Currently submitted to: Journal of Medical Internet Research
Date Submitted: Jun 9, 2019
Open Peer Review Period: Jun 12, 2019 - Aug 7, 2019
(currently open for review and needs more reviewers - can you help?)
Evaluation of the demographic representativeness and health outcomes of users of SiSU Health Stations
SiSU Wellness health check stations collect data on a range of self-reported and machine measured health indicators, including diabetes status, physical activity levels, waist circumference, dietary practices, heart rate, blood pressure, weight, Body Mass Index (BMI) and body fat percentage. Users of the health stations are able to monitor their progress and changes to health over time by connecting their health check station profile to a free application downloadable from Google Play or the iTunes store. The stations and associated application are intended to assist consumers by allowing them to monitor their health status over time and providing alerts to consumers when follow up with a General Practitioner (GP) is recommended.
To assess the demographic representativeness of SiSU Health Station users, identify the factors associated with repeat utilisation stations, and determine whether the health status of repeat users changed between their baseline and final health checks.
SiSU Health Station users were compared with 2014-2015 Australian National Health Survey participants on key demographic and health characteristics to determine representativeness. Binary logistic regression analyses were used to compare demographic and health characteristics of repeat and one-time users. Baseline and final health checks of repeat users were compared using McNemar’s Tests and Wilcoxon Signed Rank Tests. The relationship between number of checks and final health scores was investigated using generalised linear models.
Data from 180,442 SiSU Health Station health checks conducted at 192 locations across Australia between October 2017 and June 2018, including 8,441 repeat users. SiSU Health Stations located in Priceline Pharmacies accounted for 98.4% of checks. The demographic profile of SiSU Health Station users differs from that of the general population. A larger proportion of SiSU users were female (55.87% vs 50.72%), younger (47.87% vs 34.49% under 35 years) and socio-economically advantaged (35.68% vs 20.325. When considering the gender profile of Priceline Pharmacy customers, males were found to be substantially over-indexed on health station usage, accounting for 44.10% of health checks but only 3.00% of customers. Compared with NHS participants, a smaller proportion of SiSU Health Station users were overweight or obese, were smokers, had high blood pressure or had diabetes. When data were weighted for demographic differences, only rates of high blood pressure were found to be lower for SiSU users compared to National Health Survey participants (OR=1.26, p<0.001). Repeat users were more likely to be female (OR=1.37, p<0.001), younger (OR=0.99, p<0.001), and from high socio-economic status areas - those residing in SEIFA quintiles 4 and 5 were significantly more likely to be repeat users compared to those residing in quintile 1 (OR=1.243, p<0.001 and OR=1.151, p<0.001 respectively). Repeat users were more likely to have higher body mass index (OR=1.02 p<0.001), high blood pressure (OR=1.15, p<0.001), and less likely to be smokers (OR=0.77, p<0.001). Significant improvements in health status were observed for repeat users. Mean BMI decreased by 0.97kg/m2 from baseline to final check (z=-14.24, p<0.001), while the proportion of people with high blood pressure decreased from 15.8% to 12.9% (2=38.21, p<0.001). The proportion of smokers decreased from 11.9% to 10.1% (2=48.39, p<0.001). The number of repeat health checks was found to be significantly associated with smoking status (OR=0.96, p<0.048), but not with higher blood pressure (p=0.142) or BMI (p=0.225).
These findings provide valuable insight into the health benefits of health stations for self-monitoring and partially support previous research regarding the effect of demographics and health status on uptake of self-management of health.
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