Understanding the evolving preferences for use of health information technology among adults with self reported anxiety and depression in the U.S

Recent evidence suggests consumer health information technologies are increasingly utilized among those with medical conditions towards improving health and recovery. However, there is also increasing evidence that many patients, especially those with mental health conditions like depression and anxiety, may struggle to utilize these apps given issues with usability and engagement. Further, there is a paucity of literature on differences in the preference for using technologies such as smartphone apps for mental health patients compared to other patient populations. The purpose of this study is to evaluate the preferences and use of technology for health information exchange within a nationally-representative sample of adults with and without mental illness and to assess whether these preferences differ according to sociodemographic factors. For our analysis, we utilized data from the 2017 (HINTS 5 cycle 1) and 2018 (HINTS 5 cycle 2) iterations of the Health Information National Trends Survey (n=6789). We used multivariate logistic regression to identify factors associated with a higher or lower rate of using health information technology (HIT) in persons with or without mental illness. We adjusted these models for the sociodemographic variables of age, sex, household income, education level, employment status, health insurance status, marital status, and race. Of the 6789 participants, 1538 reported having depression and/or an anxiety disorder. In both the adjusted and unadjusted models, ownership of smartphones, tablet computers, health apps, and utilization of the internet did not differ by depression or anxiety status. Furthermore, in the adjusted models, those with depression and/or anxiety had a significantly higher likelihood of using electronic means such as computers and smartphones to search for health information, look up test results, communicate with a physician, and to share health information. However, these individuals were also more likely to withhold information from their health care providers due to concerns about the security or privacy of their medical records. Our analysis shows that while ownership rates for smartphones and the use of health apps did not differ by mental health status, there was an increased likelihood of those with mental illness to use health information tools in communicating with their health providers. However, concerns about data security and privacy may hinder the utilization and integration of these technologies in mental health care. Future efforts should focus on ensuring patient privacy and data protection to maximize the benefits of digital technology in mentally ill populations.