Digital segmentation to combat public health emergencies: the role of demographic, psychographic, and health status criteria on downloads of smartphone-based digital health interventions — a mixed methods study

Abstract Objective Smartphone-based digital health interventions (S-DHI) have the potential to mitigate negative health outcomes during public health emergencies such as the COVID-19 pandemic, provided they can recruit participants effectively. In the current paper, we apply digital audience segmentation (i.e. use of demographic, psychographic, and health status criteria) to understand downloads of pandemic-relevant S-DHI. Methods Findings from Facebook campaigns of a S-DHI (Study 1A and 1B) and an epidemiological survey (Study 2) are presented. Study 1A examines how demographics (age, gender) influence downloads and explores psychographic themes emerging from a sentiment analysis of comments. Study 1B reports downloads from a quasi-experiment focusing advertisements on different health status vulnerabilities. Study 2 examines how demographics (age, gender), psychographics (institutional trust), and health status criteria influence intention to use (ITU) S-DHI and link behavior (i.e. viewing a download link), using a structural equation model. Results Study 1A reached 1’381’897 individuals, with 4’994 downloads. Middle-aged females (63.1% female, 35–54 age group) constituted the predominant demographic downloading S-DHI. The sentiment analysis ( N = 364) showed fear ( n = 66), trust ( n = 62), and sadness ( n = 61) were prominent psychographic themes. Study 1B reached 312’037 individuals, with 726 downloads: loneliness ( n = 124) and physical activity ( n = 120) advertisements generated most downloads. Results of Study 2 ( N = 384) showed that demographics (age, gender) and health status (COVID-19 risk perceptions) resulted in higher ITU. ITU mediated the relationship between COVID-19 risk perceptions and link behavior ( p = 0.019, β = 0.348); the psychographic variable (institutional trust) moderated this relationship ( p = 0.017, β = . 005). Conclusion Taken together, results highlight the importance of demographic, psychographic, and health status criteria in understanding the demand for S-DHI during public health emergencies such as the COVID-19 pandemic, which may help with preparedness for future health emergencies or the equitable distribution of digital health interventions across society.