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Background: Digital health interventions (DHI) have been associated with improvement of CVD risk factors; however it has been postulated that these tools benefit affluent users more than those from lower socioeconomic environments.
Methods: We analyzed usage of DHI and change in intermediate markers of CVD over the course of one year in 30,974 participants of a work health program across 81 organizations in 42 states between 2011 and 2014. Baseline demographic data for participants included home zip code. Using publicly available data from the American Community Survey, we obtained the median income for each zip code as a marker for socioeconomic status. DHI usage was analyzed based on socioeconomic status while controlling for age, gender, and race.
Results: The cohort was found to represent a wide sample of socioeconomic environments from a median income of $11,000 to $171,000. As a whole, a doubling of income was associated with 7.6% increase in log-in frequency. This translates to an increase in annual log-ins from 5.7 at $20,000 to 7.0 at $150,000. These results varied across races. Blacks showed a 400% increase and Hispanics showed a 217% increase in use between the lowest and highest income groups, compared to 7.4% for Whites. Based on previous work involving this cohort, these increases in usage across income groups would result in an expected weight reduction of 0.36 lb in Whites, 3.8 lb in Hispanics and 7 lb in Blacks.
Conclusions: This works adds evidence that socioeconomic status may influence DHI use and benefit especially in minority groups. In this previously validated tool that has been associated with positive risk factor modification, addition of socioeconomic data confirms no clinically relevant relationship exists between socioeconomic environment and DHI usage for Whites. However, a strong relationship is present for Black and Hispanic cohorts. This study identifies a digital divide across socioeconomic environments that is remarkably prominent in minority populations.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Current Issues in Cardiovascular Epidemiology, Disparities, and Safety
Abstract Category: 32. Prevention: Clinical
Presentation Number: 1148-063
- 2017 American College of Cardiology Foundation