Socio-demographic characteristics of diet and physical activity app users and non-users in Austria, Germany and Italy

Background: Mobile interventions for health promotion (mHealth) are promising behaviour change tools. Yet they are infrequently used, and research suggests that use may be unevenly distributed in the population, potentially widening existing health inequalities. This study tested for individual and joint associations between socio-demographic characteristics and nutrition and physical activity app use. Methods: Nationally representative samples for Austria, Germany and Italy were recruited with N = 1974 participants in total. In an online survey, participants reported on nutrition and physical activity app use as well as a range of relevant socio-demographic characteristics associated with social inequality according to PROESS-Plus (age, gender, education, income, employment status, rural vs. urban residency, Austrian/ German/ Italian citizenship, migration history, minority status, and sexual orientation).Results: Except residency and migration status, all socio-demographic characteristics were associated with mHealth app (non-)use if analysed independently. A latent class analysis revealed four distinct classes of mHealth app (non-)users, which overall highlighted age, education, income and employment are crucial inequality indicators. Conclusions: These results confirm the existence of a digital health divide in Europe primarily driven by age and socio-economic status that urgently needs addressing to promote digital health for all.