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Kidney Week

Abstract: TH-PO721

Frequency of Text Messaging as a Screening Tool for Assessing Electronic Health (eHealth) Literacy in Patients With CKD/ESKD and Low Health App Usage

Session Information

Category: Diversity and Equity in Kidney Health

  • 800 Diversity and Equity in Kidney Health


  • Goyal, Rohan, Montefiore Medical Center, Bronx, New York, United States
  • Baglieri, Nicholas, Montefiore Medical Center, Bronx, New York, United States
  • Markell, Mariana S., SUNY Downstate Health Sciences University, Brooklyn, New York, United States

There are many mobile health apps avilable for pts with kidney disease but pts may be unable to use them due to low eHealth literacy. We assessed eHealth literacy and potential barriers to app use in an underserved inner-City population of CKD and HD pts.


38 CKD pts and 31 HD pts were questioned face to face using the eHEALS electronic health literacy assessment (scored from 8 to 40), and questions regarding text messaging/app usage. eHEALS is an 8 question survey that characterizes subjective ability to find and use electronic health resources. Independent t-tests, Pearson correlation coefficient calculations, and generalized linear models were performed when appropriate.


CKD pts were older (67.5±15.1 vs. 60.6 ±13.0m for HD, p=0.045). 61% of HD pts are male vs 34% of CKD pts (p=0.025). 51% of HD pts have attended some college or more vs 74% of CKD pts (p=0.034). Income was similar with 51% making <$25,000 per year. Mean eHEALS score for CKD pts was 23.6 (SD = 7.7) vs 27.6 (SD = 8.2) for HD with no difference controlling for age and education. 97% of pts owned a cell phone, 91% owned a smartphone. 26% of pts reported never sending text messages, 22% reported sending a few times per week, 12% reported sending once or twice daily, and 41% reported sending more than twice daily. 45% of pts reported needing help downloading apps; 64% of pts did not report using any mobile health apps with no difference by clinic setting. Per a generalized linear model, frequency of text messaging was associated with eHEALS score with a p = 0.001 after controlling for age, education, and clinic setting.


In our population of inner city pts with kidney disease, 1. The vast majority of pts own a smart phone but do not use any mobile health apps. 2. Almost half of all pts need help downloading apps. 3. Almost half of patients surveyed do not send text messages or send them less than 1-2x per week. 4. Frequency of text messaging is significantly associated with eHealth literacy suggesting that this parameter can be used to quickly assess this potential social determinant in kidney pts. 5. Inability to utilize health apps may further accentuate health disparities and this simple question may hellp identify pts who need education or support in order to fully utilize available healthcare resources.