Heterogeneity in Digital Health Behaviors among Black Adult Smartphone Owners: An Exploration of the Digi-ble Planets

To assess how U.S. Black adult smartphone owners, segmented by sociodemographics and health status, engage in accessing, generating, and interacting with digital health. This study utilized cycles (2017–2020) of the Health Information National Trends Survey (HINTS), including respondents who identified as Black smartphone owners (N = 1,303). We analyzed responses to eleven items to assess digital health behaviors. Descriptive frequency statistics were calculated and multivariate logistic regression models were applied. All analyses were weighted to ensure results are nationally representative of U.S. Black adults who own smartphones. Age, education, and living with diabetes were major factors significantly associated with multiple digital health behaviors across all three digital health categories (accessing, generating, and interacting). Black smartphone owners who were younger, middle-aged, and living with diabetes reported higher levels of digital health engagement. Those who reported a lower educational attainment had lower odds of digital health engagement. A detailed analysis of a nationally representative sample of Black adult smartphone owners provides new data about digital health tool use. These findings suggest that despite broad-based smartphone ownership, Black adults vary in their digital health engagement. To ensure equitable use of digital health tools, public health strategies and clinical interventions could consider within-group differences for Black adults and may benefit from refining the tailoring of digital health information and services by age, education, and health condition. Black adults who are older or have less education may need additional supportive resources to use digital health tools to their full capacity. Additional research on these digital tools, as well as emerging ones, may identify other factors that, if addressed, could bolster Black adults’ use of digital health tools.