@Article{info:doi/10.2196/41767,
author="Hogan, Timothy P
and Etingen, Bella
and Lipschitz, Jessica M
and Shimada, Stephanie L
and McMahon, Nicholas
and Bolivar, Derek
and Bixler, Felicia R
and Irvin, Dawn
and Wacks, Rachel
and Cutrona, Sarah
and Frisbee, Kathleen L
and Smith, Bridget M",
title="Factors Associated With Self-reported Use of Web and Mobile Health Apps Among US Military Veterans: Cross-sectional Survey",
journal="JMIR Mhealth Uhealth",
year="2022",
month="Dec",
day="30",
volume="10",
number="12",
pages="e41767",
keywords="mobile health apps; patient engagement; consumer health informatics; provider encouragement; veterans",
abstract="Background: Despite their prevalence and reported patient interest in their use, uptake of health-related apps is limited. The Veterans Health Administration (VHA) has developed a variety of apps to support veterans; however, uptake remains low nationally. Objective: We examined the prevalence of VHA health-related app use and how veterans learned about these apps in order to identify factors associated with their use. Methods: As part of a VHA quality improvement initiative, we recruited a national cohort of veterans to obtain feedback on their use of technology for health and collected data from them via a cross-sectional survey. The survey data were supplemented with VHA administrative data. We used descriptive statistics to examine demographic and health characteristics, health-related technology use, and how veterans learned about apps. We assessed factors associated with app use using bivariate analyses and multiple logistic regression models. Results: We had complete data on 1259 veterans. A majority of the sample was male (1069/1259, 84.9{\%}), aged older than 65 years (740/1259, 58.8{\%}), White (1086/1259, 86.3{\%}), and non-Hispanic (1218/1259, 96.7{\%}). Most respondents (1125/1259, 89.4{\%}) reported being very comfortable and confident using computers, over half (675/1259, 53.6{\%}) reported being an early adopter of technology, and almost half (595/1259, 47.3{\%}) reported having used a VHA health-related app. Just over one-third (435/1259, 34.6{\%}) reported that their VHA care team members encouraged them to use health-related apps. Respondents reported learning about available VHA health-related apps by reading about them on the VHA's patient portal (468/1259, 37.2{\%}), being told about them by their VHA health care team (316/1259, 25.1{\%}), and reading about them on the VHA's website (139/1259, 11{\%}). Veterans who self-reported having used VHA health-related apps were more likely to receive care at the VHA (OR [odds ratio] 1.3, 95{\%} CI 1.0-1.7), be in worse health (as assessed by Hierarchical Condition Community score; OR 1.1, 95{\%} CI 1.0-1.2), report owning a desktop or laptop computer (OR 1.8, 95{\%} CI 1.1-3.1), have posttraumatic stress disorder (OR 1.4, 95{\%} CI 1.1-1.9), and report having VHA health care team members encourage them to use the apps (OR 2.7, 95{\%} CI 2.1-3.4). Conclusions: We found strong associations between self-reported use by veterans of VHA health-related apps and multiple variables in our survey. The strongest association was observed between a veteran self-reporting app use and having received encouragement from their VHA health care team to use the apps. Veterans who reported receiving encouragement from their VHA care team members had nearly 3 times higher odds of using VHA apps than veterans who did not report receiving such encouragement. Our results add to growing evidence suggesting that endorsement of apps by a health care system or health care team can positively impact patient uptake and use. ",
issn="2291-5222",
doi="10.2196/41767",
url="https://mhealth.jmir.org/2022/12/e41767",
url="https://doi.org/10.2196/41767",
url="http://www.ncbi.nlm.nih.gov/pubmed/36583935"
}