Abstract 17: Associations Between Digital Health App Engagement and Physical Activity Among African American Women With Cardiovascular-Kidney-Metabolic Syndrome: Data From the Step It Up Digital Health-Enabled Physical Activity Intervention

Background: Physical activity (PA) improves cardiovascular-kidney-metabolic health (CKMH); however, few digital health tools to increase PA are tailored for populations disproportionately impacted by adverse social determinants, such as African American (AA) women. Less is known about the effects of engagement with digital health applications (apps) on PA among AA women from under-resourced communities. The objective was to examine associations between app engagement and PA over six months in the Step It Up (SIU) digital health PA intervention. Methods: We enrolled women with ≥Stage 1 CKM syndrome (overweight/obesity) from resource-limited Washington, DC areas into SIU. Before the study, we created the SIU app with community-engaged approaches. Participants used the SIU app and a Fitbit Charge 2 PA monitor for the study. After collecting baseline PA data for two weeks, the app provides interactive PA educational modules, motivational and place-tailored messages about PA, and CKMH self-monitoring tools for six months. We examined associations between overall app and specific feature engagement (i.e. ecological momentary stress assessments (EMA) completed when opening the app, goal setting, modules) with PA (in steps/day) using linear mixed modeling. Results: Participants (N=57) had mean age=60±14 years and BMI=37±8 kg/m 2 . Overall app engagement was positively associated with PA, with each unit increase in engagement associated with 148 more steps/day (p<0.001, Table). Of the app features, engagement with the app EMA was significantly associated with higher PA (p<0.001). Engagement with app goal-setting tools and modules were less significantly associated with higher PA (p=.06 and p=.07 respectively). Conclusions: Engagement with community-tailored, digital health tools like the SIU app can increase PA for AA women with CKM syndrome from under-resourced communities. Future studies should identify methods for increasing engagement in digital health interventions to improve PA and CKMH among AA women.