Study Finds Demographics And Health Factors Associated With Long-Term Use Of Digital Health Tools

A new study has demonstrated that several sociodemographic and health-related factors, such as age, gender, education, and depressive symptoms, are significantly linked to the long-term use of digital health technologies. The research, which was published in npj Digital Medicine, sought to determine the long-term use of digital health devices and apps in different studies. Smartphones, smartwatches, and Bluetooth-enabled devices are becoming more and more prevalent in health research as they enable the tracking of an extensive array of health behaviors and help patients to manage their diseases more effectively. However, researchers highlighted that one of the primary issues with digital health studies is getting people to adhere to device use over an extended period of time.

In 2016, the Framingham Heart Study launched a nested e-cohort to investigate cardiovascular disease phenotypes using digital devices. Established in 1948, this long-term study aims to discover the common elements that cause cardiovascular disease across multiple generations. Those in the e-cohort had access to a health survey app, a smartwatch, and a digital BP cuff. Participants using the app were instructed to fill out surveys at enrollment and every three months, while those with the smartwatch had their steps and heart rate monitored daily. Lastly, those with the BP cuff had measurements taken weekly.  A total of 1,243 people chose to utilize a smartwatch, while 1,125 opted for a BP device. Out of those, 1,185 submitted step or heart rate data from the smartwatch, while 969 provided BP measurements. From the 1,918 cohort members who used the smartphone app, 1,705 finished a baseline survey within three months. In the end, 798 individuals used all three tools. 

The study revealed that the utilization of both smartwatches and BP cuffs declined over a one-year period. Smartwatch usage decreased from 56% at 26 weeks to 44% at 52 weeks, while BP cuff use dropped from 26% at 26 weeks to 21% at 52 weeks. In addition, research found that the odds of using a smartwatch were higher than a BP cuff overall, and that older individuals were more likely to utilize these digital devices than younger adults. Moreover, it was revealed that participants with higher depressive symptoms scores had a lower propensity for smartwatch usage. At the beginning of the study, both men and women had a high survey return rate. However, as time went on, survey completion using the smartphone app decreased. Female participants were more likely than male participants to finish the surveys at each three-month interval during the study. Furthermore, those in the age groups of 65 years and older and 55-65 were more likely to use the survey app than younger participants. Lastly, college graduates and those with a professional degree were more likely to utilize the app than those with a high school or less than a high school education.

According to the researchers, this study’s results can be used to design future research that will expand engagement with digital devices for CVD monitoring. Those with lower education levels, below-excellent reported health, and greater depressive symptoms may need extra assistance to maintain device utilization. As health care providers increasingly rely on digital devices to optimize patient care, sustaining engagement will be even more essential.