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Since the hospital served as the study sponsor and employer of the HCW, we implemented a custom mobile application. We aimed to evaluate the implementation, adherence, benefits, and limitations of this study\u2019s app. Methods: The app allowed secure data collection through questionnaires, disseminated serological results, and managed bidirectional communication. Access was double-pseudonymized and irreversibly anonymized six months after enrollment. Download frequency, login events, and questionnaire submissions between October 2021 and December 2022 were analyzed. Multivariable logistic regression identified factors associated with app adherence. Results: Of the 3979 participants with app access, 3622 (91%) used the app; out of these, 1016 (28%) were \u201cadherent users\u201d (\u226512 submitted questionnaires). App adherence significantly increased with age. Among HCW, adherent users were more likely to be non-smokers (p &lt; 0.001), working as administrators or nursing staff vs. physicians (p &lt; 0.001), vaccinated against influenza (p &lt; 0.001), and had not travelled abroad in the past year (p &lt; 0.001). IBD patients exposed to SARS-CoV-2 (p = 0.0133) and those with adverse events following the second COVID-19 vaccination (p = 0.0171) were more likely adherent app users. Despite technical issues causing dropout or non-adherence, the app served as a secure solution for cohort management and longitudinal data collection. Discussion: App-based cohort management enabled continuous data acquisition and individualized care while providing flexibility and anonymity for the study team and participants. App usability, technical issues, and cohort characteristics need to be thoroughly considered prior to implementation to optimize usage and adherence in clinical research.<\/jats:p>","DOI":"10.3390\/idr17040088","type":"journal-article","created":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T10:28:09Z","timestamp":1753352889000},"page":"88","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Implementation and Adherence of a Custom Mobile Application for Anonymous Bidirectional Communication Among Nearly 4000 Participants: Insights from the Longitudinal RisCoin Study"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8085-5003","authenticated-orcid":false,"given":"Ana","family":"Zhelyazkova","sequence":"first","affiliation":[{"name":"Institut f\u00fcr Notfallmedizin und Medizinmanagement (INM), LMU Klinikum, LMU M\u00fcnchen, 80336 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2374-8778","authenticated-orcid":false,"given":"Sibylle","family":"Koletzko","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Gastroenterology and Nutrition, School of Medicine Collegium Medicum, University of Warmia and Mazury, 10-561 Olsztyn, Poland"},{"name":"Department of Pediatrics, Dr. von Hauner Children\u2019s Hospital, LMU University Hospital Munich, 80337 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7501-9556","authenticated-orcid":false,"given":"Kristina","family":"Adorjan","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland"},{"name":"Institute of Psychiatric Phenomics and Genomics (IPPG), LMU University Hospital Munich, 80336 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Schrimf","sequence":"additional","affiliation":[{"name":"Institute of Psychiatric Phenomics and Genomics (IPPG), LMU University Hospital Munich, 80336 Munich, Germany"},{"name":"Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, 80336 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6929-3831","authenticated-orcid":false,"given":"Stefanie","family":"V\u00f6lk","sequence":"additional","affiliation":[{"name":"Department of Neurology, LMU University Hospital Munich, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leandra","family":"Koletzko","sequence":"additional","affiliation":[{"name":"Department of Medicine II, LMU University Hospital Munich, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Fabry-Said","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Dr. von Hauner Children\u2019s Hospital, LMU University Hospital Munich, 80337 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Osterman","sequence":"additional","affiliation":[{"name":"Max von Pettenkofer Institute and Gene Center, Virology, National Reference Center for Retroviruses, LMU Munich, 80336 Munich, Germany"},{"name":"German Center for Infection Research (DZIF), Partner Site, 80336 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6629-3542","authenticated-orcid":false,"given":"Irina","family":"Badell","sequence":"additional","affiliation":[{"name":"Max von Pettenkofer Institute and Gene Center, Virology, National Reference Center for Retroviruses, LMU Munich, 80336 Munich, Germany"},{"name":"German Center for Infection Research (DZIF), Partner Site, 80336 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Eden","sequence":"additional","affiliation":[{"name":"KAIROS GmbH, 44801 Bochum, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0133-4104","authenticated-orcid":false,"given":"Alexander","family":"Chouk\u00e9r","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Laboratory of Translational Research Stress and Immunity, LMU University Hospital Munich, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5570-770X","authenticated-orcid":false,"given":"Marina","family":"Tuschen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Laboratory of Translational Research Stress and Immunity, LMU University Hospital Munich, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5345-7165","authenticated-orcid":false,"given":"Berthold","family":"Koletzko","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Dr. von Hauner Children\u2019s Hospital, LMU University Hospital Munich, 80337 Munich, Germany"},{"name":"German Center for Child and Adolescent Health, Site Munich, 80337 Munich, Germany"},{"name":"Stiftung Kindergesundheit, c\/o Dr. von Hauner Children\u2019s Hospital, LMU University Hospital Munich, 80337 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7657-8042","authenticated-orcid":false,"given":"Yuntao","family":"Hao","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Dr. von Hauner Children\u2019s Hospital, LMU University Hospital Munich, 80337 Munich, Germany"},{"name":"German Center for Child and Adolescent Health, Site Munich, 80337 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Thi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Dr. von Hauner Children\u2019s Hospital, LMU University Hospital Munich, 80337 Munich, Germany"},{"name":"German Center for Child and Adolescent Health, Site Munich, 80337 Munich, Germany"},{"name":"Stiftung Kindergesundheit, c\/o Dr. von Hauner Children\u2019s Hospital, LMU University Hospital Munich, 80337 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,24]]},"reference":[{"key":"ref_1","unstructured":"Albrecht, U.-V., von Jan, U., Pramann, O., and Fangerau, H. 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