Digital Health Engagement Behaviors in US Family Caregivers: Trend Analysis Using the Health Information National...

Digital health has provided caregivers with access to supportive resources without space-time restrictions. Caregivers' digital health engagement behaviors can help them track their own health and that of care recipients as well as communicate with others. While digital health tools have become more prevalent since the COVID-19 pandemic, the trend in caregiver engagement has been less explored.

This study examined the trends and factors associated with selected digital health engagement behaviors in family caregivers in the United States, using the HINTS (Health Information National Trends Survey) datasets collected from HINTS 5 Cycles 3 and 4 and HINTS 6 from 2019 to 2022.

Our cross-sectional data analysis included 1676 family caregivers. Dependent variables were (1) access to online medical records (caregivers' and care recipients') and (2) health-related use of social media (sharing health information, interacting with others, and watching health-related videos). Independent variables were survey cycles, demographic, socioeconomic, caregiving, and internet technology factors. Weighted multivariable logistic regression analyses were conducted.

Among 1676 caregivers (HINTS 5 Cycle 3: n=570; HINTS 5 Cycle 4: n=412; HINTS 6: n=694), access to online medical records increased from HINTS 5 Cycle 3 in 2019 to HINTS 6 in 2022. Access to caregivers' own records rose from 48.7% to 72.6% (P<.001), and access to care recipients' records increased from 30.8% to 44.5% (P<.001). Health-related social media use also increased, including sharing health information (22.5% vs 39.1%; P<.001), interacting with others (16.6% vs 27.0%; P<.001), and watching health-related videos (49.5% vs 60.9%; P=.005). In adjusted analyses, higher education (≥ college graduate vs ≤ high school: odds ratio [OR] 2.75, 95% CI 1.56-4.85; P<.001) and having health insurance (OR 2.40, 95% CI 1.24-4.68; P=.010) were associated with access to caregivers' records. Female participants (OR 1.96, 95% CI 1.36-2.84; P<.001) and spousal caregiving (OR 2.14, 95% CI 1.26-3.65; P=.005) were associated with access to care recipients' records. High-speed internet access was strongly associated with digital health engagement outcomes (eg, sharing health information: OR 3.98, 95% CI 2.15-7.35; P<.001).

Digital health engagement-including access to online medical records and the use of social media for health-related purposes-among US family caregivers increased following the COVID-19 pandemic. These findings suggest that health care professionals and researchers should consider multifaceted factors, such as age, race/ethnicity, geography, education, insurance coverage, and digital access, when designing and implementing digital health tools and technology-based interventions. Future research should evaluate how digital technologies and the automation of systems "talking" to other systems, including AI, can better support caregivers' health information needs and care coordination. The varying learning curves for individuals and groups could be further explored for effective and efficient adoption and usage.