Factors associated with long-term use of digital devices in the electronic Framingham Heart Study.

Factors associated with long-term use of digital devices in the electronic Framingham Heart Study.
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与长期使用数字设备在电子弗雷明汉心脏研究中的因素。

DOI:
10.1038/s41746-022-00735-1
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发表时间:
2022-12-27
影响因子:
15.2
通讯作者:
--
中科院分区:
医学1区
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--
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长期使用数字设备对于成功的临床或研究使用至关重要,但数字健康研究面临着参与率迅速下降的挑战。一个嵌套的电子队列(eFHS)嵌入在心脏研究中,使用三个系统组件:一个新的智能手机应用程序,一个数字血压(BP)袖带和一个智能手表。本研究旨在确定与使用单个eFHS系统组件超过1年相关的因素。在1948名eFHS参与者中,我们检查了在90天内返回调查的参与者(n = 1918),以及选择使用智能手表(n = 1243)和BP袖带(n = 1115)的参与者。对于每个组分,我们研究了相同的候选预测因子,并使用广义线性混合模型选择预测因子(P < 0.1,P值来自Z检验统计量),调整年龄、性别和时间(应用程序使用:用途:3个月,器械使用:用途:每周)。使用具有从初始测试中选择的预测因子的多变量模型来识别与使用针对年龄、性别和时间调整的组分(P < 0.05,来自Z检验统计量的P值)相关的因素。在多变量模型中,年龄越大,所有系统组件的使用率越高。女性性别和更高的教育水平与基于应用程序的调查的完成率较高相关,而抑郁症状的得分较高,以及低于优秀的自评健康状况与12个月随访期间智能手表的使用率较低相关。我们的研究结果表明,社会人口和健康相关因素与长期使用数字设备显着相关。未来的研究需要测试干预策略,重点是这些因素,以评估长期参与的改善。
Long-term use of digital devices is critical for successful clinical or research use, but digital health studies are challenged by a rapid drop-off in participation. A nested e-cohort (eFHS) is embedded in the Framingham Heart Study and uses three system components: a new smartphone app, a digital blood pressure (BP) cuff, and a smartwatch. This study aims to identify factors associated with the use of individual eFHS system components over 1-year. Among 1948 eFHS enrollees, we examine participants who returned surveys within 90 days (n = 1918), and those who chose to use the smartwatch (n = 1243) and BP cuff (n = 1115). For each component, we investigate the same set of candidate predictors for usage and use generalized linear mixed models to select predictors (P < 0.1, P value from Z test statistic), adjusting for age, sex, and time (app use: 3-month period, device use: weekly). A multivariable model with the predictors selected from initial testing is used to identify factors associated with use of components (P < 0.05, P value from Z test statistic) adjusting for age, sex, and time. In multivariable models, older age is associated with higher use of all system components. Female sex and higher education levels are associated with higher completion of app-based surveys whereas higher scores for depressive symptoms, and lower than excellent self-rated health are associated with lower use of the smartwatch over the 12-month follow-up. Our findings show that sociodemographic and health related factors are significantly associated with long-term use of digital devices. Future research is needed to test interventional strategies focusing on these factors to evaluate improvement in long-term engagement.
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