Determinants of Digital Health Resource Utilization Among Individuals With Self-Reported Bipolar Disorder in...

This study examines the utilization of digital health resources among individuals with bipolar disorder (BD) in Germany, applying the Andersen Healthcare Utilization Model (AHUA) to this context for the first time. While resources such as health-related websites, social media and online forums, smartphone apps, digital devices such as wearables, and online interaction with health care professionals offer new opportunities for self-management, less is known about which factors systematically influence their use among individuals with BD. To address this gap, the AHUA, which classifies healthcare utilization through predisposing, enabling, and need factors, was adapted to investigate digital health resource utilization.

An anonymous online cross-sectional survey of 213 individuals with a self-reported diagnosis of bipolar disorder collected data on demographics, illness history, digital literacy, and digital health resource utilization. Hierarchical multiple linear regression analysis was conducted to examine associations between predisposing, enabling, and need-related factors with digital health resources.

The final model explained 30.6% of the variance in digital health resource utilization. Among predisposing factors, female gender was associated with higher utilization. Among enabling factors, wearable ownership was the strongest and most significant factor associated with higher utilization. Among need factors, earlier age of diagnosis and lower health-related quality of life were significantly associated with greater utilization. In contrast, smartphone ownership, digital health literacy, subjective health status, concentration difficulties, and the interaction between cognition and wearable ownership were not significantly associated with utilization.

These findings highlight that digital health resource utilization in individuals with BD is primarily driven by enabling factors and objective health-related need rather than subjective health perceptions or cognitive functioning. The results underscore the importance of device access and clinical characteristics in influencing engagement with digital health tools. Targeting wearable-based interventions and tailoring digital health solutions to individuals with greater clinical need may enhance adoption and improve self-management in BD.