Mobile Health (mHealth) Technology: Assessment of Availability, Acceptability, and Use in CKD

Abstract [from journal]

Rationale & objective: Digital and mobile health (mHealth) technologies improve patient-provider communication and increase information accessibility. We assessed technology use, attitudes toward using mHealth technologies, and the proficiency in using mHealth technologies among individuals with chronic kidney disease (CKD).

Study design: Cross-sectional survey with open text responses SETTING & PARTICIPANTS: Chronic Renal Insufficiency Cohort Study participants who completed current use and interest in using mHealth technologies questionnaires, and the eHealth literacy Survey (eHEALS).

Exposures: Participant characteristics OUTCOMES: Technology use (internet/email/smartphone/mHealth applications [apps]), interest in future mHealth use, and proficiency in using digital and mHealth technologies, or eHealth literacy, determined by eHEALS score.

Analytic approach: Poisson regression and a qualitative content analysis of open-ended responses RESULTS: Study participants (N=932) had a mean age of 68 years, eGFR 54 ml/min/1.73m2, and 59% were male. Approximately 70% reported current use of internet/email/smartphones, and 35% used mHealth apps; only 27% had adequate eHealth literacy (eHEALS score ≥32). Participants <65 years (vs. ≥65), with more education, higher income, better cognition, and adequate health literacy reported more technology use, and greater interest in using technologies. Participants of white (vs. non-white) race reported more internet/email use, but less interest in future mHealth use. Younger age, higher annual income, and greater disease self-efficacy were associated with adequate eHealth literacy. Three themes regarding interest in using digital and mHealth technologies emerged: willingness, concerns, and barriers.

Limitations: Residual confounding, ascertainment bias CONCLUSIONS: Many individuals with CKD currently use the internet and smartphones, and are interested in using mHealth in the future, but few use mHealth apps or have adequate eHealth literacy. mHealth technologies present an opportunity to engage individuals with CKD, especially members of racial or ethnic minority groups since they reported greater interest in using mHealth technology, compared to the non-minority population. Further research is needed to identify strategies to overcome inadequate eHealth literacy.