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Clinical Digital Health Engagement and Psychological Distress Among Adults
1Center for Food Allergy and Asthma Research, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
JAMA Network Open
|July 16, 2026
Summary
Higher digital health engagement in US adults was linked to modestly increased psychological distress. This suggests engagement may reflect patient activation and underlying distress.
Area of Science:
- Digital health technologies
- Psychological distress
- Health Information National Trends Survey (HINTS)
Background:
- Digital health tools are increasingly used in healthcare.
- The psychological impact of digital health engagement is not well understood.
Purpose of the Study:
- To investigate the association between digital health engagement and psychological distress in US adults.
- To explore how digital health use relates to mental well-being within clinical settings.
Main Methods:
- Cross-sectional study utilizing pooled data from HINTS cycles (2017-2024).
- Included 23,682 noninstitutionalized US adults.
- Digital health engagement measured via composite index; psychological distress assessed using PHQ-4 scale.
Main Results:
- Higher digital health engagement was associated with modestly higher psychological distress (β=0.51, P<.001).
- The association remained positive across engagement levels and in those reporting good health.
- Active digital behaviors, such as electronic communication and mobile app use, showed the strongest associations.
Conclusions:
- Increased digital health engagement in US adults correlates with modestly higher psychological distress.
- Digital engagement patterns may indicate both patient activation and underlying psychological distress.
- Further research is needed to understand the complex relationship between digital health and mental well-being.
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