JMIR Publications

ABSTRACT

Background:

Smartphone applications (apps) can be used to monitor chronic conditions and offer opportunities for self-assessment conveniently at home. However, few digital studies include older adults.

Objective:

To describe a new electronic cohort (eCohort) of older adults embedded in the Framingham Heart Study (FHS) including baseline smartphone survey return rates and survey completion rates by smartphone type (iPhone and Android users). To report survey results for selected baseline surveys and participant experience with the study app.

Methods:

FHS Offspring and Omni (multi-ethnic cohort) participants who owned a smartphone were invited to download the study app that contained a range of survey types to report on different aspects of health including self-reported measures from the Patient-Reported Outcomes Measurement Information System (PROMIS). iPhone users also completed four cognitive and physical function testing tasks. Baseline survey return and completion rates were calculated for 12 surveys and compared between iPhone and Android users. We calculated standardized scores for the PROMIS surveys. The Mobile App Rating Survey (MARS) was deployed 30 days after enrollment to obtain participant feedback on app functionality and aesthetics.

Results:

We enrolled 611 smartphone users (average age 73.6±6.3 years, 56.6% women, 14.4% Omni participants, 77% iPhone users) and 596 (97.5%) returned at least one baseline survey. iPhone users had higher app survey return rates than Android users for each survey (range 85.5 to 98.3% vs 73.8 to 95.2% respectively), but survey completion rates did not differ in the two smartphone groups. The return rate for the four iPhone tasks ranged from 80.9% for the Gait task to 88.9% for the Trail Making Test task. The eFHS participants had better standardized T-scores in six of seven PROMIS surveys compared to the general population mean (T-score =50) including higher cognitive function (55.6) and lower fatigue (45.5). Among 469 participants who returned the MARS survey, app functionality and aesthetics was rated high (total MARS score = 8.6 on a 1-10 scale).

Conclusions:

We effectively engaged community-dwelling older adults to use a smartphone app designed to collect health information relevant to older adults. High app survey return rates and very high app survey completion rates were observed along with high participant rating of the study app.