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Med."],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Long-term use of digital devices is critical for successful clinical or research use, but digital health studies are challenged by a rapid drop-off in participation. A nested e-cohort (eFHS) is embedded in the Framingham Heart Study and uses three system components: a new smartphone app, a digital blood pressure (BP) cuff, and a smartwatch. This study aims to identify factors associated with the use of individual eFHS system components over 1-year. Among 1948 eFHS enrollees, we examine participants who returned surveys within 90 days (<jats:italic>n<\/jats:italic>\u2009=\u20091918), and those who chose to use the smartwatch (<jats:italic>n<\/jats:italic>\u2009=\u20091243) and BP cuff (<jats:italic>n<\/jats:italic>\u2009=\u20091115). For each component, we investigate the same set of candidate predictors for usage and use generalized linear mixed models to select predictors (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.1, <jats:italic>P<\/jats:italic> value from <jats:italic>Z<\/jats:italic> test statistic), adjusting for age, sex, and time (app use: 3-month period, device use: weekly). A multivariable model with the predictors selected from initial testing is used to identify factors associated with use of components (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05, <jats:italic>P<\/jats:italic> value from <jats:italic>Z<\/jats:italic> test statistic) adjusting for age, sex, and time. In multivariable models, older age is associated with higher use of all system components. Female sex and higher education levels are associated with higher completion of app-based surveys whereas higher scores for depressive symptoms, and lower than excellent self-rated health are associated with lower use of the smartwatch over the 12-month follow-up. Our findings show that sociodemographic and health related factors are significantly associated with long-term use of digital devices. Future research is needed to test interventional strategies focusing on these factors to evaluate improvement in long-term engagement.<\/jats:p>","DOI":"10.1038\/s41746-022-00735-1","type":"journal-article","created":{"date-parts":[[2022,12,27]],"date-time":"2022-12-27T03:02:36Z","timestamp":1672110156000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Factors associated with long-term use of digital devices in the electronic Framingham Heart Study"],"prefix":"10.1038","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2170-1247","authenticated-orcid":false,"given":"Chathurangi H.","family":"Pathiravasan","sequence":"first","affiliation":[]},{"given":"Yuankai","family":"Zhang","sequence":"additional","affiliation":[]},{"given":"Xuzhi","family":"Wang","sequence":"additional","affiliation":[]},{"given":"Ludovic","family":"Trinquart","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4076-2336","authenticated-orcid":false,"given":"Emelia J.","family":"Benjamin","sequence":"additional","affiliation":[]},{"given":"Belinda","family":"Borrelli","sequence":"additional","affiliation":[]},{"given":"David D.","family":"McManus","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4752-4229","authenticated-orcid":false,"given":"Vik","family":"Kheterpal","sequence":"additional","affiliation":[]},{"given":"Honghuang","family":"Lin","sequence":"additional","affiliation":[]},{"given":"Nicole L.","family":"Spartano","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9458-4585","authenticated-orcid":false,"given":"Eric","family":"Schramm","sequence":"additional","affiliation":[]},{"given":"Chunyu","family":"Liu","sequence":"additional","affiliation":[]},{"given":"Joanne M.","family":"Murabito","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2022,12,27]]},"reference":[{"key":"735_CR1","doi-asserted-by":"publisher","first-page":"e11244","DOI":"10.2196\/11244","volume":"7","author":"Q Yang","year":"2019","unstructured":"Yang, Q., Van & Stee, S. 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Biometrical J. 60, 431\u2013449 (2018).","journal-title":"Biometrical J."}],"container-title":["npj Digital Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41746-022-00735-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41746-022-00735-1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41746-022-00735-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,30]],"date-time":"2022-12-30T07:05:12Z","timestamp":1672383912000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41746-022-00735-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,27]]},"references-count":52,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["735"],"URL":"https:\/\/doi.org\/10.1038\/s41746-022-00735-1","relation":{},"ISSN":["2398-6352"],"issn-type":[{"value":"2398-6352","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,27]]},"assertion":[{"value":"22 July 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 November 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 December 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"J.M.M. is a guest lecturer at Merck Research Laboratories. D.D.M. received research support from Apple Computer, Bristol-Myers Squibb, Boehringer-Ingelheim, Pfizer, Flexcon, Samsung, Philips Healthcare, Fitbit and Biotronik, and has received consultancy fees from Bristol-Myers Squibb, Pfizer, Fitbit, Flexcon, Boston Biomedical Associates, Heart Rhythm Society, Avania and Rose Consulting. He also received financial support for serving on the Steering Committee for the GUARD-AF study (NCT04126486) and Advisory Committee for the Fitbit Heart Study (NCT04176926). V.K. and E.S. are Employees of CareEvolution, Inc, a health care technology company. N.L.S. received funding from Novo Nordisk for an investigator-initiated research grant unrelated to the current paper. All other authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"195"}}