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      Digital Connectedness in the Framingham Heart Study

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          Abstract

          Background

          New avenues of data collection such as eHealth and mobile technology have the potential to revolutionize the way large populations can be assessed and managed outside of standard research and clinical settings.

          Methods and Results

          A digital connectedness survey was administered within the Framingham Heart Study from 2014 to 2015. The exposure was usage of the Internet, email, cell phones, and smartphones in relation to demographic and cardiovascular disease risk factors; all results were adjusted for age and sex. Among 8096 living study participants, 6503 (80.3%) completed the digital survey. Among survey responders, 5678 (87.4%) reported regular Internet use. Participants reporting regular Internet use were younger (aged 59.1 versus 76.5 years, P<0.0001), were more likely to be employed (70.3% versus 23.7%, P=0.002), and had more favorable cardiovascular disease risk factors than those who did not use the Internet (all P≤0.05). Overall, 5946 (92.1%) responders reported using cell phones. Among cell phone users, 3907 (67.8%) had smartphones. Smartphone users were younger (aged 55.4 versus 68.5 years, P<0.0001), more likely to be employed (81.1% versus 43.9%, P<0.0001) and to have a college education, and less likely to have hypertension (27.9% versus 55.7%, P=0.0002) than those who did not use smartphones.

          Conclusions

          Digital connectedness varies substantially by age; connected persons tend to be younger and better educated and to have more favorable cardiovascular disease risk factor profiles. Less than two‐thirds of study participants who completed the survey had a smartphone. The generalizability of studies focused on digitally connected persons may have limitations.

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          In search of a few good apps.

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            New Models for Large Prospective Studies: Is There a Better Way?

            Large prospective cohort studies are critical for identifying etiologic factors for disease, but they require substantial long-term research investment. Such studies can be conducted as multisite consortia of academic medical centers, combinations of smaller ongoing studies, or a single large site such as a dominant regional health-care provider. Still another strategy relies upon centralized conduct of most or all aspects, recruiting through multiple temporary assessment centers. This is the approach used by a large-scale national resource in the United Kingdom known as the “UK Biobank,” which completed recruitment/examination of 503,000 participants between 2007 and 2010 within budget and ahead of schedule. A key lesson from UK Biobank and similar studies is that large studies are not simply small studies made large but, rather, require fundamentally different approaches in which “process” expertise is as important as scientific rigor. Embedding recruitment in a structure that facilitates outcome determination, utilizing comprehensive and flexible information technology, automating biospecimen processing, ensuring broad consent, and establishing essentially autonomous leadership with appropriate oversight are all critical to success. Whether and how these approaches may be transportable to the United States remain to be explored, but their success in studies such as UK Biobank makes a compelling case for such explorations to begin.
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              An approach to longitudinal studies in a community: the Framingham Study.

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                Author and article information

                Journal
                J Am Heart Assoc
                J Am Heart Assoc
                10.1002/(ISSN)2047-9980
                JAH3
                ahaoa
                Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
                John Wiley and Sons Inc. (Hoboken )
                2047-9980
                13 April 2016
                April 2016
                : 5
                : 4 ( doiID: 10.1002/jah3.2016.5.issue-4 )
                : e003193
                Affiliations
                [ 1 ] National Heart, Lung, and Blood Institute Center for Population StudiesNational Institutes of Health Framingham MA
                [ 2 ] Division of Endocrinology, Hypertension, and Metabolism Brigham and Women's HospitalHarvard Medical School Boston MA
                [ 3 ]Framingham Heart Study Framingham MA
                [ 4 ] Department of Mathematics and StatisticsBoston University Boston MA
                [ 5 ] Department of EpidemiologyBoston University School of Public Health Boston MA
                [ 6 ] Section of Cardiology and Preventive Medicine Department of MedicineBoston University School of Medicine Boston MA
                [ 7 ] Section of General Internal Medicine Department of MedicineBoston University School of Medicine Boston MA
                Author notes
                [*] [* ] Correspondence to: Caroline S. Fox, MD, MPH, Framingham Heart Study, National Heart, Lung, and Blood Institute, 73 Mount Wayte Avenue, Suite 2, Framingham, MA 01702. E‐mail: foxca@ 123456nhlbi.nih.gov
                Article
                JAH31446
                10.1161/JAHA.116.003193
                4859293
                27076568
                05d04bbf-a3c8-4f6f-8b1b-19b8edb9d9b0
                © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

                This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 01 January 2016
                : 12 March 2016
                Page count
                Pages: 11
                Funding
                Funded by: National Heart, Lung, and Blood Institute's Framingham Heart Study
                Award ID: N01‐HC‐25195
                Award ID: HHSN268201500001I
                Award ID: 2R01HL092577
                Award ID: 1R01HL128914
                Award ID: 1P50HL120163
                Categories
                Original Research
                Original Research
                Epidemiology
                Custom metadata
                2.0
                jah31446
                April 2016
                Converter:WILEY_ML3GV2_TO_NLMPMC version:4.8.9 mode:remove_FC converted:04.05.2016

                Cardiovascular Medicine
                cardiovascular risk,ehealth,epidemiology,mhealth,smartphones,technology,lifestyle,risk factors,primary prevention

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