Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Aug 27, 2025
Open Peer Review Period: Aug 27, 2025 - Oct 22, 2025
Date Accepted: Dec 16, 2025
(closed for review but you can still tweet)
User Profiles and Engagement in a Hypertension Self-Management App: Cross-Sectional Survey
ABSTRACT
Background:
Mobile health (mHealth) technologies can improve hypertension self-management, yet real-world adoption remains limited and unequally distributed.
Objective:
This study aimed to characterize the profiles, usage patterns and engagement of active users of a hypertension self-management app (Hypertension.APP) in Germany, with a focus on user engagement and potential digital divides.
Methods:
A cross-sectional online survey was conducted among adult users of the Hypertension.APP between January and September 2023. An 88-item questionnaire assessed app usage patterns, perceived utility, integration into clinical care, sociodemographic and clinical data, and digital health literacy (eHEALS). Descriptive statistics and univariable ordinal logistic regression were used for analysis.
Results:
Of 254 respondents (mean age 53.6 years, 54.3% male), 44.5% had higher education and 44.5% reported above-average income. Most (72.0%) showed moderate or high digital health literacy. While app engagement was high, 80.7% used the app at least weekly, and 52.4% to prepare for medical visits, only 20.1% reported formal integration of the app into their care. Higher education, longer hypertension duration, and residence in small towns were associated with more frequent use, while elevated systolic blood pressure (≥140 mmHg) was associated with less frequent use.
Conclusions:
App users were predominantly well-educated, digitally literate individuals with established hypertension, indicating a persistent digital divide. To promote equitable access and usage, future mHealth strategies should emphasize inclusivity, clinical integration, and support for users with lower digital literacy. Clinical Trial: DRKS00029761
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