# Trends in level of education and area of residence of users of a mobile app to support treatment of urinary incontinence

## TL;DR

This study examines how the demographics of users of a urinary incontinence app in Sweden changed over time, showing more balanced education levels and increased rural representation.

## Contribution

The study provides new insights into the evolving demographic trends of a digital health app's user base compared to the general population.

## Key findings

- The proportion of Tät users with university education decreased slightly over time.
- Users with fewer than 7 years of education increased significantly among Tät users.
- The percentage of Tät users in rural areas increased, exceeding the general population's rural percentage.

## Abstract

Between 25% and 45% of women experience urinary incontinence. The Tät® app is intended to treat stress urinary incontinence in women, and has been evaluated for efficacy and effectiveness. The level of usage of digital healthcare differs depending on demographics, and this might lead to unequal access to healthcare. This study aims to analyse the change in level of education and area of residence of users of the Tät app over time, and compare this with overall demographic data for Sweden.

When the app was downloaded, the user was invited to respond anonymously to a questionnaire. We included women aged 18–89 years living in Sweden. We weighted the app data to reflect the age distribution of the general female population of Sweden. We then compared the users’ level of education and area of residence with data from Statistics Sweden.

The study encompassed 153,819 users between 2016 and 2021. The percentage of Tät users with university education decreased from 63.14% (95% CI 62.16–64.11) to 61.07% (95% CI 60.53–61.61), and the percentage of users with fewer than 7 years of education increased from 0.02% (95% CI 0.006–0.077) to 1.94% (95% CI 1.80–2.10). In contrast to this, the Statistics Sweden data comparing 2016 with 2020, showed an increase in the category “university or higher education institution” from 38.94 to 42.10% and a decrease in the other categories. Comparing Tät users’ area of residence between 2018 and 2021 showed an increase in the amount of users living in rural areas from 16.90% (95% CI 16.44–17.37) to 20.53% (95% CI 20.08–20.98). Data from Statistics Sweden did not show any significant change, and in 2020 6.23% of women in Sweden lived in rural areas.

The proportion of Tät users in both the highest and the lowest educational categories had changed to be more like the overall Swedish female population. The proportion of Tät users living in rural areas had increased and was considerably larger than for the population in general. We thus see positive trends in the distribution of users, although users with a university education are still over-represented.