This study explores public perceptions and engagement in mobile health (mHealth) across eight European countries: Italy, the Netherlands, France, Germany, Spain, Poland, Romania, and Hungary. The focus is on the public’s attitudes toward health app usage and data sharing examined through a cross-sectional survey involving 6,581 participants. The survey revealed that 21.87% of respondents currently use health apps, with 42.71% expressing interest in future use. Regarding data sharing, 52.82% are willing to share health data with healthcare providers, and 25.48% would share data with public and private research institutions. However, concerns about data privacy and security are prevalent, with 63.68% fearing hacking of their data and 72.34% afraid that their data might be used for inappropriate purposes. However, prevalent concerns about data privacy and security emerged, with 72.34% expressing worry about data misuse and 63.68% fearing data hacking.

The study highlights significant generational and geographical differences in mHealth engagement, with older generations displaying a lower adoption level of health apps. Education level emerged as a crucial factor influencing attitudes toward mHealth, with those having tertiary education more likely to use health apps and demand transparency. These findings underscore the need for targeted strategies to enhance digital literacy, ensure data privacy, and promote equitable access to mHealth technologies across Europe.

The authors have declared no competing interest.

The survey is part of the "European network staff eXchange for integrating precision health in the Health Care Systems" (ExACT) project, supported by the European Union's Horizon 2020 research and innovation program under the RISE Marie Curie Actions, under grant agreement n. 823995. This survey contributes to a project funded by the Italian Center for Disease Prevention and Control of the Ministry of Health (CCM2021, CUP B85F21004970001), which focuses on creating the Italian Genomic Strategy and providing national backing for the European initiatives 1+Million Genomes (1+MG) and Beyond 1+Million Genomes (B1MG)

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Ethical approval for this study was obtained from the Policlinico Universitario 'Agostino Gemelli' Ethics Committee in Rome (ID 5047) and Amsterdam UMC (reference 2022.0214). All participants were informed about the purpose of the study and their rights as participants, including the voluntary nature of their involvement. Consent was obtained prior to participation, ensuring that respondents understood their data would be used for research purposes while maintaining confidentiality and anonymity. Participants were also made aware of their right to withdraw from the study at any time without any consequences

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All data produced in the present study are available upon reasonable request to the authors