Understanding Patient Attitudes Toward Smart Digital Health Devices

By Dr Silpaja Chandrasekar, PhDReviewed by Susha Cheriyedath, M.Sc.Feb 25 2024

In a paper published in the journal Digital Medicine, researchers investigated the ownership, usage, and willingness to share data collected by intelligent portable devices among patients within a southeastern United States (US) academic health system. A survey of 1368 participants from an online patient advisory group found that 98% owned smartphones and 59% owned wearables, with specific demographics more inclined towards wearable ownership.

About half of the respondents were willing to share their smart device data, with preferences varying by demographic factors. These insights offer opportunities for designing inclusive digital health studies and advancing the development of equitable digital health technologies.

Related Work

Past research has highlighted the transformative potential of intelligent portable digital devices like smartphones and smartwatches, which gather extensive physiological and activity data for health monitoring and disease tracking. However, despite their widespread adoption, there needs to be more understanding regarding ownership, usage patterns, and the willingness of individuals to share personal data for research.

Previous studies have pointed to challenges, including the need for more diversity in research cohorts and potential biases in data analysis. Additionally, stakeholders have raised concerns about the security and privacy of personal data collected by these devices and have questioned the reliability and accuracy of the data collected, particularly in certain demographic groups. Moreover, there is a need to address digital literacy disparities. Not all individuals may have the knowledge or resources to utilize these technologies for health monitoring and research purposes effectively.

DUHS Patient Survey

A survey was conducted among patients within the Duke University Health System (DUHS) using the Duke Health Listens (DHL) online community. DHL, housing 3021 members, predominantly DUHS patients, serves as a platform for direct feedback on improving patient experience and healthcare services. The survey, administered from January 18 to January 30, 2022, encompassed 14 questions on smart device ownership, usage patterns, willingness to engage in digital health studies, and demographic details.

Participants of the DHL community provided informed e-consent upon joining, covering their involvement in various studies organized within the community. The Duke Health Institutional Review Board granted exemption from review under protocol ID: Pro00115157. The DHL leadership collaborated in preparing the survey, managed the study, and supplied de-identified responses to the research team.

Upon data collection, responses alongside demographic information were subjected to statistical analysis to discern associations between demographic factors (gender, age group, race/ethnicity, education level, employment status) and aspects related to smart device ownership, usage, and willingness to participate in digital health studies. Researchers explored potential associations using chi-square tests of independence and then conducted post hoc testing utilizing Benjamini-Hochberg multiple hypothesis correction for statistically significant associations.

Statistical analysis examined potential associations between demographic factors and outcome variables, with post hoc testing applied to correct for significant associations. Researchers established statistical significance at α = 0.05. Descriptive statistics were reported, including total number, percentage, degrees of freedom, sample size, test statistics, and p-values.

Survey Overview and Findings

The DUHS survey utilized the DHL platform, encompassing 3021 members, predominantly DUHS patients, to gather responses from a diverse sample of patients. Administered between January 18 and January 30, 2022, the survey comprised 14 questions about smart device ownership, usage patterns, willingness to engage in digital health studies, and demographic details. Among the respondents, totaling 1368, there was a notable representation of females (64%), and individuals aged 58 and above constituted approximately half of the respondents.

Smart device ownership was widespread among the surveyed population, with 98% owning a smartphone, predominantly iPhones (66.6%). Wearable device ownership was also significant, with 60% of respondents owning one, particularly favoring the Apple Watch and Fitbit. Differences in ownership were observed across demographic factors such as age, education, and employment status, underscoring disparities in access to these technologies.

Usage patterns revealed that most smartphone owners (59%) utilized their devices for health and fitness tracking. Wearable device usage varied, with 42.3% reporting continuous wear, while 42.1% wore them only during the day. The primary reason for owning wearables was fitness and workout monitoring, followed by communication functions.

Factors influencing the decision not to own wearable devices included cost, lack of interest in tracking, and privacy concerns, with notable variations across demographic groups. Privacy concerns were more pronounced among specific demographic segments, indicating potential barriers to data sharing in research and clinical settings. Understanding these nuances is crucial for designing equitable digital health studies and interventions.

The willingness to participate in digital health studies and share personal data varied across demographic factors, with younger generations exhibiting higher willingness than retirees. Fitness and workout monitoring data were most readily shared, while self-reported measures from health and fitness apps were less favored. Comfort around data sharing differed by gender, age, education, and employment status, underscoring the importance of considering these factors in research design and implementation.

Conclusion

In conclusion, the survey conducted among DUHS patients through the DHL platform revealed widespread ownership and usage of smartphones and wearables, with notable variations across demographic groups. While usage patterns emphasized health and fitness tracking, barriers such as cost and privacy concerns were identified, influencing willingness to participate in digital health studies and share personal data. Addressing these barriers and leveraging the potential of smart devices can facilitate more inclusive and effective digital health interventions, ultimately improving health outcomes for diverse patient populations.