JMIR Publications

ABSTRACT

Background:

Background:

To address the obesity epidemic there is a need for novel paradigms including those that address timing of eating and sleep in relation to circadian rhythms. Electronic health records (EHRs) are an efficient way to identify potentially eligible participants for health research studies, and mobile health (mHealth) applications (apps) offer available and convenient data collection of health behaviors, like timing of eating and sleep.

Objective:

Objective:

This study reports on recruitment, retention and app use over a 6-month study using a mobile app called Daily24.

Methods:

Methods:

Using an EHR query, adult patients from 3 health care systems in the PaTH Clinical Research Network were identified as potentially eligible, electronically invited to participate and instructed to download and use the Daily24 mobile app focused on eating and sleep timing. Online surveys were completed at baseline and 4 months. We described app-use and identified predictors of app-use (defined as one or more days of use) vs. non-use and usage categories (immediate, consistent and sustained) using multivariate regression analyses.

Results:

Results:

Of 70,661 patients sent research invitations, 1,021 (1.4%) completed e-consent and baseline online surveys; 4 withdrew, leaving a total of 1,017 participants in the analytic sample. 54% (n=546) of participants were app-users and, of those, 75% (n=412), 50% (n=274) and 25% (n=139) were immediate, consistent and sustained users, respectively. Median app use was 28 days (IQR 7.0-75.3) over 6-months. Younger age, White race, higher education levels and income, having no children <18, and having used 1-5 health apps significantly predicted app-use (vs non-use) in adjusted models. Older age and lower BMI predicted early, consistent and sustained use. About half (52%) of participants completed 4-month online surveys and 34%, 30%, and 26% of app-users were still using the app for at least 2 days/month during months 4, 5 and 6 of the study, respectively.

Conclusions:

Conclusions:

EHR recruitment offers an efficient way to recruit participants from healthcare settings into mHealth research. Efforts to recruit and retain less engaged subgroups are needed to collect more generalizable data. Additionally, future app iterations should include more evidence-based features to increase participant utilization.