Neighborhood Characteristics and Digital Health Use and Attitudes in Black and Hispanic Women: Insights for Physical Activity and Sleep Interventions for Cancer Prevention.
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IntroductionDigital interventions for 24-hour movement patterns (i.e., physical activity, sedentary behavior, sleep) show promise for cancer prevention, particularly among Black and Hispanic women, who experience worse cancer outcomes and lower adherence to sleep and physical activity guidelines. This study examined whether neighborhood characteristics influence digital health use and attitudes among Black and Hispanic women and explored whether individual sociodemographic factors moderate these relationships.MethodsIn a secondary analysis of a cross-sectional study, a total of 992 Black and Hispanic women aged 18-49 completed an online survey assessing demographic factors, sleep quality, physical activity levels, digital health use, and attitudes towards digital health interventions for sleep and physical activity. Neighborhood-level data on socioeconomic status, racial composition, and access to health services were extracted from geocoded addresses. Multivariable binary logistic regression models tested associations between neighborhood characteristics and digital health outcomes. Moderation by age, race, and education was assessed.ResultsBlack and Hispanic women living in neighborhoods with low or moderate-to-high socioeconomic risk were more likely to own wearable devices than those in high-risk neighborhoods. Health app use was more common among Black and Hispanic women in neighborhoods with higher rates of adults having personal doctors and greater out-of-pocket medical expenses. Among women in medically underserviced neighborhoods, Black women were more likely to use a health app, while Hispanic women were less likely. Race, age, and education moderated the influence of access to health services and racial structures on interest in digital health interventions for physical activity and sleep.ConclusionNeighborhood characteristics such as socioeconomic status, healthcare access, and racial structures play a vital role in shaping digital health use and attitudes among Black and Hispanic women. Tailored digital interventions that consider neighborhood-level factors may improve adoption, engagement, and effectiveness, and ultimately reduce cancer risk in these populations.