title: Self-Monitoring Utilization Patterns Among Individuals in an Incentivized Program for Healthy Behaviors.
abstract: The advent of digital technology has enabled individuals to track meaningful biometric data about themselves. This novel capability has spurred nontraditional health care organizations to develop systems that aid users in managing their health. One of the most prolific systems is Walgreens Balance Rewards for healthy choices (BRhc) program, an incentivized, Web-based self-monitoring program.
  
  
  
  This study was performed to evaluate health data self-tracking characteristics of individuals enrolled in the Walgreens' BRhc program, including the impact of manual versus automatic data entries through a supported device or apps.
  
  
  
  We obtained activity tracking data from a total of 455,341 BRhc users during 2014. Upon identifying users with sufficient follow-up data, we explored temporal trends in user participation.
  
  
  
  Thirty-four percent of users quit participating after a single entry of an activity. Among users who tracked at least two activities on different dates, the median length of participating was 8 weeks, with an average of 5.8 activities entered per week. Furthermore, users who participated for at least twenty weeks (28.3% of users; 33,078/116,621) consistently entered 8 to 9 activities per week. The majority of users (77%; 243,774/315,744) recorded activities through manual data entry alone. However, individuals who entered activities automatically through supported devices or apps participated roughly four times longer than their manual activity-entering counterparts (average 20 and 5 weeks, respectively; P<.001).
  
  
  
  This study provides insights into the utilization patterns of individuals participating in an incentivized, Web-based self-monitoring program. Our results suggest automated health tracking could significantly improve long-term health engagement.
authors.affiliation: Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam-si, Republic Of Korea.
authors.forename: Ju Young
authors.identifier: 0000-0001-6018-3337
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Scripps Translational Science Institute, La Jolla, CA, United States.
authors.forename: Nathan E
authors.identifier: 0000-0003-4517-228X
authors.initials: NE
authors.lastname: Wineinger
authors.affiliation: Health Analytics, Research & Reporting, Walgreen Company, Deerfield, IL, United States.
authors.forename: Michael
authors.identifier: 0000-0002-3582-4451
authors.initials: M
authors.lastname: Taitel
authors.affiliation: Department of Digital Health, Scripps Translational Science Institute, La Jolla, CA, United States.
authors.forename: Jennifer M
authors.identifier: 0000-0003-3843-0842
authors.initials: JM
authors.lastname: Radin
authors.affiliation: Health Analytics, Research & Reporting, Walgreen Company, Deerfield, IL, United States.
authors.forename: Osayi
authors.identifier: 0000-0003-1869-9908
authors.initials: O
authors.lastname: Akinbosoye
authors.affiliation: Health Analytics, Research & Reporting, Walgreen Company, Deerfield, IL, United States.
authors.forename: Jenny
authors.identifier: 0000-0002-6136-1841
authors.initials: J
authors.lastname: Jiang
authors.affiliation: Department of Digital Health, Scripps Translational Science Institute, La Jolla, CA, United States.
authors.forename: Nima
authors.identifier: 0000-0002-0223-0534
authors.initials: N
authors.lastname: Nikzad
authors.affiliation: Digital Health, Walgreen Company, Bellevue, WA, United States.
authors.forename: Gregory
authors.identifier: 0000-0003-0472-6477
authors.initials: G
authors.lastname: Orr
authors.affiliation: Scripps Translational Science Institute, La Jolla, CA, United States.
authors.forename: Eric
authors.identifier: 0000-0002-1478-4729
authors.initials: E
authors.lastname: Topol
authors.affiliation: Department of Digital Health, Scripps Translational Science Institute, La Jolla, CA, United States.
authors.forename: Steve
authors.identifier: 0000-0002-9256-7914
authors.initials: S
authors.lastname: Steinhubl
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D012647:Self-Assessment; D017216:Telemedicine / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: blood glucose self-monitoring; health behavior; mobile apps; mobile health; reward; self blood pressure monitoring