User Profiles and Engagement in a Hypertension Self-Management App: Cross-Sectional Survey

Area of Science:

• Digital Health
• Cardiovascular Disease Management
• Health Informatics

Background:

• Mobile health (mHealth) technologies offer potential for improving hypertension self-management.
• However, real-world adoption of mHealth tools for hypertension is limited and unevenly distributed.
• This raises concerns about equitable access and effectiveness in diverse populations.

Purpose of the Study:

• To characterize user profiles, usage patterns, and engagement of a hypertension self-management app (Hypertension.APP) in Germany.
• To investigate potential digital divides among active users.
• To assess the integration of app data into clinical care.

Main Methods:

• A cross-sectional online survey was conducted with adult users of Hypertension.APP in Germany (Jan-Sep 2023).
• The survey assessed app usage, perceived utility, clinical integration, sociodemographics, clinical data, and digital health literacy (eHealth Literacy Scale).
• Descriptive statistics and univariable ordinal logistic regression were used to analyze data.

Main Results:

• 254 users (mean age 53.6 years, 54.3% male) were analyzed.
• Most users had moderate or high digital health literacy (88.2%) and used the app weekly (80.7%).
• Higher education and longer hypertension duration correlated with more frequent app use, while high blood pressure correlated with less frequent use. Clinical integration was low (20.1%).

Conclusions:

• Hypertension app users in Germany are predominantly well-educated and digitally literate, indicating a digital divide.
• High app engagement exists, but formal clinical integration and medication adjustments based on app data are limited.
• Strategies are needed to promote equitable access, enhance clinical integration, and support users with lower digital health literacy for effective mHealth in hypertension management.