There's an App for That, Is There an Audience for That?: Determinants of Smartphone Ownership and Comfort of Use in an Urban Pre and Post Renal Transplant Population

Purpose:

Cellular phone ownership, including Smartphones, has increased substantially in the last several years According to a recent Nielsen survey, 3 out of 5 mobile subscribers own Smartphones.  According to a 2012 report from the Pew Center, African Americans are more likely to own Smartphones and engage in the full functionality of the devices when compared to whites. The report also concluded that African Americans were significantly more likely to download mobile applications when compared to whites.  It is suggested that this adoption of Smartphone technology by African-Americans could provide a means to reduce racial disparities in health care.

Methods:

This is a secondary analysis of data collected during a cross-sectional study of health information technology among pre- and post-renal transplant patients. In brief, data were collected during scheduled transplant education sessions at a single urban renal transplant center from January 15, 2012 to June 1, 2012.  All patients that presented either for a pre-renal transplant education session or a post-renal transplant clinic visit were invited to participate in the survey. Of the 270 surveys that were distributed, 255 surveys from this sample of convenience were returned, for a response rate of 94 All statistical analyses were conducted using Stata 11.0 (College Station, TX).

Results:

 Using a multivariate logistic regression model we found that there was no difference in Smartphone use by race.  Those who reported having kidney disease for over five years were three times as likely to own a Smartphone compared to those who reported having kidney disease less than one year.  Those who reported being on dialysis were 54% less likely to report owning a Smartphone compared to those who were not on dialysis.  Those who reported an education level of college or beyond were 1.84 times more likely to report having a Smartphone compared to those with an education level of high school or less.  As age increased, Smartphone ownership decreased. 

Using an ordinal logistic regression model we found that those who reported having kidney disease of 1-3 years were almost 4 times more likely to report being comfortable using a Smartphone compared to those who reported having kidney disease less than 1 year.  As age increased, self reported comfort using a Smartphone decreased.  Those who reported being on dialysis were 55% less likely to report being comfortable using a Smartphone.  Those who reported having an education level of college and beyond were one-and-a-half times more likely to report being comfortable using a Smartphone compared to those with an education level of high school or less.

Conclusion:

Only forty-three percent of pre and post kidney transplant patients reported owning Smartphones.  Determinants of Smartphone ownership and comfort of use included being younger, more educated and free of dialysis.  There were no differences in Smartphone ownership by race.  Alternatives to mobile applications should be considered for those who do not have access to Smartphone technologies.