Sociodemographic inequalities in adoption, engagement, and effectiveness of the digital BitHabit wellbeing promoting app

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Abstract

Digital interventions may help promote mental wellbeing, yet existing evidence shows that adoption of wellbeing promoting apps varies across socioeconomic groups. Socioeconomic inequalities in resources, and opportunities shape patterns of health behaviour and may influence who benefits from digital interventions. This study examined how socioeconomic position relates to the adoption and engagement with a wellbeing promoting app, and whether inequalities are reflected in effectiveness of intervention.
We implemented a digital mental wellbeing intervention for working-age adults in North Savo, Finland in 2024-2025. The BitHabit app helps integrate wellbeing-promoting habits into the user’s daily life based on their personal needs and own initiative. Altogether, 1704 adults aged 18-68 years were recruited through random sampling and complementary self-selection. Mental wellbeing, health behaviors, and socioeconomic position were assessed at baseline and several follow-ups during an 18-month period. App usage data were utilized to assess the associations of socioeconomic position with adoption and engagement behaviors. The effectiveness of intervention was analyzed using multilevel linear models with the SWEMWBS mental wellbeing and PHQ‑9 depression scales.
Higher education and prior use of wellbeing promoting apps were associated with greater probability of initiating app use but not with further engagement frequency. Based on preliminary effectiveness results, the digital intervention slightly improved mental wellbeing, with gradually accumulating effects which appeared to be stronger for unemployed participants.
Our findings highlight socioeconomic inequalities in the adoption and potential benefits of digital wellbeing tools. The positive effects appeared stronger for participants in disadvantaged socioeconomic positions indicating that digital wellbeing promotion has potential to support users with greater needs. Future research should clarify mechanisms driving socioeconomic differences in adoption of wellbeing promoting apps and explore how they may shape effectiveness. Interventions should be tailored to the needs of diverse socioeconomic groups, thus contributing to reducing, rather than widening, existing wellbeing inequalities.

Authors

• Hanna Rekola, University of Eastern Finland

• Tiina Annika Karoliina Ahonen, University of Eastern Finland

• Anna-Kaisa Vartiainen, Department of Health and Social Management, University of Eastern Finland

• Ismo Linnosmaa, Department of Health and Social Management, University of Eastern Finland

• Tommi Tolmunen, University of Eastern Finland and Wellbeing Services County of North Savo, Finland

• Timo Lakka, University of Eastern Finland

• Juho Strömmer, Wellpro Impact Solutions Ltd

• Ulla Sankilampi, University of Eastern Finland and Wellbeing Services County of North Savo, Finland

• Tomi Mäki-Opas, Tomi Mäki-Opas, Department of Social Sciences, University of Eastern Finland, Finland and Social, Wellbeing, and Rescue Service Research Centre, Wellbeing Services County of North Savo, Finland