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Electronic Health Record-Based Recruitment and Retention and Mobile Health App Usage: Multisite Cohort Study.

Janelle W Coughlin1,2, Lindsay M Martin3, Di Zhao2,4

  • 1Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States.

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Summary

Electronic health record (EHR) recruitment efficiently identified participants for a mobile health (mHealth) study on eating and sleep timing. Further efforts are needed to engage diverse populations for more generalizable mHealth research findings.

Keywords:
EHRengagementmHealthmobile appsobesityrecruitmentretentiontiming of eatingtiming of sleep

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Area of Science:

  • Chronobiology
  • Obesity Research
  • Digital Health

Background:

  • Addressing the obesity epidemic requires novel approaches, including understanding the interplay between eating/sleep timing and circadian rhythms.
  • Electronic health records (EHRs) provide an efficient method for identifying research participants.
  • Mobile health (mHealth) applications enable convenient data collection on health behaviors like eating and sleep patterns.

Purpose of the Study:

  • To describe recruitment, retention, and mobile app usage in a 6-month cohort study.
  • To evaluate the Daily24 mobile app for collecting data on eating and sleep timing.
  • To identify predictors of app engagement and usage patterns.

Main Methods:

  • Adult patients were identified via EHR query across three healthcare systems.
  • Participants were invited electronically to download and use the Daily24 mHealth app.
  • Online surveys were administered at baseline and 4 months, with app usage analyzed using multivariate regression.

Main Results:

  • 1017 participants were included; 53.79% used the app, with 25.4% classified as sustained users.
  • Younger age, White race, higher education/income, and prior health app use predicted app use.
  • Older age and lower BMI predicted early, consistent, and sustained app use.
  • App usage declined over time, with 27.1% using the app at least 2 days/month by month 6.

Conclusions:

  • EHR recruitment is an efficient strategy for recruiting participants to mHealth studies.
  • Recruiting and retaining underrepresented subgroups is crucial for generalizable mHealth research.
  • Future mHealth app development should incorporate evidence-based features to enhance user engagement and retention.