Factors associated with long-term use of digital devices in the electronic Framingham Heart Study
Abstract Long-term use of digital devices is critical for successful clinical or research use, but digital health studies are challenged by a rapid drop-off in participation. A nested e-cohort (eFHS) is embedded in the Framingham Heart Study and uses three system components: a new smartphone app, a...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2022-12-01
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| Series: | npj Digital Medicine |
| Online Access: | https://doi.org/10.1038/s41746-022-00735-1 |
| _version_ | 1827609298181554176 |
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| author | Chathurangi H. Pathiravasan Yuankai Zhang Xuzhi Wang Ludovic Trinquart Emelia J. Benjamin Belinda Borrelli David D. McManus Vik Kheterpal Honghuang Lin Nicole L. Spartano Eric Schramm Chunyu Liu Joanne M. Murabito |
| author_facet | Chathurangi H. Pathiravasan Yuankai Zhang Xuzhi Wang Ludovic Trinquart Emelia J. Benjamin Belinda Borrelli David D. McManus Vik Kheterpal Honghuang Lin Nicole L. Spartano Eric Schramm Chunyu Liu Joanne M. Murabito |
| author_sort | Chathurangi H. Pathiravasan |
| collection | DOAJ |
| description | Abstract Long-term use of digital devices is critical for successful clinical or research use, but digital health studies are challenged by a rapid drop-off in participation. A nested e-cohort (eFHS) is embedded in the Framingham Heart Study and uses three system components: a new smartphone app, a digital blood pressure (BP) cuff, and a smartwatch. This study aims to identify factors associated with the use of individual eFHS system components over 1-year. Among 1948 eFHS enrollees, we examine participants who returned surveys within 90 days (n = 1918), and those who chose to use the smartwatch (n = 1243) and BP cuff (n = 1115). For each component, we investigate the same set of candidate predictors for usage and use generalized linear mixed models to select predictors (P < 0.1, P value from Z test statistic), adjusting for age, sex, and time (app use: 3-month period, device use: weekly). A multivariable model with the predictors selected from initial testing is used to identify factors associated with use of components (P < 0.05, P value from Z test statistic) adjusting for age, sex, and time. In multivariable models, older age is associated with higher use of all system components. Female sex and higher education levels are associated with higher completion of app-based surveys whereas higher scores for depressive symptoms, and lower than excellent self-rated health are associated with lower use of the smartwatch over the 12-month follow-up. Our findings show that sociodemographic and health related factors are significantly associated with long-term use of digital devices. Future research is needed to test interventional strategies focusing on these factors to evaluate improvement in long-term engagement. |
| first_indexed | 2024-03-09T07:29:19Z |
| format | Article |
| id | doaj.art-7e28d9f22a3d48a79663ea723f5f6793 |
| institution | Directory Open Access Journal |
| issn | 2398-6352 |
| language | English |
| last_indexed | 2024-03-09T07:29:19Z |
| publishDate | 2022-12-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | npj Digital Medicine |
| spelling | doaj.art-7e28d9f22a3d48a79663ea723f5f67932023-12-03T06:30:55ZengNature Portfolionpj Digital Medicine2398-63522022-12-015111110.1038/s41746-022-00735-1Factors associated with long-term use of digital devices in the electronic Framingham Heart StudyChathurangi H. Pathiravasan0Yuankai Zhang1Xuzhi Wang2Ludovic Trinquart3Emelia J. Benjamin4Belinda Borrelli5David D. McManus6Vik Kheterpal7Honghuang Lin8Nicole L. Spartano9Eric Schramm10Chunyu Liu11Joanne M. Murabito12Department of Biostatistics, Boston University School of Public HealthDepartment of Biostatistics, Boston University School of Public HealthDepartment of Biostatistics, Boston University School of Public HealthDepartment of Biostatistics, Boston University School of Public HealthBoston University’s and National Heart, Lung, and Blood Institute’s Framingham Heart StudyHenry M. Goldman School of Dental Medicine, Center for Behavioral Science Research, Department of Health Policy & Health Services Research, Boston UniversityDepartment of Medicine, University of Massachusetts Chan Medical SchoolCareEvolutionDepartment of Medicine, University of Massachusetts Chan Medical SchoolSection of Endocrinology, Diabetes, Nutrition, and Weight Management, Boston University Chobanian & Avedisian School of MedicineCareEvolutionDepartment of Biostatistics, Boston University School of Public HealthBoston University’s and National Heart, Lung, and Blood Institute’s Framingham Heart StudyAbstract Long-term use of digital devices is critical for successful clinical or research use, but digital health studies are challenged by a rapid drop-off in participation. A nested e-cohort (eFHS) is embedded in the Framingham Heart Study and uses three system components: a new smartphone app, a digital blood pressure (BP) cuff, and a smartwatch. This study aims to identify factors associated with the use of individual eFHS system components over 1-year. Among 1948 eFHS enrollees, we examine participants who returned surveys within 90 days (n = 1918), and those who chose to use the smartwatch (n = 1243) and BP cuff (n = 1115). For each component, we investigate the same set of candidate predictors for usage and use generalized linear mixed models to select predictors (P < 0.1, P value from Z test statistic), adjusting for age, sex, and time (app use: 3-month period, device use: weekly). A multivariable model with the predictors selected from initial testing is used to identify factors associated with use of components (P < 0.05, P value from Z test statistic) adjusting for age, sex, and time. In multivariable models, older age is associated with higher use of all system components. Female sex and higher education levels are associated with higher completion of app-based surveys whereas higher scores for depressive symptoms, and lower than excellent self-rated health are associated with lower use of the smartwatch over the 12-month follow-up. Our findings show that sociodemographic and health related factors are significantly associated with long-term use of digital devices. Future research is needed to test interventional strategies focusing on these factors to evaluate improvement in long-term engagement.https://doi.org/10.1038/s41746-022-00735-1 |
| spellingShingle | Chathurangi H. Pathiravasan Yuankai Zhang Xuzhi Wang Ludovic Trinquart Emelia J. Benjamin Belinda Borrelli David D. McManus Vik Kheterpal Honghuang Lin Nicole L. Spartano Eric Schramm Chunyu Liu Joanne M. Murabito Factors associated with long-term use of digital devices in the electronic Framingham Heart Study npj Digital Medicine |
| title | Factors associated with long-term use of digital devices in the electronic Framingham Heart Study |
| title_full | Factors associated with long-term use of digital devices in the electronic Framingham Heart Study |
| title_fullStr | Factors associated with long-term use of digital devices in the electronic Framingham Heart Study |
| title_full_unstemmed | Factors associated with long-term use of digital devices in the electronic Framingham Heart Study |
| title_short | Factors associated with long-term use of digital devices in the electronic Framingham Heart Study |
| title_sort | factors associated with long term use of digital devices in the electronic framingham heart study |
| url | https://doi.org/10.1038/s41746-022-00735-1 |
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