JMIR Publications

ABSTRACT

Background:

Health and fitness apps have potential benefits to improve self-management and disease control in patients with asthma. However, inconsistent adoption rates have been reported across studies, regions and health systems. A better understanding of the characteristics of users and non-users is critical to design solutions that are effectively adopted by patients, and to ensure that these equitably reach out to different groups of patients, improving rather than entrenching health inequities.

Objective:

To identify the determinants of adoption of general health and fitness mobile apps in patients with asthma and explore the differences between users and non-users in terms of their demographic, educational, clinical, and health services use characteristics.

Methods:

A secondary analysis of Inspirers observational studies was conducted using face-to-face visits. Patients with a diagnosis of asthma were included between November 2017 and August 2020. Individual-level data were collected, including age, gender, marital status, educational level, health status, presence of anxiety and/or depression, postcode, socio-economic index, digital literacy, health services use, and use of health and fitness apps. Multivariate logistic regression was used to model the probability of being a health and fitness app user. Statistical analysis was performed in R.

Results:

A total of 514 patients attended a face-to-face visit in the 49 recruiting centers. Most participants were 40 years or less (66.4%), had at least 10 years of education (57.4%) and were in the three higher quintiles of the socio-economic deprivation index (70.1%). The majority reported an overall good health status (VAS score > 70 in 93.1%) and the prevalence of anxiety and depression was, respectively, 34.3% and 11.9%. The proportion of participants that reported using health and fitness mobile apps was 41.1% (n=211).The multivariate models revealed that single individuals and those with more than 10 years of education are more likely to use health and fitness mobile apps (adjusted OR 2.22 (95%CI [1.05-4.75]) and 1.95 (95%CI [1.12-3.45]), respectively). Higher digital literacy scores were also associated with higher odds of being a user of health and fitness apps, with participants in the second, third and fourth quartiles showing, respectively, adjusted ORs of 6.74 (95%CI [2.90-17.40]), 10.30 (95%CI [4.28-27.56]), and 11.52 (95%CI [4.78-30.87]). Participants with depression symptoms had lower odds of using mobile health and fitness apps (adjusted OR 0.32, 95%CI [0.12-0.83]).

Conclusions:

More studies should be performed in order to better understand which patients with asthma are more prone to use general health and fitness apps as a key to design tailored interventions to improve the adoption of these technologies. Future studies should also assess participants’ general health-seeking behavior, as well as their interest and concerns about digital tools specifically. These factors may impact both initial engagement and sustained use.