Sociodemographic Differences in Logins and Engagement With the Electronic Health Coach Messaging Feature of a Mobile App to Support Opioid and Stimulant Use Recovery: Results From a 1-Month Observational Study

BackgroundMobile health apps can serve as a critical tool in supporting the overall health of uninsured and underinsured individuals and groups who have been historically marginalized by the medical community and may be hesitant to seek health care. However, data on uptake an...

Full description

Saved in:
Bibliographic Details
Main Authors: Lindsey M Filiatreau, Hannah Szlyk, Alex T Ramsey, Erin Kasson, Xiao Li, Zhuoran Zhang, Patricia Cavazos-Rehg
Format: Article
Language:English
Published: JMIR Publications 2025-04-01
Series:JMIR mHealth and uHealth
Online Access:https://mhealth.jmir.org/2025/1/e54753
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850186360062738432
author Lindsey M Filiatreau
Hannah Szlyk
Alex T Ramsey
Erin Kasson
Xiao Li
Zhuoran Zhang
Patricia Cavazos-Rehg
author_facet Lindsey M Filiatreau
Hannah Szlyk
Alex T Ramsey
Erin Kasson
Xiao Li
Zhuoran Zhang
Patricia Cavazos-Rehg
author_sort Lindsey M Filiatreau
collection DOAJ
description BackgroundMobile health apps can serve as a critical tool in supporting the overall health of uninsured and underinsured individuals and groups who have been historically marginalized by the medical community and may be hesitant to seek health care. However, data on uptake and engagement with specific app features (eg, in-app messaging) are often lacking, limiting our ability to understand nuanced patterns of app use. ObjectiveThis study aims to characterize sociodemographic differences in uptake and engagement with a smartphone app (uMAT-R) to support recovery efforts in a sample of individuals with opioid and stimulant use disorders in the Greater St. Louis area. MethodsWe enrolled individuals into the uMAT-R service program from facilities providing recovery support in the Greater St. Louis area between January 2020 and April 2022. Study participants were recruited from service project enrollees. We describe the number of logins and electronic health coach (eCoach) messages participants sent in the first 30 days following enrollment using medians and IQRs and counts and proportions of those who ever (vs never) logged in and sent their eCoach a message. We compare estimates across sociodemographic subgroups, by insurance status, and for those who did and did not participate in the research component of the project using Wilcoxon rank-sum tests and Pearson chi-square tests. ResultsOf all 695 participants, 446 (64.2%) logged into uMAT-R at least once during the 30 days following enrollment (median 2, IQR 0-8 logins). Approximately half of those who logged in (227/446) used the eCoach messaging feature (median 1, IQR 0-3 messages). Research participants (n=498), who could receive incentives for app engagement, were more likely to log in and use the eCoach messaging feature compared to others (n=197). Younger individuals, those with higher educational attainment, and White, non-Hispanic individuals were more likely to log in at least once compared to their counterparts. The median number of logins was higher among women, and those who were younger, employed, and not on Medicaid compared to their counterparts. Among those who logged in at least once, younger individuals and those with lower educational attainment were more likely to send at least one eCoach message compared to others. ConclusionsMobile apps are a viable tool for supporting individuals in recovery from opioid and stimulant use disorders. However, older individuals, racial and ethnic minorities, and those with lower educational attainment may need additional login support, or benefit from alternative mechanisms of recovery support. In addition, apps may need to be tailored to achieve sustained engagement (ie, repeat logins) among men, and individuals who are older, unemployed, or on Medicaid. Older individuals and those with higher educational attainment who may be less likely to use eCoach messaging features could benefit from features tailored to their preferences.
format Article
id doaj-art-dccabc1381ea4e4a882559d82d50fbc4
institution OA Journals
issn 2291-5222
language English
publishDate 2025-04-01
publisher JMIR Publications
record_format Article
series JMIR mHealth and uHealth
spelling doaj-art-dccabc1381ea4e4a882559d82d50fbc42025-08-20T02:16:22ZengJMIR PublicationsJMIR mHealth and uHealth2291-52222025-04-0113e5475310.2196/54753Sociodemographic Differences in Logins and Engagement With the Electronic Health Coach Messaging Feature of a Mobile App to Support Opioid and Stimulant Use Recovery: Results From a 1-Month Observational StudyLindsey M Filiatreauhttps://orcid.org/0000-0002-0355-4477Hannah Szlykhttps://orcid.org/0000-0001-7337-8475Alex T Ramseyhttps://orcid.org/0000-0002-3471-3725Erin Kassonhttps://orcid.org/0000-0003-4888-3319Xiao Lihttps://orcid.org/0000-0002-3649-1820Zhuoran Zhanghttps://orcid.org/0000-0001-7336-695XPatricia Cavazos-Rehghttps://orcid.org/0000-0003-3352-1198 BackgroundMobile health apps can serve as a critical tool in supporting the overall health of uninsured and underinsured individuals and groups who have been historically marginalized by the medical community and may be hesitant to seek health care. However, data on uptake and engagement with specific app features (eg, in-app messaging) are often lacking, limiting our ability to understand nuanced patterns of app use. ObjectiveThis study aims to characterize sociodemographic differences in uptake and engagement with a smartphone app (uMAT-R) to support recovery efforts in a sample of individuals with opioid and stimulant use disorders in the Greater St. Louis area. MethodsWe enrolled individuals into the uMAT-R service program from facilities providing recovery support in the Greater St. Louis area between January 2020 and April 2022. Study participants were recruited from service project enrollees. We describe the number of logins and electronic health coach (eCoach) messages participants sent in the first 30 days following enrollment using medians and IQRs and counts and proportions of those who ever (vs never) logged in and sent their eCoach a message. We compare estimates across sociodemographic subgroups, by insurance status, and for those who did and did not participate in the research component of the project using Wilcoxon rank-sum tests and Pearson chi-square tests. ResultsOf all 695 participants, 446 (64.2%) logged into uMAT-R at least once during the 30 days following enrollment (median 2, IQR 0-8 logins). Approximately half of those who logged in (227/446) used the eCoach messaging feature (median 1, IQR 0-3 messages). Research participants (n=498), who could receive incentives for app engagement, were more likely to log in and use the eCoach messaging feature compared to others (n=197). Younger individuals, those with higher educational attainment, and White, non-Hispanic individuals were more likely to log in at least once compared to their counterparts. The median number of logins was higher among women, and those who were younger, employed, and not on Medicaid compared to their counterparts. Among those who logged in at least once, younger individuals and those with lower educational attainment were more likely to send at least one eCoach message compared to others. ConclusionsMobile apps are a viable tool for supporting individuals in recovery from opioid and stimulant use disorders. However, older individuals, racial and ethnic minorities, and those with lower educational attainment may need additional login support, or benefit from alternative mechanisms of recovery support. In addition, apps may need to be tailored to achieve sustained engagement (ie, repeat logins) among men, and individuals who are older, unemployed, or on Medicaid. Older individuals and those with higher educational attainment who may be less likely to use eCoach messaging features could benefit from features tailored to their preferences.https://mhealth.jmir.org/2025/1/e54753
spellingShingle Lindsey M Filiatreau
Hannah Szlyk
Alex T Ramsey
Erin Kasson
Xiao Li
Zhuoran Zhang
Patricia Cavazos-Rehg
Sociodemographic Differences in Logins and Engagement With the Electronic Health Coach Messaging Feature of a Mobile App to Support Opioid and Stimulant Use Recovery: Results From a 1-Month Observational Study
JMIR mHealth and uHealth
title Sociodemographic Differences in Logins and Engagement With the Electronic Health Coach Messaging Feature of a Mobile App to Support Opioid and Stimulant Use Recovery: Results From a 1-Month Observational Study
title_full Sociodemographic Differences in Logins and Engagement With the Electronic Health Coach Messaging Feature of a Mobile App to Support Opioid and Stimulant Use Recovery: Results From a 1-Month Observational Study
title_fullStr Sociodemographic Differences in Logins and Engagement With the Electronic Health Coach Messaging Feature of a Mobile App to Support Opioid and Stimulant Use Recovery: Results From a 1-Month Observational Study
title_full_unstemmed Sociodemographic Differences in Logins and Engagement With the Electronic Health Coach Messaging Feature of a Mobile App to Support Opioid and Stimulant Use Recovery: Results From a 1-Month Observational Study
title_short Sociodemographic Differences in Logins and Engagement With the Electronic Health Coach Messaging Feature of a Mobile App to Support Opioid and Stimulant Use Recovery: Results From a 1-Month Observational Study
title_sort sociodemographic differences in logins and engagement with the electronic health coach messaging feature of a mobile app to support opioid and stimulant use recovery results from a 1 month observational study
url https://mhealth.jmir.org/2025/1/e54753
work_keys_str_mv AT lindseymfiliatreau sociodemographicdifferencesinloginsandengagementwiththeelectronichealthcoachmessagingfeatureofamobileapptosupportopioidandstimulantuserecoveryresultsfroma1monthobservationalstudy
AT hannahszlyk sociodemographicdifferencesinloginsandengagementwiththeelectronichealthcoachmessagingfeatureofamobileapptosupportopioidandstimulantuserecoveryresultsfroma1monthobservationalstudy
AT alextramsey sociodemographicdifferencesinloginsandengagementwiththeelectronichealthcoachmessagingfeatureofamobileapptosupportopioidandstimulantuserecoveryresultsfroma1monthobservationalstudy
AT erinkasson sociodemographicdifferencesinloginsandengagementwiththeelectronichealthcoachmessagingfeatureofamobileapptosupportopioidandstimulantuserecoveryresultsfroma1monthobservationalstudy
AT xiaoli sociodemographicdifferencesinloginsandengagementwiththeelectronichealthcoachmessagingfeatureofamobileapptosupportopioidandstimulantuserecoveryresultsfroma1monthobservationalstudy
AT zhuoranzhang sociodemographicdifferencesinloginsandengagementwiththeelectronichealthcoachmessagingfeatureofamobileapptosupportopioidandstimulantuserecoveryresultsfroma1monthobservationalstudy
AT patriciacavazosrehg sociodemographicdifferencesinloginsandengagementwiththeelectronichealthcoachmessagingfeatureofamobileapptosupportopioidandstimulantuserecoveryresultsfroma1monthobservationalstudy