A total of 151 participants were approached and all participants consented to the survey (100% response rate). The demographic information of participants is summarized in Table 1. The mean age of participants was 62.3±14.4 years of age and consisted of 35.8% male. Race demographics were not collected after the pilot population was expanded, but the pilot population consisted primarily of minority groups (83.1%). While 60.3% of participants had a high school degree or less, 39.7% obtained at least an undergraduate degree with 5.9% of total participants achieved additional education (Table 1).
The response distribution of selected survey items is outlined in Table 2. Interestingly, only 73.5% of survey respondents have daily access to internet services. Individuals without internet tended to be older (mean age of 71.9±11.2 vs. 58.8±13.9) and less educated (12.5% with a college degree vs. 49.5%) than their counterparts with internet. Similar characteristics were seen in individuals that lacked either a mobile phone or smartphone (Table 2). Among the 106 individuals that currently own a smartphone, 60.4% use phone that operates iOS software (iPhone®) and 39.6% use a phone that operates Android software (Samsung®, LG®, etc.). The frequency of previous, defined as over the past 6 months, mobile access to general health and personal health information was similar (53% and 51.7% respectively). However, 59 participants (39.1% of total) neither accessed general nor personal health information while 66 participants (43.7% of total) utilized both forms of health technology (Table 2).
Future-oriented survey items (items 12 through 16) evaluated different aspects of integrating mHealth technology into practice and were met with modest support overall. However, acceptance was significantly different based on current technology utilization. Among individuals without access to the internet, the mean acceptance rate of future-oriented items was 7.5%. This pattern was also demonstrated in individuals lacking a mobile phone (4.2%) and smartphone (2.3%) (data not shown).
Regarding demographic factors influencing the willingness to utilize a mobile application for daily health monitoring, acceptance was significantly associated with both age and educational achievement (table 3). Willingness to utilize a mHealth application was highest in individuals <50 years of age (83.3% favorable) and lowest in individuals >80 years of age (82.4% unfavorable). Logistic regression revealed that age groups 61-70 (OR; 0.24, 0.07-0.90, p<0.01), 71-80 (OR; 0.05, 0.01-0.23, p<0.01), and >80 years (OR; 0.04, 0.01-0.22, p<0.01) were significantly less likely to utilize a daily mHealth application than individuals <50 years (Figure 1A). 71.7% of individuals with at least a college degree were favorable of a mHealth application compared to 41.8% of individuals without a college education (OR; 2.78,1.25-5.88, p<0.01) (Table 3 & Figure 1A). No significant differences in race, gender, or marital status were identified. However, differences among age groups and education were eliminated when adjusting for current smartphone use (Figure 1B).
A desire to increase cancer-related knowledge was associated with an increased odds of utilizing a daily mHealth application (OR; 261.5, 10.13 – 6748.71, p<0.01). Interestingly, no other features of a mobile application exhibited signficant associations despite being similar in nature (Figure 2B). Evaluation of the frequency of each response revealed that of the 81 participants that were willing to use a daily mobile application, 80 (98.8% ) also desired an application to increase cancer-related knowledge. Conversely, of the 70 individuals not willing to utilize a daily application, 63 (90.0%) also did not desire an application to increase their cancer-related knowledge (data not shown).