JMIR Publications

ABSTRACT

Background:

In the United States, some 90% of women are at risk of at least one chronic condition. However, the awareness, management, and monitoring of these conditions are low and present a significant public health problem. Digital health tools have the potential to advance and monitor chronic diseases because they are a considerable opportunity to prevent and reduce the alarmingly high rates of chronic condition-related mortality and morbidity in women.

Objective:

This study aimed to investigate the four-year trend of digital health use for health promotion activities among women with chronic conditions in the United States.

Methods:

Data for this study was obtained from the 2017 to 2020 iterations of the Health Information Trends Survey (HINTS) 5. Chi-square tests were used to compare the demographic characteristics of the study population by chronic disease status. Separate weighted logistic regression models were then conducted to test the unadjusted association of the study variables and each digital health use. Next, multivariate logistic regression models were performed to measure the association between the six digital health use variables and covariates. The 95% confidence interval (CI), adjusted odds ratio (aOR), and p-value (.05) were reported. Analysis was conducted using Stata 17

Results:

8573 women were included in this study. The use of a smartphone/tablet to track health goals was 50.3% (95% CI 48.4-52.2), to make a health decision was 43.6% (95% CI 41.9-45.3), and to discuss with a provider was 40% (95% CI 38.2-41.8). In the preceding twelve months, 33% (95% CI 30.9-35.2) used an electronic wearable device, 18.7% (95% CI 17.3-20.2) shared health information, and 35.2% (95% CI 33.2-37.3) sent/received a text message with a health professional. The weighted prevalence of having zero, one, and multiple chronic conditions was 37.4%, 33.4%, and 29.3%. However, there was a steady rise in the prevalence of multiple chronic conditions between 2017 and 2020. Women with multiple chronic conditions had higher odds of using their tablet/smartphone to achieve a health-related goal (aOR 1.43, 95% CI 1.16-1.77) and discuss with their provider (aOR 1.55 95% CI 1.20-2.00) than do those without any chronic condition. Correspondingly, in the past 12 months, the odds of using an electronic wearable device (aOR 1.40, 95% CI 1.00-1.96), sharing health information (aOR 1.91, 95% CI 1.46-2.51), and communicating via text with a provider (aOR 1.31, 95% CI 1.02-1.68) was significantly higher than women without a chronic condition.

Conclusions:

Women with chronic conditions accept and integrate digital health tools to manage their care. However, certain subpopulations experience a digital disconnect that may exacerbate existing health inequities. Implications for research and opportunities to leverage and integrate digital health tools to prevent, monitor, manage, and treat chronic conditions in women are discussed.