/reference-manager [accessed 2022-08-03]
• Better systematic review management. Covidence. URL: https://www.covidence.org/ [accessed 2023-02-13]
• Franco-Trigo L, Fernandez-Llimos F, Martínez-Martínez F, Benrimoj SI, Sabater-Hernández D. Stakeholder analysis in health innovation planning processes: A systematic scoping review. Health Policy. Oct 2020;124(10):1083-1099. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Walt G, Gilson L. Reforming the health sector in developing countries: the central role of policy analysis. Health Policy Plan. Dec 1994;9(4):353-370. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Digital health: a call for government leadership and cooperation between ICT and health. Broadband Commission. 2017. URL: https://broadbandcommission.org/wp-content/uploads/2021/09/WGHealth_Report2017-.pdf [accessed 2021-06-28]
• Vota W. Every African country’s national eHealth strategy or digital health policy. ICT works. 2019. URL: https://www.ictworks.org/african-national-ehealth-strategy-policy/ [accessed 2023-12-10]
• Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. Jul 21, 2009;6(7):e1000097. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Standards and guidelines for electronic medical record systems in Kenya. Kenya Ministry of Medical Services, Kenya Ministry of Public Health and Sanitation. 2010. URL: http://guidelines.health.go.ke:8000/media/Standards_and_Guidelines_for_EMR_Systems.pdf [accessed 2023-04-21]
• Kenya standards and guidelines for E-health systems interoperability. Kenya Ministry of Health, AfyaInfo Project. 2014. URL: https://pdf.usaid.gov/pdf_docs/PA00TB2K.pdf [accessed 2023-03-21]
• Health sector ICT standards and guidelines. Kenya Ministry of Health. 2013. URL: https://www.medbox.org/pdf/5e148832db60a2044c2d2895 [accessed 2023-03-21]
• Health information exchange standard operating procedure (SOP) and guideline. Nigeria Federal Ministry of Health. Jul 2020.
• National eHealth strategy 2018-2022. Benin Ministry of Health. 2017.
• The eHealth strategy of botswana 2020-2024. Botswana Ministry of Health. URL: https://ehealth.ub.bw/bhdc/Docs/MOH%20ehealth%20Strategy%20Book%20A4.pdf [accessed 2023-04-22]
• Health sector digital strategy 2016-2020. Burkina Faso Ministry of Health.
• National health informatics development plan of Burundi. Burundi Ministry of Public Health. 2015.
• The 2020-2024 national digital health strategic plan. Cameroon Ministry of Public Health. 2020.
• National eHealth strategy 2017-2021. Comoros Ministry of Health. 2016.
• eHealth strategic plan. Cote d’Ivoire Minister of Health and Public Hygiene. 2011.
• National development plan for health informatics. Democratic Republic of Congo Ministry of Public Health. 2014.
• Kingdom of Swaziland eHealth strategy 2016 - 2020. Kingdom of Swaziland Ministry Of Health. 2016.
• Information revolution strategic plan (2018-2025). Ethiopia Ministry of Health. 2018.
• Strategic master plan of the health information system of the Gabon. Gabon Ministry of Public Health and Population. 2017.
• National e-Health strategy. Ghana Ministry of Health. 2010.
• Kenya national e-Health strategy. Kenya Ministry of Medical Services, Kenya Ministry of Public Health & Sanitation. 2011.
• Kenya national eHealth policy 2016-2030. Kenya Ministry of Health. 2016.
• National strategy - Liberia - 2016-2021. Liberia Ministry of Health. 2016.
• Strategic plan for strengthening the health information system of Madagascar 2018–2022. Madagascar Ministry of Public Health. 2017.
• National digital health strategy 2020-2025. Malawi Ministry of Health. 2020.
• National eHealth policy in Mali. Mali Ministry of Health and Public Hygiene. 2013.
• Health 2015: seamless continuity of care. Mauritius Ministry of Health and Quality of Life. 2015.
• Strategic plan of information system for health 2009-2014. Mozambique Ministry of Health. 2009.
• National eHealth strategy 2019-2023. Niger Ministry of Public Health. 2018.
• National digital health strategy 2021-2025. Nigeria Federal Ministry of Health. 2021.
• National digital health policy. Nigeria Federal Ministry of Health. 2021.
• National digital health strategic plan 2018-2023. Rwanda Ministry of Health. 2018. URL: https://elearning.helinanet.org/mod/resource/view.php?id=890 [accessed 2023-05-09]
• Strategic plan for digital health 2018-2023. Senegal Ministry of Health and Social Action. 2018.
• National digital health strategy 2018-2023. Sierra Leone Ministry of Health and Sanitation, Sierra Leone Ministry of Information and Communication. 2018.
• The national digital health strategy 2019 – 2024. Tanzania Ministry of Health, Community Development, Gender, Elderly and Children. 2019.
• National digital health strategy for South Africa 2019 - 2024. South Africa Department of Health. 2019.
• Strategic plan for the development of eHealth in Togo 2013-2015. Togo Ministry of Health. 2012.
• Uganda national eHealth policy. Uganda Ministry of Health. 2016.
• Uganda national eHealth strategy 2017 - 2021. Uganda Ministry of Health. URL: https://health.go.ug/sites/default/files/National%20e_Health%20Strategy_0.pdf [accessed 2023-05-16]
• National eHealth strategy 2017-2021. Zambia Ministry of Health. 2017.
• Zimbabwe’s E-Health strategy 2012-2017. Ministry of Health and Child Welfare. 2012.
• National eHealth strategy 2021-2025. Namibia Ministry of Health & Social Services. 2021. URL: https://www.scribd.com/document/639371316/eHealth-Strategy-Namibia-2021# [accessed 2023-05-13]
• Health sector ICT policy and strategy. Ghana Ministry of Health. 2005. URL: https://www.moh.gov.gh/wp-content/uploads/2016/02/Health-Sector-ICT-Policy-and-Strategy.pdf [accessed 2023-05-08]
• Adebola OJ. Beyond national digital health strategy: final report of end term evaluation for the National Health ICT Strategic Framework 2015-2020. Nigeria Federal Ministry of Health. May 2021.
• National Health ICT Strategic Framework 2015 - 2020. Nigeria Federal Ministry of Health. 2016. URL: https://www.health.gov.ng/doc/HealthICTStrategicFramework.pdf [accessed 2023-05-16]
• Digital health blueprint. Ethiopia Ministry of Health. 2021. URL: http:/​/repository.​iifphc.org/​bitstream/​handle/​123456789/​1658/​Ethiopian-Digital-Health-Blueprint.​pdf?sequence=1&isAllowed=y [accessed 2023-05-16]
• Kenya health information systems interoperability framework. Kenya Ministry of Health. 2020. URL: https:/​/www.​data4sdgs.org/​sites/​default/​files/​services_files/​Kenya%20Health%20Information%20Systems%20Interoperability%20Framework.​pdf [accessed 2023-05-16]
• National community health digitization strategy 2020-2025. Kenya Ministry of Health, Division of Community Health Services. 2021. URL: https:/​/www.​eahealth.org/​sites/​www.eahealth.org/​files/​content/​attachments/​2021-08-02/​eCHIS-Strategy-2020-2025.​pdf [accessed 2023-05-16]
• Leitner C, Potenziani D. Health information systems interoperability in Liberia. IntraHealth International. 2016. URL: https://elearning.helinanet.org/mod/resource/view.php?id=938 [accessed 2023-05-16]
• Narrative for 2022 national digital health annual operational plan (AOP). Nigeria Federal Ministry of Health. 2022.
• Tanzania digital health investment road map 2017-2023. Tanzania Ministry of Health, Community Development, Gender, Elderly and Children, President’s Office Regional Administration and Local Government. 2017.
• Yu H. Regulation of digital health technologies in the European Union: intended versus actual use. In: Cohen GI, Minssen T, Price II NW, Robertson C, Shachar C, editors. The Future of Medical Device Regulation: Innovation and Protection. Cambridge. Cambridge University Press; Mar 31, 2022;103-114.
• Policy for device software functions and mobile medical applications: guidance for industry and Food and Drug Administration staff. U.S. Food and Drug Administration. 2022. URL: https://www.fda.gov/media/80958/download [accessed 2023-10-10]
• Gordon WJ, Landman A, Zhang H, Bates DW. Beyond validation: getting health apps into clinical practice. NPJ Digit Med. 2020;3:14. [ FREE Full text ] [ CrossRef ] [ Medline ]
• FDA clears mobile medical app to help those with opioid use disorder stay in recovery programs. U.S. Food and Drug Administration. 2018. URL: https:/​/www.​fda.gov/​news-events/​press-announcements/​fda-clears-mobile-medical-app-help-those-opioid-use-disorder-stay-recovery-programs [accessed 2021-01-27]
• Digital maturity model: achieving digital maturity to drive growth. Deloitte. 2018. URL: https:/​/www2.​deloitte.com/​content/​dam/​Deloitte/​global/​Documents/​Technology-Media-Telecommunications/​deloitte-digital-maturity-model.​pdf [accessed 2021-10-20]
• May E. How digital health apps are empowering patients. Deloitte. 2021. URL: https:/​/www2.​deloitte.com/​us/​en/​blog/​health-care-blog/​2021/​how-digital-health-apps-are-empowering-patients.​html [accessed 2023-10-06]
• Guidance: criteria for health app assessment. Public Health England. 2017. URL: https:/​/www.​gov.uk/​government/​publications/​health-app-assessment-criteria/​criteria-for-health-app-assessment [accessed 2023-10-16]
• Clinical risk management standards. National Health Service Digital. 2020. URL: https://digital.nhs.uk/services/clinical-safety/clinical-risk-management-standards [accessed 2023-10-28]
• Report a problem with a medicine or medical device. Gov.uk. URL: https://www.gov.uk/report-problem-medicine-medical-device [accessed 2023-11-07]
• Digital technology assessment criteria for health and social care (DTAC) - Version 1.0. National Health Service X. 2021. URL: https:/​/view.​officeapps.live.com/​op/​view.​aspx?src=https%3A%2F%2Ftransform.​england.​nhs.​uk%2Fmedia%2Fdocuments%2FDTAC_version_1.​0_FINAL_updated_16.​04.​odt&wdOrigin=BROWSELINK [accessed 2023-11-07]
• Data protection impact assessment: NHS login - formerly Citizen Identity. National Health Service Digital. 2022. URL: https://digital.nhs.uk/services/nhs-login/data-protection-impact-assessment [accessed 2023-11-07]
• Risks and data protection impact assessments (DPIAs). Information Commissioner’s Office. URL: https:/​/ico.​org.uk/​for-organisations/​uk-gdpr-guidance-and-resources/​accountability-and-governance/​accountability-framework/​risks-and-data-protection-impact-assessments-dpias/​ [accessed 2023-11-07]
• A guide to good practice for digital and data-driven health technologies. Department of Health and Social Care. 2021. URL: https:/​/www.​gov.uk/​government/​publications/​code-of-conduct-for-data-driven-health-and-care-technology/​initial-code-of-conduct-for-data-driven-health-and-care-technology [accessed 2023-10-30]
• Interoperability in healthcare. Healthcare Information and Management Systems Society (HIMSS). 2023. URL: https://www.himss.org/resources/interoperability-healthcare [accessed 2023-10-17]
• DAPB4020: UK core Fast Healthcare Interoperability Resources (FHIR) release 4 (R4) governance. National Health Service Digital. 2022. URL: https:/​/digital.​nhs.uk/​data-and-information/​information-standards/​information-standards-and-data-collections-including-extractions/​publications-and-notifications/​standards-and-collections/​dapb4020-uk-core-fhir-r4-governance [accessed 2023-10-17]
• Fast Healthcare Interoperability Resources (FHIR). National Health Service Digital. 2022. URL: https://digital.nhs.uk/services/fhir-apis [accessed 2023-10-17]
• FHIR Interoperability Basics: 4 things to know. Health IT Analytics. 2022. URL: https://healthitanalytics.com/news/4-basics-to-know-about-the-role-of-fhir-in-interoperability [accessed 2023-11-07]
• Giordanengo A, Bradway M, Pedersen R, Grøttland A, Hartvigsen G, Årsand E. Integrating data from apps, wearables and personal electronic health record (pEHR) systems with clinicians’ electronic health records (EHR) systems. Int J Integr Care. Nov 09, 2016;16(5):16. [ FREE Full text ] [ CrossRef ]
• A plan for digital health and social care. Department of Health & Social Care. 2022. URL: https:/​/www.​gov.uk/​government/​publications/​a-plan-for-digital-health-and-social-care/​a-plan-for-digital-health-and-social-care [accessed 2022-12-01]
• Ryu B, Kim N, Heo E, Yoo S, Lee K, Hwang H, et al. Impact of an electronic health record-integrated personal health record on patient participation in health care: development and randomized controlled trial of MyHealthKeeper. J Med Internet Res. Dec 07, 2017;19(12):e401. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Winter A, Takabayashi K, Jahn F, Kimura E, Engelbrecht R, Haux R, et al. Quality requirements for electronic health record systems*. A Japanese-German information management perspective. Methods Inf Med. Aug 07, 2017;56(7):e92-e104. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Wachter RM. Making IT work: harnessing the power of health information technology to improve care in England. National Advisory Group on Health Information Technology. 2016. URL: https:/​/assets.​publishing.service.gov.uk/​government/​uploads/​system/​uploads/​attachment_data/​file/​550866/​Wachter_Review_Accessible.​pdf [accessed 2021-07-22]
• Framework on integrated people-centred health services (IPCHS). World Health Organisation. 2023. URL: https:/​/www.​who.int/​teams/​integrated-health-services/​clinical-services-and-systems/​service-organizations-and-integration [accessed 2023-06-05]
• Ibeneme S, Karamagi H, Muneene D, Goswami K, Chisaka N, Okeibunor J. Strengthening health systems using innovative digital health technologies in Africa. Front Digit Health. 2022;4:854339. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Ibeneme S, Ukor N, Ongom M, Dasa T, Muneene D, Okeibunor J. Strengthening capacities among digital health leaders for the development and implementation of national digital health programs in Nigeria. BMC Proc. 2020;14(Suppl 10):9. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Delivering safe digital health. Organisation for the Review of Care and Health Apps. URL: https://orchahealth.com/ [accessed 2023-10-22]
• Mamuye AL, Yilma TM, Abdulwahab A, Broomhead S, Zondo P, Kyeng M, et al. Health information exchange policy and standards for digital health systems in Africa: a systematic review. PLOS Digit Health. Oct 2022;1(10):e0000118. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Digital health platform handbook: Building a digital information infrastructure (infostructure) for health. World Health Organization, International Telecommunication Union. 2022. URL: https://www.itu.int/dms_pub/itu-d/opb/str/D-STR-E_HEALTH.10-2020-PDF-E.pdf [accessed 2021-05-22]
• Framework for involving patients in patient safety 2021. National Health Service England. 2021. URL: https://www.england.nhs.uk/patient-safety/framework-for-involving-patients-in-patient-safety/ [accessed 2023-03-23]
• Olesch A. Towards harmonised EU landscape for digital health: summary of the roundtable discussions in selected EIT Health InnoStars countries. EIT Health InnoStars. Jan 2023. URL: https://eithealth.eu/wp-content/uploads/2023/02/EIT_Health_DiGA_report_Jan2023.pdf [accessed 2023-10-10]
• Grieb J, Tschammler D, Färber C, Woitz S. Digital health laws and regulations germany. Global Legal Group. 2023. URL: https://iclg.com/practice-areas/digital-health-laws-and-regulations/germany [accessed 2023-11-03]
• Human regulatory: medical devices. European Medicines Agency. URL: https://www.ema.europa.eu/en/human-regulatory/overview/medical-devices [accessed 2023-10-12]
• Strengthening the capacity for regulation of medical products in the African region. World Health Organization Regional Office for Africa. 2013. URL: https://iris.who.int/bitstream/handle/10665/94308/AFR_RC63_7.pdf?sequence=1 [accessed 2023-10-17]
• Ncube BM, Dube A, Ward K. Establishment of the African Medicines Agency: progress, challenges and regulatory readiness. J Pharm Policy Pract. Mar 08, 2021;14(1):29. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Post market surveillance system. European Union Medical Device Regulation. 2023. URL: https://eumdr.com/post-market-surveillance-system/ [accessed 2023-10-31]
• Dayal R. Effective post-market surveillance for medical devices: An essential part of medical devices regulation (MDR). Capgemini. 2020. URL: https:/​/www.​capgemini.com/​insights/​expert-perspectives/​effective-post-market-surveillance-for-medical-devices-an-essential-part-of-mdr/​ [accessed 2023-10-31]
• NHS app library reaches 70 apps in honour of the NHS birthday. Northampton General Hospital NHS Trust. 2018. URL: https:/​/www.​northamptongeneral.nhs.uk/​News/​News-Archive/​2018/​NHS-App-Library-reaches-70-apps-in-honour-of-the-NHS-birthday.​aspx [accessed 2023-09-21]
• Developers invited to add to NHS apps library. National Health Service Digital. 2018. URL: https://digital.nhs.uk/news/2018/developers-invited-to-add-to-nhs-apps-library [accessed 2023-09-22]
• The NHS apps library has closed. National Health Service Digital. 2021. URL: https:/​/digital.​nhs.uk/​services/​nhs-apps-library#:~:text=The%20NHS%20Apps%20Library%20was%20decommissioned%20in%20December%202021.​&text=Further%20information%20can%20be%20found%20on%20the%20NHS.​UK%20website [accessed 2023-09-22]
• Larsen ME, Huckvale K, Nicholas J, Torous J, Birrell L, Li E, et al. Using science to sell apps: evaluation of mental health app store quality claims. NPJ Digit Med. 2019;2:18. [ FREE Full text ] [ CrossRef ] [ Medline ]
• About the NHS app. National Health Service. Dec 4, 2023. URL: https://www.nhs.uk/nhs-app/about-the-nhs-app/ [accessed 2023-09-22]
• Scope of registration: regulated activities. Care Quality Commission. 2022. URL: https://www.cqc.org.uk/guidance-providers/scope-registration-regulated-activities [accessed 2023-11-05]
• Distributing great apps into health and care services across the world. Organisation for the Review of Care and Health Apps. 2020. URL: https://orchahealth.com/wp-content/uploads/2020/12/Health-and-Care-1.pdf [accessed 2023-10-09]
• Our founder, our story and our values: we exist to make digital health healthy. Organisation for the Review of Care and Health Apps. URL: https://orchahealth.com/about-us/ [accessed 2023-10-09]
• Health app library: empower your community with safe access to health apps and digital health products. Organisation for the Review of Care and Health Apps. URL: https:/​/orchahealth.​com/​our-products/​health-app-library/​#:~:text=A%20Health%20App%20Library%20is,on%20the%20Health%20App%20Library [accessed 2023-10-09]
• Digital technology assessment criteria (DTAC). National Health Service X. URL: https://www.nhsx.nhs.uk/key-tools-and-info/digital-technology-assessment-criteria-dtac/ [accessed 2023-10-09]
• Evidence standards framework (ESF) for digital health technologies. National Institute for Health and Care Excellence. 2023. URL: https:/​/www.​nice.org.uk/​about/​what-we-do/​our-programmes/​evidence-standards-framework-for-digital-health-technologies [accessed 2023-10-08]
• Tsang L, Kerr-Peterson H. UK NICE updates its evidence standards framework for data-driven digital health technologies. Ropes & Gray. 2022. URL: https:/​/www.​ropesgray.com/​en/​insights/​alerts/​2022/​10/​uk-nice-updates-its-evidence-standards-framework-for-data-driven-digital-health-technologies [accessed 2023-10-09]
• Guidance: medical device stand-alone software including apps (including IVDMDs). Medicines and healthcare products regulatory agency. 2023. URL: https:/​/assets.​publishing.service.gov.uk/​government/​uploads/​system/​uploads/​attachment_data/​file/​1168485/​Medical_device_stand-alone_software_including_apps__including_IVDMDs_.​pdf [accessed 2023-10-09]
• Digital therapeutics in the United Kingdom. Digital Therapeutics Alliance. 2021. URL: https://dtxalliance.org/wp-content/uploads/2021/06/DTA_DTx-Overview_UK.pdf [accessed 2023-10-09]
• Transforming global healthcare by advancing digital therapeutics. Digital Therapeutics Alliance. 2023. URL: https://dtxalliance.org/ [accessed 2023-10-10]
• International Organization for Standardization (ISO) digital therapeutic definition. Digital Therapeutic Alliance. Jun 2023. URL: https://dtxalliance.org/wp-content/uploads/2023/06/DTA_FS_ISO-Definition.pdf [accessed 2023-10-09]
• Ndomondo-Sigonda M, Miot J, Naidoo S, Dodoo A, Kaale E. Medicines regulation in Africa: current state and opportunities. Pharmaceut Med. 2017;31(6):383-397. [ FREE Full text ] [ CrossRef ] [ Medline ]
• Chinele J. East Africa shows solid support for African Medicines Agency treaty. Health Policy Watch. Aug 16, 2023. URL: https://healthpolicy-watch.news/east-africa-shows-solid-support-for-african-medicines-agency-treaty/ [accessed 2023-10-09]
• Treaty for the establishment of the African Medicines Agency 2019. African Union. 2019. URL: https://au.int/sites/default/files/treaties/36892-treaty-0069_-_ama_treaty_e.pdf [accessed 2023-10-17]
• European Medicines Agency: about us. European Medicines Agency. Mar 1, 2023. URL: https://www.ema.europa.eu/en/documents/other/about-us-european-medicines-agency-ema_en.pdf [accessed 2023-10-18]
• Bryson JM. What to do when stakeholders matter. Public Adm Rev. Mar 2004;6(1):21-53. [ FREE Full text ] [ CrossRef ]
• Iyawa G, Herselman M, Botha A. Potential stakeholders and perceived benefits of a digital health innovation ecosystem for the Namibian context. Procedia Computer Science. 2017;121:431-438. [ CrossRef ]
• Ferretti V. From stakeholders analysis to cognitive mapping and multi-attribute value theory: an integrated approach for policy support. European Journal of Operational Research. Sep 2016;253(2):524-541. [ CrossRef ]
• Brugha R, Varvasovszky Z. Stakeholder analysis: a review. Health Policy Plan. Sep 2000;15(3):239-246. [ CrossRef ] [ Medline ]
• Schmeer K. Guidelines for conducting a stakeholder analysis 1999. Partnerships for Health Reform, Abt Associates. 1999. URL: https://www.ktecop.ca/wordpress/wp-content/uploads/guidelines-stakeholder-analysis-PHR-1999.pdf [accessed 2023-10-17]
• Gilmour J, Beilin R. Stakeholder mapping for effective risk assessment and communication. Australian Centre of Excellence for Risk Analysis, University of Melbourne. Apr 2007. URL: https://cebra.unimelb.edu.au/__data/assets/pdf_file/0006/2220990/gilmour0609.pdf [accessed 2023-10-17]
• Quality, service improvement and redesign tools: stakeholder analysis. National Health Service England, National Health Service Improvement. 2022. URL: https://www.england.nhs.uk/wp-content/uploads/2022/02/qsir-stakeholder-analysis.pdf [accessed 2023-10-20]
• Craven MP, Lang AR, Martin JL. Developing mHealth apps with researchers: multi-stakeholder design considerations. Springer; 2014. Presented at: Third International Conference, DUXU 2014, held as a part of HCI International; June 22-27, 2014;15-24; Heraklion, Greece. URL: https://doi.org/10.1007/978-3-319-07635-5_2 [ CrossRef ]
• How to encourage stakeholder participation. SustaiNet Software International. URL: https://sustainet.com/how-to-encourage-stakeholder-participation/ [accessed 2023-10-20]
• Stakeholder engagement. Organisation for Economic Cooperation and Development. URL: https:/​/www.​oecd.org/​governance/​better-international-rulemaking/​compendium/​keyprinciples/​stakeholderengagement.​htm [accessed 2023-10-20]
• Microsoft Copilot in Bing. Microsoft. URL: https://www.bing.com/chat?form=NTPCHB [accessed 2023-03-15]

Abbreviations

Edited by A Mavragani; submitted 19.05.23; peer-reviewed by N O'Brien, A Essén; comments to author 07.09.23; revised version received 08.12.23; accepted 23.02.24; published 11.04.24.

©Benard Ayaka Bene, Sunny Ibeneme, Kayode Philip Fadahunsi, Bala Isa Harri, Nkiruka Ukor, Nikolaos Mastellos, Azeem Majeed, Josip Car. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 11.04.2024.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.

After being insulted, writing down your feelings on paper then getting rid of it reduces anger

A research group in Japan has discovered that writing down one's reaction to a negative incident on a piece of paper and then shredding it or throwing it away reduces feelings of anger.

"We expected that our method would suppress anger to some extent," lead researcher Nobuyuki Kawai said. "However, we were amazed that anger was eliminated almost entirely."

This research is important because controlling anger at home and in the workplace can reduce negative consequences in our jobs and personal lives. Unfortunately, many anger management techniques proposed by specialists lack empirical research support. They can also be difficult to recall when angry.

The results of this study, published in Scientific Reports , are the culmination of years of previous research on the association between the written word and anger reduction. It builds on work showing how interactions with physical objects can control a person's mood.

For their project, Kawai and his graduate student Yuta Kanaya, both at the Graduate School of Informatics, Nagoya University, asked participants to write brief opinions about important social problems, such as whether smoking in public should be outlawed. They then told them that a doctoral student at Nagoya University would evaluate their writing.

However, the doctoral students doing the evaluation were plants. Regardless of what the participants wrote, the evaluators scored them low on intelligence, interest, friendliness, logic, and rationality. To really drive home the point, the doctoral students also wrote the same insulting comment: "I cannot believe an educated person would think like this. I hope this person learns something while at the university."

After handing out these negative comments, the researchers asked the participants to write their thoughts on the feedback, focusing on what triggered their emotions. Finally, one group of participants was told to either dispose of the paper they wrote in a trash can or keep it in a file on their desk. A second group was told to destroy the document in a shredder or put it in a plastic box.

The students were then asked to rate their anger after the insult and after either disposing of or keeping the paper. As expected, all participants reported a higher level of anger after receiving insulting comments. However, the anger levels of the individuals who discarded their paper in the trash can or shredded it returned to their initial state after disposing of the paper. Meanwhile, the participants who held on to a hard copy of the insult experienced only a small decrease in their overall anger.

Kawai imagines using his research to help businesspeople who find themselves in stressful situations. "This technique could be applied in the moment by writing down the source of anger as if taking a memo and then throwing it away when one feels angry in a business situation," he explained.

Along with its practical benefits, this discovery may shed light on the origins of the Japanese cultural tradition known as hakidashisara ( hakidashi refers to the purging or spitting out of something, and sara refers to a dish or plate) at the Hiyoshi shrine in Kiyosu, Aichi Prefecture, just outside of Nagoya. Hakidashisara is an annual festival where people smash small discs representing things that make them angry. Their findings may explain the feeling of relief that participants report after leaving the festival.

• Anger Management
• Social Psychology
• Disorders and Syndromes
• Educational Psychology
• Consumer Behavior
• Anger management
• Social psychology
• Cognitive dissonance
• Self-awareness
• Obsessive-compulsive disorder
• Collaboration

Story Source:

Materials provided by Nagoya University . Note: Content may be edited for style and length.

Journal Reference :

• Yuta Kanaya, Nobuyuki Kawai. Anger is eliminated with the disposal of a paper written because of provocation . Scientific Reports , 2024; 14 (1) DOI: 10.1038/s41598-024-57916-z

Cite This Page :

Explore More

• Pacific Cities Much Older Than Previously ...
• The Milky Way in Ancient Egyptian Mythology
• Physical Activity Best in the Evening
• How the Body Switches out of 'Fight' Mode
• New Drug Prevents Flu-Related Lung Damage
• 3D Mouth of an Ancient Jawless Fish
• Connecting Lab-Grown Brain Cells
• Device: Self-Healing Materials, Drug Delivery
• How We Perceive Bitter Taste
• Next-Generation Digital Displays

Trending Topics

Strange & offbeat.