To examine virtual health service (VHS) device usage patterns and identify factors associated with VHS engagement among Indigenous Australian adults with chronic conditions.

Cross-sectional survey.

An Aboriginal Community Controlled Health Organisation providing primary healthcare services across rural and remote Queensland, Australia.

74 consenting Indigenous Australian adults with at least one chronic condition who were registered VHS users.

Participants completed surveys assessing their use of four Bluetooth-enabled monitoring devices (pulse oximeter, blood glucose monitor, blood pressure monitor, weight scale) over a 2-week recall period. The primary outcome was VHS device usage status, categorised as active versus inactive users. Active users were defined as participants who reported any frequency of device use, while those reporting no use were classified as inactive users. All participants had access to Indigenous health coach support as part of the VHS model. Binary logistic regression was used to identify sociodemographic and geographical factors associated with VHS engagement.

Sixty-four per cent (n=47) were active users, with 73% of these using all four devices concurrently. Among active users, blood pressure monitors showed the highest utilisation (98%), followed by weight scales (91%), blood glucose monitors (89%) and pulse oximeters (86%). Three factors were significantly associated with VHS usage using binary logistic regression: residing in medium rural towns (adjusted OR 4.71, 95% CI 1.23 to 17.94, p=0.02), age 18–65 years (adjusted OR 3.59, 95% CI 1.05 to 12.22, p=0.04) and having multiple chronic conditions (adjusted OR 10.95, 95% CI 1.25 to 95.87, p=0.03) compared with those in more remote areas, aged ≥66 years and with single condition, respectively.

Indigenous-led VHS achieve substantial engagement through culturally grounded health coach support. However, addressing digital connectivity in remote areas, age-appropriate support for older adults and Indigenous workforce development is essential to ensure equitable access and sustained engagement