Tech-based health programmes less beneficial for users with low socio-economic status

New GW4 research led by Bath’s Dr Max Western is published in the International Journal of Behavioral Nutrition and Physical Activity.

  • Last updated on Friday 12 November 2021

Technology-based health and exercise programmes and apps, designed to offer a convenient and accessible way to boost physical activity, are dramatically less beneficial for users with low socio-economic status, a study has shown.

A team of experts, led by Dr Max Western from Bath's Department for Health, conducted a major study to determine whether digital health programmes are equally beneficial to users from all socio-economic backgrounds.

The team from the universities of Bath, Bristol, Cardiff and Exeter - part of the GW4 Alliance - found that health and exercise apps helped users from middle and higher socio-economic status achieve a higher level of physical activity. However, those participants with lower socio-economic status experienced no clear benefit from using digital health programmes and apps.

The team suggest that, rather than providing an easy and available healthy lifestyle for everyone, the apps could in fact be exacerbating health inequalities.

The research is published in the International Journal of Behavioural Nutrition and Physical Activity .

Dr Max Western , lead author and behavioural scientist at the University of Bath proposes that "these findings suggest that access to technologies is not the issue, but more likely the way in which people interact with and have the capability and opportunity to act upon the advice of digital health tools."

He explained: "Digital technology is often lauded as a way of bringing healthcare or interventions to hard to reach, more disadvantaged populations given the rapidly rising access to the internet and mobile devices. We wanted to examine whether the benefits of technology based interventions targeting physical activity were equivalent in people of low Socio-economic status and high socio-economic status."

Professor Mark Kelson , Associate Professor of Statistics for Health at the University of Exeter added: "This finding is really quite striking. Across multiple sensitivity analyses we are seeing the same result: the apps work for those from higher socio-economic backgrounds and they don’t for those with lower socio-economic status."

For the study, the researchers screened more than 14,000 studies, published over a 30-year period, selecting 19 randomised controlled trials that evaluated the effectiveness of digital technology - such as mobile apps, websites and wearable health technology such as smart watches - on people’s physical activity.

They found that, while people with higher socio-economic status displayed significant and long-term benefits from using such technology, those of lower socioeconomic status displayed no discernible benefits at all. This finding was true irrespective of the behaviour change techniques used in these studies.

The team suggest that future providers of digital health interventions targeting physical activity and other behaviours should account for the needs of users with lower socio-economic status to ensure they don’t, inadvertently, widen socio-economic inequalities.

Dr Western explains: "Given the rapid acceleration towards a digital health landscape it is essential that the technologies created and applied to make healthcare and behaviour change more efficient and widespread do not inadvertently widen inequalities. We need to understand the mechanisms behind why these technologies do not seem to support people of lower SES, and accordingly design them in a way that caters for their needs."