Effects of health technology use and digital health engagement on clinical trial Participation: Findings from the Health Information National Trends Survey

Background/AimsThe existing literature indicates that clinical trial knowledge and participation is multifactorial, yet little is known about the association with digital health technology use and digital health engagement. To address this gap, we examined the multivariate association between clinical trial knowledge and participation with past-year health technology use and digital health engagement with medical providers using data from a federal surveillance system in the United States.MethodsA total of 3865 US adult respondents from the Health Information National Trends Survey 5, Cycle 4 provided data in 2020. The two outcomes were clinical trial knowledge (no knowledge, a little knowledge, a lot of knowledge) and participation (never invited, invited did not participate, invited and participated). There were four binary indicators of health technology use for the following purposes in the past year: searching for health or medical information, communicating with a doctor's office, looking up medical test results, and making medical appointments. There were four binary indicators of digital health engagement in the past year: sharing health information on social media, participating in a health forum or support group, watching health-related videos on YouTube, and awareness of ClinicalTrials.gov.ResultsSurvey-weighted multivariate regression models demonstrated that awareness of ClinicalTrials.gov had the greatest associations with clinical trial knowledge (adjusted risk ratio = 7.60, 95% confidence interval: 4.82-12.00) and participation (adjusted risk ratio = 2.60, 95% confidence interval: 1.23-5.54). Using digital technology to look for health information (adjusted risk ratio = 1.35, 95% confidence interval: 1.06-1.71) and communicate with doctor's offices were significantly associated with higher clinical trial knowledge (adjusted risk ratio = 1.64, 95% confidence interval: 1.25-2.14). Involvement in an online forum or support group was significantly associated with an increased likelihood of being invited but not participating in a clinical trial (adjusted risk ratio = 2.32, 95% confidence interval: 1.22-4.39), while using digital technology to make medical appointments was significantly associated with an increased likelihood of clinical trial participation (adjusted risk ratio = 1.79, 95% confidence interval: 1.07-2.99).ConclusionsFindings from this study can inform the design of large-scale digital health campaigns and quality improvement programs focused on increasing clinical trial participation.