Feasibility and acceptability of mobile methods to assess home and neighborhood environments related to adolescent sleep.

OBJECTIVE: A growing evidence base suggests home and neighborhood environmental exposures may influence adolescent sleep, but few studies have assessed these relationships using methods that account for time-varying, location-specific exposures, or multiple neighborhood contexts. This study aimed to assess the feasibility and acceptability of using smartphone global positioning system (GPS) tracking and ecological momentary assessment (EMA) to assess time-varying home and neighborhood environmental exposures hypothesized to be associated with adolescent sleep. METHODS: Adolescents aged 15-17 years in Philadelphia completed 7 days of continuous smartphone GPS tracking, which was used to identify daily levels of exposure to geocoded neighborhood factors (eg, crime, green space). Four daily EMA surveys assessed home sleep environment (eg, noise, light), stress, health behaviors, and neighborhood perceptions. Feasibility and acceptability of GPS tracking and EMA were assessed, and distributions of daily environmental exposures were examined. RESULTS: Among 25 teens (mean age 16, 56% male), there was a high level of GPS location data captured (median daily follow-up: 24 hours). Seventy-eight percent of EMA surveys were completed overall. Most participants (96%) reported no privacy concerns related to GPS tracking and minimal burden from EMA surveys. Exposures differed between participants' home neighborhoods and locations visited outside the home neighborhood (eg, higher crime away from home). Sleep environment disruptions were present on 29% of nights (most common: uncomfortable temperature) and were reported by 52% of adolescents. CONCLUSIONS: Results demonstrate the feasibility and acceptability of mobile methods for assessing time-varying home and neighborhood exposures relevant to adolescent sleep for up to 1 week.

Health Information Technology Use Among Persons With Self-reported Atherosclerotic Cardiovascular Disease: Analysis of the 2011-2018 National Health Interview Survey.

BACKGROUND: Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of morbidity and mortality in the United States. Health information technologies (HITs) have recently emerged as a viable intervention to mitigate the burden of ASCVD. Approximately 60% of US adults report searching the internet for health information; however, previous research has not examined the prevalence of general technology or HIT use among adults with and without ASCVD. In addition, social determinants in HIT use among adults with ASCVD are not well understood. OBJECTIVE: The aim of this study was to evaluate the prevalence and social determinants of HIT use among US adults with versus without self-reported ASCVD. METHODS: We pooled cross-sectional data from the 2011-2018 National Health Interview Survey (NHIS) to examine the general technology and HIT use among adults aged ≥18 years with and without self-reported ASCVD (coronary heart disease, stroke, or both). General technology use was defined as mobile phone ownership, internet use, and computer use. HIT use was defined as looking up health information on the internet, filling a web-based prescription, scheduling a medical appointment on the internet, communicating with a health care provider by email, or using web-based group chats to learn about health topics. We evaluated sociodemographic differences in HIT use among respondents by using Poisson regression. Analyses were weighted according to NHIS standards. RESULTS: A total sample of 256,117 individuals were included, of which 2194 (0.9%) reported prior ASCVD. Among adults with prior ASCVD, the mean age was 70.6 (SD 11.5) years, and 47.4% (1048/2194) of the adults were females. General technology use differed between participants with and without prior ASCVD, with 36.0% (614/1826) and 76.2% (157,642/213,816) indicating internet usage and 24.6% (374/1575) and 60.7% (107,742/184,557) indicating using a computer every day, respectively. Similarly, adults with ASCVD were less likely to use HIT than those without ASCVD (515/2194, 25.1% vs 123,966/253,923, 51.0%; P<.001). Among adults with prior ASCVD, social determinants that were associated with HIT use included younger age, higher education, higher income, being employed, and being married. CONCLUSIONS: HIT use was low among adults with a history of ASCVD, which may represent a barrier to delivering care via emerging HIT. Given the associations with social determinants such as income, education, and employment, targeted strategies and policies are needed to eliminate barriers to impact HIT usage.