JMIR Publications

ABSTRACT

Background:

Diverse health behaviors are addressed via mobile apps, and users' engagement might differ depending on the purpose.

Objective:

This study examined the prevalence, usage patterns, and user characteristics of various types of apps within a nationally representative sample of Czech adults. The user characteristics associated with app usage for "promoting wellness" and "managing illness" were determined. We focused on the roles of sociodemographic variables, digital knowledge and use, and health indicators to evaluate app use and usage patterns.

Methods:

A nationally representative sample of 4775 Czech adults (2365/4775, 49.5% women) aged 18 to 95 (mean 45.37, SD 16.40) was recruited for this study. The sociodemographic factors were age, gender, educational level, and income status. Digital knowledge and use were evaluated via eHealth literacy and the passive and active use of social networking sites (SNS) for health information. Symptom severity, physical activity, body mass index, and eating disorder-related risk propensity were evaluated as health indicators. We assessed app usage in the following areas: sports, number of steps, nutrition, vitals, sleep, diagnosed conditions, reproductive health, diagnosis assistance, mood and mental well-being, and emergency care guidance. The multivariate hierarchical binary logistic regression analyses examined the significant predictors of app use. mHealth apps were clustered under apps to "promote wellness" and "manage illness" using the Exploratory Structural Equation Modeling (ESEM) approach. The ESEM was also utilized to determine the user characteristics associated with wellness- and illness-related app usage.

Results:

Around half of the participants (2172/4440; 48.92%) used mHealth apps. The app use predictors were age, monthly income status, eHealth literacy, passive use of SNS for health information, and eating disorder-related risk propensity. Apps that counted the number of steps were used most frequently, followed by apps to track sleep, vitals, and sports. The two-factor structure of app usage, "promoting wellness" and "managing illness," was confirmed. Younger age and higher eating disorder-related risks were the common predictors of using wellness and illness apps. Also, wellness app users were more eHealth literate and physically active. In contrast, users of apps to manage illness engaged more actively with SNS about health. We observed that digital knowledge and use and health indicators significantly mediated the association between age and mHealth app use.

Conclusions:

Addressing specific user characteristics could significantly reduce digital disparities in mHealth app utilization and thus mitigate health disparities in various population segments.