557-P: User Engagement and Usage Patterns in a Mobile Application for Adults with Type 2 Diabetes

Introduction & Objective: Mobile applications (apps) are effective tools for improving patients’ self-management of chronic health conditions. However, there is a scarcity of published data on how patient-level characteristics are linked to app usage patterns, which could provide insight into factors influencing app engagement and health outcomes. Our study aimed to evaluate the app-usage patterns and participant characteristics of users of the DiabetesXcel mobile app, a diabetes-focused educational mobile app that has been previously shown to improve diabetes-related quality of life and clinical outcomes.

Methods: DiabetesXcel was implemented in the Bronx, NY among adult participants with Type 2 Diabetes. Logistic regression was used to determine the association of baseline characteristics with user logins and app questions answered (AQA) at 6 months. Logins and AQA were dichotomized above and below the mean.

Results: Participants (N=46) were, on average, 47 + 9 years-old, mostly women (71.7%), with half identifying as Black or African American (50.0%) and having public insurance of Medicaid or Medicare (50.0%). The average number of logins was 11 <u>+</u> 24 and AQA was 34 <u><u>+</u> </u>40. There were trends of older participants having greater odds of answering more than the mean AQA (OR=1.09 [95% CI 0.99, 1.21], p=0.07) months. Those of non-Black/African American race or ethnicity trended towards lower odds of answering more than the mean AQA (OR=0.14 [95% CI 0.02, 1.30], p=0.08) compared to those who were Black/African American, as did those with non-private insurance (OR=0.14 [95% CI 0.02, 1.30], p=0.08) than those with private insurance.

Conclusion: Our study showed trends towards older participants engaging with the app more, while those identifying as non-Black/African American and with non-private insurance engaged with the app less. Additional studies are needed to further understand this relationship, and potentially tailoring the application to these groups may improve application usage.