Log in to MyACC
Wearable Device Use in Individuals With or at Risk for CVD
Quick Takes
- Self-reported use of wearable devices for activity or health monitoring was lower among patients with or at risk for cardiovascular disease (CVD) when compared to the larger population of US adults, though this was driven by demographic and socioeconomic differences between groups.
- Important differences exist in the use of wearable devices based on demographic and socioeconomic factors, including those prevalent in patients with or at risk for CVD.
- Individuals with CVD use their wearable devices less frequently than the larger US adult population.
Study Questions:
What are the sociodemographic patterns of use of wearable devices among US adults with or at risk for cardiovascular disease (CVD)?
Methods:
The authors performed a cross-sectional study using data from the Health Information National Trends Survey (HINTS), the largest nationally representative survey of health technology utilization among community-dwelling adults. The study included adult participants from HINTS 2019 and 2020 and identified those individuals with self-reported CVD or ≥1 CVD risk factor. The primary outcome was the proportion of participants who self-reported using wearable devices to monitor their activity and health over the prior 12 months across CVD risk groups and across important demographic and socioeconomic subgroups of the population. Individual features associated with wearable device use were sequentially evaluated using logistic regression models.
Results:
The study consisted of 9,303 participants in HINTS during 2019 and 2020 (mean age 48.8 years, 51% women). Overall, 10.0% of participants had CVD and 55.7% were at risk for CVD. Among the 9,193 HINTS participants who responded to the wearable use survey question, 25.8% reported using wearable devices for monitoring their health and activity in the prior 12 months, corresponding to a weighted estimate of 29% of US adults. In comparison, 18.3% of participants with CVD reported wearable device use (weighted estimate 18% of US adults) and 23.2% of those at risk for CVD (weighted estimate 26% of US adults). Individuals with or at risk for CVD were significantly less likely to use a wearable device compared to those without CVD or CVD risk factors (p < 0.001 for both), although there were no significant differences between groups after adjusting for demographic and socioeconomic factors.
Among those with CVD, after accounting for demographic characteristics, CVD risk factors, and socioeconomic features, characteristics associated with lower wearable device use included older age, presence of diabetes mellitus, cigarette smoking, lower educational attainment, and lower household income, while non-Hispanic Black race/ethnicity was associated with higher use. Similar results were observed in those with CVD risk factors. An estimated 25% of participants with CVD reported not using their wearable devices in the prior month compared to only 12% of US adults.
Conclusions:
Disparities exist in wearable device use by demographic and socioeconomic factors, including those frequently present in individuals with or at risk for CVD. Individuals with CVD used wearable devices less frequently than the general US adult population, with one in four individuals with CVD reporting nonuse of their wearable devices in the prior month.
Perspective:
Use of mobile health technology is increasing broadly in the general population, although disparities in use persist across important sociodemographic factors, including many that are prevalent in patients with or at risk for CVD. After accounting for factors associated with lower use of wearable devices, use of wearable devices in individuals with or at risk for CVD matched that of the general population, though the frequency with which wearable devices were used remained lower in the CVD population. As use of wearable technology to monitor and manage health increases, greater attention is needed to ensure that key sociodemographic groups have access to these devices such as through loaner programs or insurance companies. Independent of device ownership, however, is the issue of frequency of wearable device use, with individuals with CVD using their devices less frequently than other groups. This may relate to issues of connectivity, perceived lack of value, or usability.
While not evaluated in the current study, those with visual, auditory, and fine motor impairment, for example, which are prevalent in an older CVD population, may be disenfranchised as current wearable devices may fail to meet their needs. For example, selecting wearables with large display screens may be an important consideration for older adults or those with visual impairment to ensure that the devices meet their needs. Thus, issues of affordability, usability, and connectivity all must be considered to achieve digital health equity.
Clinical Topics: Geriatric Cardiology, Heart Failure and Cardiomyopathies, Prevention, Acute Heart Failure, Smoking
Keywords: Aged, Cardiovascular Diseases, Diabetes Mellitus, Ethnic Groups, Heart Failure, Patient Care Team, Primary Prevention, Risk Factors, Socioeconomic Factors, Smoking, Wearable Electronic Devices
< Back to Listings
