Health App Use and Its Correlates Among Individuals With and Without Type 2 Diabetes: Nationwide Population-Based Survey

Lena M Stühmann; Rebecca Paprott; Christin Heidemann; Jens Baumert; Sylvia Hansen; Daniela Zahn; Christa Scheidt-Nave; Paul Gellert

doi:10.2196/14396

Health App Use and Its Correlates Among Individuals With and Without Type 2 Diabetes: Nationwide Population-Based Survey

JMIR Diabetes. 2020 May 20;5(2):e14396. doi: 10.2196/14396.

Authors

Lena M Stühmann¹, Rebecca Paprott², Christin Heidemann², Jens Baumert², Sylvia Hansen³, Daniela Zahn^{4

5}, Christa Scheidt-Nave², Paul Gellert¹

Affiliations

¹ Institute for Medical Sociology and Rehabilitation Science, Charité - Universitätsmedizin Berlin, Berlin, Germany.
² Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
³ Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health, Cologne, Germany.
⁴ Preventive Cardiology and Medical Prevention, Department of Cardiology, University Medical Centre, Johannes Gutenberg University, Mainz, Germany.
⁵ Federal Center for Health Education (BZgA), Office for National Education and Communication on Diabetes Mellitus, Cologne, Germany.

PMID: 32432555
PMCID: PMC7270854
DOI: 10.2196/14396

Abstract

Background: Evidence suggests that mobile health app use is beneficial for the prevention and management of type 2 diabetes (T2D) and its associated complications; however, population-based research on specific determinants of health app use in people with and without T2D is scarce.

Objective: This cross-sectional study aimed to provide population-based evidence on rates and determinants of health app use among adults with and without T2D, thereby covering a prevention perspective and a diabetes management perspective, respectively.

Methods: The study population included 2327 adults without a known diabetes diagnosis and 1149 adults with known T2D from a nationwide telephone survey in Germany conducted in 2017. Rates of smartphone ownership and health app use were estimated based on weighted sample proportions. Among smartphone owners, determinants of health app use were identified for both groups separately in multivariable logistic regression models. Sociodemographic factors, diabetes-related factors or indicators, psychological and health-related factors, and physician-provided information were selected as potential determinants.

Results: Among participants without known diabetes, 74.72% (1690/2327) were smartphone owners. Of those, 49.27% (717/1690) used health apps, most often to improve regular physical activity. Among participants with T2D, 42.26% (481/1149) were smartphone owners. Of those, 41.1% (171/481) used health apps, most commonly to target a healthy diet. Among people without known diabetes, determinants significantly (all P values <.05) associated with an increased likelihood of health app use compared with their reference group were as follows: younger and middle age of 18 to 44 or 45 to 64 years (odds ratios [ORs] 3.89; P<.001 and 1.76; P=.004, respectively), overweight or obesity (ORs 1.58; P<.001 and 2.07; P<.001, respectively), hypertension diagnosis (OR 1.31; P=.045), former or current smoking (ORs 1.51; P=.002 and 1.58; P<.001, respectively), perceiving health as very good (OR 2.21; P<.001), other chronic diseases (OR 1.48; P=.002), and having received health advice from a physician (OR 1.48; P<.001). A slight or high perceived diabetes risk (ORs 0.78; P=.04 and 0.23; P<.001, respectively) was significantly associated with a decreased likelihood of health app use. Among people with T2D, younger and middle age (18-64 years; OR 1.84; P=.007), female gender (OR 1.61; P=.02), and using a glucose sensor in addition or instead of a glucose meter (OR 2.74; P=.04) were significantly positively associated with health app use.

Conclusions: In terms of T2D prevention, age, diabetes-related risk factors, psychological and health-related factors, and medical health advice may inform app development for specific target groups. In addition, health professionals may encourage health app use when giving advice on health behaviors. Concerning T2D management, only a few determinants seem relevant for explaining health app use among people with T2D, indicating a need for more future research on which people with T2D use health apps and why.

Keywords: diabetes mellitus; health promotion; health-related behavior; mobile app; risk factors; smartphone; type 2 diabetes.

©Lena M Stühmann, Rebecca Paprott, Christin Heidemann, Jens Baumert, Sylvia Hansen, Daniela Zahn, Christa Scheidt-Nave, Paul Gellert. Originally published in JMIR Diabetes (http://diabetes.jmir.org), 20.05.2020.