Implementation of a smartphone application for precision brain health assessment in a rural low socioeconomic setting: The Bogalusa Heart Study

Abstract

AbstractBackgroundSmartphone apps for digital health with decentralized data collection enable more frequent and precise brain‐health monitoring via the abundance of embedded sensors. Such methods may improve the sensitivity of traditional metrics and representation among diverse populations impacted by health disparities, especially in ADRD studies. Here, we describe a framework for implementing a smartphone‐based digital platform for precision brain health assessment in a longitudinal cohort of Black and White men and women.MethodsParticipants are being recruited as part of a multi‐site study from the Bogalusa Heart Study (BHS), a community‐based cohort in rural Louisiana that began in 1973. The digital platform consists of a smartphone application that is used remotely every three months for two weeks. It includes tasks that assess cognition, speech, gait and balance, and questionnaires that ensure instructions are appropriately followed and to monitor usage experiences. The BHS study personnel handle the initial screening, enrollment, and application setup. To overcome internet connection and time/availability issues, remote phone calls from BHS staff and text messages from a local area code using RingCentral software were implemented. Messages included short reminders, a link to step‐by‐step instructions to complete the application setup, and examples of smartphone tasks. (Figure 1.) Participants could schedule a call to receive phone instructions to complete the process.ResultsA total of 94 participants [age 56 ± 4.5, women n = 60 (69%), Black n = 16 (19%)] have been enrolled in the study thus far. Of those, 77 (82%) registered and set up the application (69 at the study site and 8 remotely via text/phone), and 62 (81%) completed at least one set of tasks. There was no significant difference in completion rates between race [White n = 52 (84%) and Black n = 10 (77%); p = 0.54] and sex groups [women n = 45 (82%) and men n = 17 (85%); p = 0.75].ConclusionResults showed that individuals from a rural community‐based cohort are willing to use digital technologies for brain health assessments. These findings highlight the importance of utilizing low‐cost, scalable platforms and adapting research protocols to meet the requirements of specific populations, particularly those from low socioeconomic and underrepresented backgrounds.