Design and Preliminary Findings From a New Electronic Cohort Embedded in the Framingham Heart Study

J Med Internet Res. 2019 Mar 1;21(3):e12143. doi: 10.2196/12143.


Background: New models of scalable population-based data collection that integrate digital and mobile health (mHealth) data are necessary.

Objective: The aim of this study was to describe a cardiovascular digital and mHealth electronic cohort (e-cohort) embedded in a traditional longitudinal cohort study, the Framingham Heart Study (FHS).

Methods: We invited eligible and consenting FHS Generation 3 and Omni participants to download the electronic Framingham Heart Study (eFHS) app onto their mobile phones and co-deployed a digital blood pressure (BP) cuff. Thereafter, participants were also offered a smartwatch (Apple Watch). Participants are invited to complete surveys through the eFHS app, to perform weekly BP measurements, and to wear the smartwatch daily.

Results: Up to July 2017, we enrolled 790 eFHS participants, representing 76% (790/1044) of potentially eligible FHS participants. eFHS participants were, on average, 53±8 years of age and 57% were women. A total of 85% (675/790) of eFHS participants completed all of the baseline survey and 59% (470/790) completed the 3-month survey. A total of 42% (241/573) and 76% (306/405) of eFHS participants adhered to weekly digital BP and heart rate (HR) uploads, respectively, over 12 weeks.

Conclusions: We have designed an e-cohort focused on identifying novel cardiovascular disease risk factors using a new smartphone app, a digital BP cuff, and a smartwatch. Despite minimal training and support, preliminary findings over a 3-month follow-up period show that uptake is high and adherence to periodic app-based surveys, weekly digital BP assessments, and smartwatch HR measures is acceptable.

Keywords: ambulatory; blood pressure monitoring; cohort studies; smartphone; tele-medicine.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cell Phone / standards*
  • Cohort Studies
  • Electronics / methods*
  • Female
  • Humans
  • Longitudinal Studies*
  • Male
  • Middle Aged
  • Smartphone / standards*
  • Surveys and Questionnaires
  • Telemedicine / methods*