Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Feb 18, 2022
Date Accepted: Aug 24, 2022
Mobile Health Use by Older Individuals at Risk of Cardiovascular Disease and Type 2 Diabetes Mellitus in an Australian Cohort: Cross-Sectional Survey Study
ABSTRACT
Background:
The digital transformation has the potential to change healthcare toward more consumers’ involvement, for example, in form of health-related apps which are already widely available through app stores. These could be useful in helping people understand their risk of chronic conditions and helping them to live healthier.
Objective:
With this study, we assessed mobile health app use among older Australians in general and among those who were at risk of cardiovascular disease or type 2 diabetes mellitus.
Methods:
We used data from the second follow-up wave of the 45 and Up Study, which is a cohort study from New South Wales, Australia, with 267,153 participants aged 45 years and older. The 2019 follow-up questionnaire contained questions about technology and mobile health use. We further used data on prescribed drugs and hospitalizations to identify participants who already had cardiovascular disease or diabetes or who were at risk of these conditions. We used descriptive statistics and multivariate logistic regression to answer the research questions.
Results:
Overall, 31,946 individuals with a median age of 69 years (interquartile range: 63, 76) had completed the follow-up questionnaire in 2019. We classified half (51.4%) of these as being at risk of cardiovascular disease or type 2 diabetes mellitus and 38% as having cardiovascular disease or type 1 or type 2 diabetes mellitus. The proportion of mobile health app users among the at-risk group was 31.5% compared to 29.2% in the total sample. Those who used mobile health apps were more likely to be female, younger, without physical disability, and with a higher income. People at risk of cardiovascular disease or type 2 diabetes mellitus were not statistically significantly more likely to use mobile health than people without risk (odds ratio: 1.06; 95% CI: 0.97, 1.16; P=.180; adjusted for age, sex, income, and physical disability).
Conclusions:
People at risk of cardiovascular disease or type 2 diabetes mellitus were not more likely to use mobile health apps than people without risk. Those who used mobile health apps were less likely to be male, older, with a physical disability, and with a lower income. From the results, we concluded that aspects of equity must be considered when implementing a mobile health intervention to reach all those that potentially benefit from it.
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