Abstract
Background: Heart failure (HF) affects 64 million people worldwide, contributing to significant morbidity, mortality, and healthcare costs.1,2 Effective self-care is essential for improving HF outcomes, and digital health interventions have shown promise in supporting these practices.3-5 This study explores how socio-demographic factors influence engagement with a digital game app and related self-care behaviors in HF management, presenting preliminary data from a remote, digital health study.
Methods: Descriptive and correlational analyses were conducted on 40 adults from the intervention arm of an RCT after 6 months. Participants used a mobile game app, activity tracker, and smart scale to support physical activity and weight monitoring. Independent variables included sex, race, ethnicity, living situation, housing type, employment status, and work hours, and financial strain. Engagement metrics were days of game app usage, final game level, and days of weight monitoring and step goal achievement. Spearman’s correlation assessed relationships between game usage, game level, weight monitoring, and step goals due to non-normal data distribution.
Results: Of 40 participants, 77% were male, 77% White, and 82% non-Hispanic. Females engaged more in game usage and weight monitoring, while males met step goals slightly more. White, non-Hispanic participants exhibited the highest engagement in all metrics, compared to other racial/ethnic groups. Higher engagement was seen in those living with family and in single-family homes compared to those living alone or in apartments. Participants reporting financial strain exhibited lower engagement across all metrics. Significant strong positive correlations were found between game app usage and final game level (rs = .767, p < .01), days weight monitored (rs = .840, p < .01), and days meeting step goals (rs = .767, p < .01).
Conclusion: Strong positive correlations between game usage and self-care behaviors highlight the potential of mobile games in supporting HF management. However, observed differences in engagement across socio-demographics underscore the importance of identifying and addressing disparities in digital interventions to prevent reinforcing existing inequities. The ongoing RCT is focused on recruiting a more diverse participant base to strengthen these insights. Further research is needed to better understand the factors influencing differences in engagement in digital interventions across socio-demographics.
Notes
References: 1. GBD 2017. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. Nov 10 2018;392(10159):1789-1858. doi:10.1016/s0140-6736(18)32279-7
2. Savarese G, Becher PM, Lund LH, Seferovic P, Rosano GMC, Coats AJS. Global burden of heart failure: a comprehensive and updated review of epidemiology. Cardiovascular Research. 2022;118(17):3272-3287. doi:10.1093/cvr/cvac013
3. Lee CS, Bidwell JT, Paturzo M, et al. Patterns of self-care and clinical events in a cohort of adults with heart failure: 1 year follow-up. Heart Lung. Jan-Feb 2018;47(1):40-46. doi:10.1016/j.hrtlng.2017.09.004
4. McAlister FA, Stewart S, Ferrua S, McMurray JJ. Multidisciplinary strategies for the management of heart failure patients at high risk for admission: a systematic review of randomized trials. J Am Coll Cardiol. Aug 18 2004;44(4):810-9. doi:10.1016/j.jacc.2004.05.055
5. Pfaeffli Dale L, Dobson R, Whittaker R, Maddison R. The effectiveness of mobile-health behaviour change interventions for cardiovascular disease self-management: A systematic review. European Journal of Preventive Cardiology. 2016;23(8):801-817. doi:10.1177/2047487315613462
Sigma Membership
Epsilon Theta
Type
Poster
Format Type
Text-based Document
Study Design/Type
Descriptive/Correlational
Research Approach
Quantitative Research
Keywords:
Health Equity or Social Determinants of Health, Public and Community Health, Interprofessional, Interdisciplinary, Heart Failure, Self-care
Recommended Citation
Clifford, Namuun; Kim, Nani; Tunis, Rachel; Lee, Grace; O'Hair, Matthew; and Radhakrishnan, Kavita, "Socio-Demographic Influences on Digital Game Engagement and Self-Care in Adults With Heart Failure" (2025). International Nursing Research Congress (INRC). 133.
https://www.sigmarepository.org/inrc/2025/posters_2025/133
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Socio-Demographic Influences on Digital Game Engagement and Self-Care in Adults With Heart Failure
Seattle, Washington, USA
Background: Heart failure (HF) affects 64 million people worldwide, contributing to significant morbidity, mortality, and healthcare costs.1,2 Effective self-care is essential for improving HF outcomes, and digital health interventions have shown promise in supporting these practices.3-5 This study explores how socio-demographic factors influence engagement with a digital game app and related self-care behaviors in HF management, presenting preliminary data from a remote, digital health study.
Methods: Descriptive and correlational analyses were conducted on 40 adults from the intervention arm of an RCT after 6 months. Participants used a mobile game app, activity tracker, and smart scale to support physical activity and weight monitoring. Independent variables included sex, race, ethnicity, living situation, housing type, employment status, and work hours, and financial strain. Engagement metrics were days of game app usage, final game level, and days of weight monitoring and step goal achievement. Spearman’s correlation assessed relationships between game usage, game level, weight monitoring, and step goals due to non-normal data distribution.
Results: Of 40 participants, 77% were male, 77% White, and 82% non-Hispanic. Females engaged more in game usage and weight monitoring, while males met step goals slightly more. White, non-Hispanic participants exhibited the highest engagement in all metrics, compared to other racial/ethnic groups. Higher engagement was seen in those living with family and in single-family homes compared to those living alone or in apartments. Participants reporting financial strain exhibited lower engagement across all metrics. Significant strong positive correlations were found between game app usage and final game level (rs = .767, p < .01), days weight monitored (rs = .840, p < .01), and days meeting step goals (rs = .767, p < .01).
Conclusion: Strong positive correlations between game usage and self-care behaviors highlight the potential of mobile games in supporting HF management. However, observed differences in engagement across socio-demographics underscore the importance of identifying and addressing disparities in digital interventions to prevent reinforcing existing inequities. The ongoing RCT is focused on recruiting a more diverse participant base to strengthen these insights. Further research is needed to better understand the factors influencing differences in engagement in digital interventions across socio-demographics.
Description
This study examines the impact of socio-demographics on digital game engagement and self-care in HF management. Data from 40 participants show higher engagement among females, White, non-Hispanic individuals, while those facing financial strain had lower engagement. Strong positive correlations between game app usage and self-care behaviors underscore the potential of mobile games in HF care. Findings emphasize the need to address socio-demographic disparities in digital health interventions.