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Danielsson ML, Vergeer M, Plasqui G, Baumgart JK. Accuracy of the Apple Watch Series 4 and Fitbit Versa for Assessing Energy Expenditure and Heart Rate of Wheelchair Users During Treadmill Wheelchair Propulsion: Cross-sectional Study. JMIR Form Res 2024; 8:e52312. [PMID: 38713497 DOI: 10.2196/52312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 02/19/2024] [Accepted: 02/26/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND The Apple Watch (AW) Series 1 provides energy expenditure (EE) for wheelchair users but was found to be inaccurate with an error of approximately 30%, and the corresponding error for heart rate (HR) provided by the Fitbit Charge 2 was approximately 10% to 20%. Improved accuracy of estimated EE and HR is expected with newer editions of these smart watches (SWs). OBJECTIVE This study aims to assess the accuracy of the AW Series 4 (wheelchair-specific setting) and the Fitbit Versa (treadmill running mode) for estimating EE and HR during wheelchair propulsion at different intensities. METHODS Data from 20 manual wheelchair users (male: n=11, female: n=9; body mass: mean 75, SD 19 kg) and 20 people without a disability (male: n=11, female: n=9; body mass: mean 75, SD 11 kg) were included. Three 4-minute wheelchair propulsion stages at increasing speed were performed on 3 separate test days (0.5%, 2.5%, or 5% incline), while EE and HR were collected by criterion devices and the AW or Fitbit. The mean absolute percentage error (MAPE) was used to indicate the absolute agreement between the criterion device and SWs for EE and HR. Additionally, linear mixed model analyses assessed the effect of exercise intensity, sex, and group on the SW error. Interclass correlation coefficients were used to assess relative agreement between criterion devices and SWs. RESULTS The AW underestimated EE with MAPEs of 29.2% (SD 22%) in wheelchair users and 30% (SD 12%) in people without a disability. The Fitbit overestimated EE with MAPEs of 73.9% (SD 7%) in wheelchair users and 44.7% (SD 38%) in people without a disability. Both SWs underestimated HR. The device error for EE and HR increased with intensity for both SWs (all comparisons: P<.001), and the only significant difference between groups was found for HR in the AW (-5.27 beats/min for wheelchair users; P=.02). There was a significant effect of sex on the estimation error in EE, with worse accuracy for the AW (-0.69 kcal/min; P<.001) and better accuracy for the Fitbit (-2.08 kcal/min; P<.001) in female participants. For HR, sex differences were found only for the AW, with a smaller error in female participants (5.23 beats/min; P=.02). Interclass correlation coefficients showed poor to moderate relative agreement for both SWs apart from 2 stage-incline combinations (AW: 0.12-0.57 for EE and 0.11-0.86 for HR; Fitbit: 0.06-0.85 for EE and 0.03-0.29 for HR). CONCLUSIONS Neither the AW nor Fitbit were sufficiently accurate for estimating EE or HR during wheelchair propulsion. The AW underestimated EE and the Fitbit overestimated EE, and both SWs underestimated HR. Caution is hence required when using SWs as a tool for training intensity regulation and energy balance or imbalance in wheelchair users.
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Affiliation(s)
- Marius Lyng Danielsson
- Centre for Elite Sports Research, Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Melanie Vergeer
- Centre for Elite Sports Research, Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Nutrition and Movement Sciences, Maastricht University, Maastricht, Netherlands
| | - Guy Plasqui
- Department of Nutrition and Movement Sciences, Maastricht University, Maastricht, Netherlands
| | - Julia Kathrin Baumgart
- Centre for Elite Sports Research, Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
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Tong HL, Alnasser A, Alshahrani NZ, Bawaked RA, AlAhmed R, Alsukait RF, Rakic S, Cetinkaya V, Al-Hazzaa HM, Alqahtani SA. The Use of Mobile Technologies to Promote Physical Activity and Reduce Sedentary Behaviors in the Middle East and North Africa Region: Systematic Review and Meta-Analysis. J Med Internet Res 2024; 26:e53651. [PMID: 38502160 PMCID: PMC10988381 DOI: 10.2196/53651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 12/01/2023] [Accepted: 02/12/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND The Middle East and North Africa (MENA) region faces unique challenges in promoting physical activity and reducing sedentary behaviors, as the prevalence of insufficient physical activity is higher than the global average. Mobile technologies present a promising approach to delivering behavioral interventions; however, little is known about the effectiveness and user perspectives on these technologies in the MENA region. OBJECTIVE This study aims to evaluate the effectiveness of mobile interventions targeting physical activity and sedentary behaviors in the MENA region and explore users' perspectives on these interventions as well as any other outcomes that might influence users' adoption and use of mobile technologies (eg, appropriateness and cultural fit). METHODS A systematic search of 5 databases (MEDLINE, Embase, CINAHL, Scopus, and Global Index Medicus) was performed. Any primary studies (participants of all ages regardless of medical condition) conducted in the MENA region that investigated the use of mobile technologies and reported any measures of physical activity, sedentary behaviors, or user perceptions were included. We conducted a narrative synthesis of all studies and a meta-analysis of randomized controlled trials (RCTs). The Cochrane risk-of-bias tool was used to assess the quality of the included RCTs; quality assessment of the rest of the included studies was completed using the relevant Joanna Briggs Institute critical appraisal tools. RESULTS In total, 27 articles describing 22 interventions (n=10, 37% RCTs) and 4 (15%) nonexperimental studies were included (n=6141, 46% women). Half (11/22, 50%) of the interventions included mobile apps, whereas the other half examined SMS. The main app functions were goal setting and self-monitoring of activity, whereas SMS interventions were primarily used to deliver educational content. Users in experimental studies described several benefits of the interventions (eg, gaining knowledge and receiving reminders to be active). Engagement with the interventions was poorly reported; few studies (8/27, 30%) examined users' perspectives on the appropriateness or cultural fit of the interventions. Nonexperimental studies examined users' perspectives on mobile apps and fitness trackers, reporting several barriers to their use, such as perceived lack of usefulness, loss of interest, and technical issues. The meta-analysis of RCTs showed a positive effect of mobile interventions on physical activity outcomes (standardized mean difference=0.45, 95% CI 0.17-0.73); several sensitivity analyses showed similar results. The trim-and-fill method showed possible publication bias. Only 20% (2/10) of the RCTs measured sedentary behaviors; both reported positive changes. CONCLUSIONS The use of mobile interventions for physical activity and sedentary behaviors in the MENA region is in its early stages, with preliminary evidence of effectiveness. Policy makers and researchers should invest in high-quality studies to evaluate long-term effectiveness, intervention engagement, and implementation outcomes, which can inform the design of culturally and socially appropriate interventions for countries in the MENA region. TRIAL REGISTRATION PROSPERO CRD42023392699; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=392699.
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Affiliation(s)
- Huong Ly Tong
- Cultural and Indigenous Research Centre Australia, Redfern, Australia
- The World Bank Group, Washington, DC, United States
| | - Aroub Alnasser
- Department of Food Science and Nutrition, King Saud University, Riyadh, Saudi Arabia
| | - Najim Z Alshahrani
- Department of Family and Community Medicine, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Rowaedh A Bawaked
- Department of Public Health, Saudi Electronic University, Riyadh, Saudi Arabia
| | - Reem AlAhmed
- Department of Biostatistics, Epidemiology and Scientific Computing, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | | | | | | | - Hazzaa M Al-Hazzaa
- Health Sciences Research Center, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Saleh A Alqahtani
- Organ Transplant Center of Excellence, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
- Division of Gastroenterology & Hepatology, Johns Hopkins University, Baltimore, MD, United States
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Vetrovsky T, Siranec M, Frybova T, Gant I, Svobodova I, Linhart A, Parenica J, Miklikova M, Sujakova L, Pospisil D, Pelouch R, Odrazkova D, Parizek P, Precek J, Hutyra M, Taborsky M, Vesely J, Griva M, Semerad M, Bunc V, Hrabcova K, Vojkuvkova A, Svoboda M, Belohlavek J. Lifestyle Walking Intervention for Patients With Heart Failure With Reduced Ejection Fraction: The WATCHFUL Trial. Circulation 2024; 149:177-188. [PMID: 37955615 PMCID: PMC10782943 DOI: 10.1161/circulationaha.123.067395] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 10/13/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Physical activity is pivotal in managing heart failure with reduced ejection fraction, and walking integrated into daily life is an especially suitable form of physical activity. This study aimed to determine whether a 6-month lifestyle walking intervention combining self-monitoring and regular telephone counseling improves functional capacity assessed by the 6-minute walk test (6MWT) in patients with stable heart failure with reduced ejection fraction compared with usual care. METHODS The WATCHFUL trial (Pedometer-Based Walking Intervention in Patients With Chronic Heart Failure With Reduced Ejection Fraction) was a 6-month multicenter, parallel-group randomized controlled trial recruiting patients with heart failure with reduced ejection fraction from 6 cardiovascular centers in the Czech Republic. Eligible participants were ≥18 years of age, had left ventricular ejection fraction <40%, and had New York Heart Association class II or III symptoms on guidelines-recommended medication. Individuals exceeding 450 meters on the baseline 6MWT were excluded. Patients in the intervention group were equipped with a Garmin vívofit activity tracker and received monthly telephone counseling from research nurses who encouraged them to use behavior change techniques such as self-monitoring, goal-setting, and action planning to increase their daily step count. The patients in the control group continued usual care. The primary outcome was the between-group difference in the distance walked during the 6MWT at 6 months. Secondary outcomes included daily step count and minutes of moderate to vigorous physical activity as measured by the hip-worn Actigraph wGT3X-BT accelerometer, NT-proBNP (N-terminal pro-B-type natriuretic peptide) and high-sensitivity C-reactive protein biomarkers, ejection fraction, anthropometric measures, depression score, self-efficacy, quality of life, and survival risk score. The primary analysis was conducted by intention to treat. RESULTS Of 218 screened patients, 202 were randomized (mean age, 65 years; 22.8% female; 90.6% New York Heart Association class II; median left ventricular ejection fraction, 32.5%; median 6MWT, 385 meters; average 5071 steps/day; average 10.9 minutes of moderate to vigorous physical activity per day). At 6 months, no between-group differences were detected in the 6MWT (mean 7.4 meters [95% CI, -8.0 to 22.7]; P=0.345, n=186). The intervention group increased their average daily step count by 1420 (95% CI, 749 to 2091) and daily minutes of moderate to vigorous physical activity by 8.2 (95% CI, 3.0 to 13.3) over the control group. No between-group differences were detected for any other secondary outcomes. CONCLUSIONS Whereas the lifestyle intervention in patients with heart failure with reduced ejection fraction improved daily steps by about 25%, it failed to demonstrate a corresponding improvement in functional capacity. Further research is needed to understand the lack of association between increased physical activity and functional outcomes. REGISTRATION URL: https://www.clinicaltrials.gov; Unique identifier: NCT03041610.
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Affiliation(s)
- Tomas Vetrovsky
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic (T.V., M. Semerad, V.B.)
| | - Michal Siranec
- 2nd Department of Medicine, Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic (M. Siranec, T.F., I.G., I.S., A.L., J.B.)
| | - Tereza Frybova
- 2nd Department of Medicine, Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic (M. Siranec, T.F., I.G., I.S., A.L., J.B.)
| | - Iulian Gant
- 2nd Department of Medicine, Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic (M. Siranec, T.F., I.G., I.S., A.L., J.B.)
| | - Iveta Svobodova
- 2nd Department of Medicine, Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic (M. Siranec, T.F., I.G., I.S., A.L., J.B.)
| | - Ales Linhart
- 2nd Department of Medicine, Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic (M. Siranec, T.F., I.G., I.S., A.L., J.B.)
| | - Jiri Parenica
- Department of Internal Medicine and Cardiology, University Hospital Brno and Faculty of Medicine of Masaryk University, Brno, Czech Republic (J.P., M.M., L.S., D.P.)
| | - Marie Miklikova
- Department of Internal Medicine and Cardiology, University Hospital Brno and Faculty of Medicine of Masaryk University, Brno, Czech Republic (J.P., M.M., L.S., D.P.)
| | - Lenka Sujakova
- Department of Internal Medicine and Cardiology, University Hospital Brno and Faculty of Medicine of Masaryk University, Brno, Czech Republic (J.P., M.M., L.S., D.P.)
| | - David Pospisil
- Department of Internal Medicine and Cardiology, University Hospital Brno and Faculty of Medicine of Masaryk University, Brno, Czech Republic (J.P., M.M., L.S., D.P.)
| | - Radek Pelouch
- 1st Department of Internal Medicine, Cardioangiology, Faculty of Medicine in Hradec Kralove, Charles University in Prague and University Hospital Hradec Kralove, Czech Republic (R.P., D.O., P.P.)
| | - Daniela Odrazkova
- 1st Department of Internal Medicine, Cardioangiology, Faculty of Medicine in Hradec Kralove, Charles University in Prague and University Hospital Hradec Kralove, Czech Republic (R.P., D.O., P.P.)
| | - Petr Parizek
- 1st Department of Internal Medicine, Cardioangiology, Faculty of Medicine in Hradec Kralove, Charles University in Prague and University Hospital Hradec Kralove, Czech Republic (R.P., D.O., P.P.)
| | - Jan Precek
- Department of Internal Medicine 1, Cardiology, University Hospital Olomouc, Czech Republic (J.P., M.H., M.T.)
| | - Martin Hutyra
- Department of Internal Medicine 1, Cardiology, University Hospital Olomouc, Czech Republic (J.P., M.H., M.T.)
| | - Milos Taborsky
- Department of Internal Medicine 1, Cardiology, University Hospital Olomouc, Czech Republic (J.P., M.H., M.T.)
| | - Jiri Vesely
- Edumed sro, Broumov, and Faculty of Medicine in Hradec Kralove, Charles University, Prague, Czech Republic (J.V.)
| | - Martin Griva
- Department of Cardiology, Tomas Bata Regional Hospital, Zlin, Czech Republic (M.G.)
| | - Miroslav Semerad
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic (T.V., M. Semerad, V.B.)
| | - Vaclav Bunc
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic (T.V., M. Semerad, V.B.)
| | - Karolina Hrabcova
- Institute of Biostatistics and Analyses, Ltd, Brno, Czech Republic (K.H., A.V., M. Svoboda)
| | - Adela Vojkuvkova
- Institute of Biostatistics and Analyses, Ltd, Brno, Czech Republic (K.H., A.V., M. Svoboda)
| | - Michal Svoboda
- Institute of Biostatistics and Analyses, Ltd, Brno, Czech Republic (K.H., A.V., M. Svoboda)
| | - Jan Belohlavek
- 2nd Department of Medicine, Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic (M. Siranec, T.F., I.G., I.S., A.L., J.B.)
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Johnson NE, Venturo-Conerly KE, Rusch T. Using wearable activity trackers for research in the global south: Lessons learned from adolescent psychotherapy research in Kenya. Glob Ment Health (Camb) 2023; 10:e86. [PMID: 38161741 PMCID: PMC10755372 DOI: 10.1017/gmh.2023.85] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/13/2023] [Accepted: 11/23/2023] [Indexed: 01/03/2024] Open
Abstract
Wearable activity trackers have emerged as valuable tools for health research, providing high-resolution data on measures such as physical activity. While most research on these devices has been conducted in high-income countries, there is growing interest in their use in the global south. This perspective discusses the challenges faced and strategies employed when using wearable activity trackers to test the effects of a school-based intervention for depression and anxiety among Kenyan youth. Lessons learned include the importance of validating data output, establishing an internal procedure for international procurement, providing on-site support for participants, designating a full-time team member for wearable activity tracker operation, and issuing a paper-based information sheet to participants. The insights shared in this perspective serve as guidance for researchers undertaking studies with wearables in similar settings, contributing to the evidence base for mental health interventions targeting youth in the global south. Despite the challenges to set up, deploy and extract data from wearable activity trackers, we believe that wearables are a relatively economical approach to provide insight into the daily lives of research participants, and recommend their use to other researchers.
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Affiliation(s)
- Natalie E. Johnson
- Department of Research and Evidence, Shamiri Institute, Nairobi, Kenya
- Division of Clinical Epidemiology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Katherine E. Venturo-Conerly
- Department of Research and Evidence, Shamiri Institute, Nairobi, Kenya
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Thomas Rusch
- Competence Center for Empirical Research Methods, WU Vienna University of Economics and Business, Vienna, Austria
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Barteit S, Colmar D, Nellis S, Thu M, Watterson J, Gouwanda D, Bärnighausen T, Su TT. Developing Climate Change and Health Impact Monitoring with eHealth at the South East Asia Community Observatory and Health and Demographic Surveillance Site, Malaysia (CHIMES). Front Public Health 2023; 11:1153149. [PMID: 38125843 PMCID: PMC10732307 DOI: 10.3389/fpubh.2023.1153149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 10/31/2023] [Indexed: 12/23/2023] Open
Abstract
Background Malaysia is projected to experience an increase in heat, rainfall, rainfall variability, dry spells, thunderstorms, and high winds due to climate change. This may lead to a rise in heat-related mortality, reduced nutritional security, and potential migration due to uninhabitable land. Currently, there is limited data regarding the health implications of climate change on the Malaysian populace, which hinders informed decision-making and interventions. Objective This study aims to assess the feasibility and reliability of using sensor-based devices to enhance climate change and health research within the SEACO health and demographic surveillance site (HDSS) in Malaysia. We will particularly focus on the effects of climate-sensitive diseases, emphasizing lung conditions like chronic obstructive pulmonary disease (COPD) and asthma. Methods In our mixed-methods approach, 120 participants (>18 years) from the SEACO HDSS in Segamat, Malaysia, will be engaged over three cycles, each lasting 3 weeks. Participants will use wearables to monitor heart rate, activity, and sleep. Indoor sensors will measure temperature in indoor living spaces, while 3D-printed weather stations will track indoor temperature and humidity. In each cycle, a minimum of 10 participants at high risk for COPD or asthma will be identified. Through interviews and questionnaires, we will evaluate the devices' reliability, the prevalence of climate-sensitive lung diseases, and their correlation with environmental factors, like heat and humidity. Results We anticipate that the sensor-based measurements will offer a comprehensive understanding of the interplay between climate-sensitive diseases and weather variables. The data is expected to reveal correlations between health impacts and weather exposures like heat. Participant feedback will offer perspectives on the usability and feasibility of these digital tools. Conclusion Our study within the SEACO HDSS in Malaysia will evaluate the potential of sensor-based digital technologies in monitoring the interplay between climate change and health, particularly for climate-sensitive diseases like COPD and asthma. The data generated will likely provide details on health profiles in relation to weather exposures. Feedback will indicate the acceptability of these tools for broader health surveillance. As climate change continues to impact global health, evaluating the potential of such digital technologies is crucial to understand its potential to inform policy and intervention strategies in vulnerable regions.
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Affiliation(s)
- Sandra Barteit
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - David Colmar
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Syahrul Nellis
- South East Asia Community Observatory (SEACO) and Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Min Thu
- South East Asia Community Observatory (SEACO) and Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Jessica Watterson
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
| | - Darwin Gouwanda
- School of Engineering (Mechanical), Monash University Malaysia, Bandar Sunway, Malaysia
| | - Till Bärnighausen
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, United States
- Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Cambridge, MA, United States
| | - Tin Tin Su
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- South East Asia Community Observatory (SEACO) and Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Malaysia
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Mazzeo M, Hernan G, Veerubhotla A. Usability and ease of use of long-term remote monitoring of physical activity for individuals with acquired brain injury in community: a qualitative analysis. Front Neurosci 2023; 17:1220581. [PMID: 37781244 PMCID: PMC10534037 DOI: 10.3389/fnins.2023.1220581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 08/23/2023] [Indexed: 10/03/2023] Open
Abstract
Introduction Objective and continuous monitoring of physical activity over the long-term in the community is perhaps the most important step in the paradigm shift toward evidence-based practice and personalized therapy for successful community integration. With the advancement in technology, physical activity monitors have become the go-to tools for objective and continuous monitoring of everyday physical activity in the community. While these devices are widely used in many patient populations, their use in individuals with acquired brain injury is slowly gaining traction. The first step before using activity monitors in this population is to understand the patient perspective on usability and ease of use of physical activity monitors at different wear locations. However, there are no studies that have looked at the feasibility and patient perspectives on long-term utilization of activity monitors in individuals with acquired brain injury. Methods This pilot study aims to fill this gap and understand patient-reported aspects of the feasibility of using physical activity monitors for long-term use in community-dwelling individuals with acquired brain injury. Results This pilot study found that patients with acquired brain injury faced challenges specific to their functional limitations and that the activity monitors worn on the waist or wrist may be better suited in this population. Discussion The unique wear location-specific challenges faced by individuals with ABI need to be taken into account when selecting wearable activity monitors for long term use in this population.
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Affiliation(s)
| | | | - Akhila Veerubhotla
- Department of Rehabilitation Medicine, New York University - Grossman School of Medicine, New York, NY, United States
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Williamson Lewis R, Howell KE, Effinger KE, Meacham LR, Wasilewski-Masker K, Mertens A, Gilleland Marchak J. Feasibility of Fitbit Use in Adolescent Survivors of Pediatric Cancer: Who Consistently Uses It and for How Long? J Adolesc Young Adult Oncol 2023; 12:529-536. [PMID: 36178482 DOI: 10.1089/jayao.2022.0071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: Wearable activity trackers with real-time feedback and goal-setting features are being incorporated into programs to increase physical activity among childhood cancer survivors. This analysis describes the adoption and use of a Fitbit® Flex™ among adolescent-aged survivors of childhood cancer without incentives, reminders, or interventions to encourage use. Procedures: Cancer survivors aged 13-18 and ≥2 years from therapy received a Fitbit Flex with instructions to wear it daily. Researchers downloaded participants' daily total steps and active minutes for 1 year. Participants were classified as consistent (≥5 days/week for >4 weeks during the first 12 weeks) or inconsistent users, and comparisons between user types were made. Longitudinal use of the Fitbit and participants' 1-year acceptability evaluations are described. Results: Overall, 67.1% (47/70) of survivors enrolled, and Fitbit data were available for 36 participants. Initially, 30.6% (11/36) were consistent users. Consistent users had lower body mass index z-scores at enrollment (0.4 ± 0.7 vs. 1.2 ± 0.9; p = 0.01), but were otherwise comparable with inconsistent users. Over time survivors' use declined; at 12 months, only one participant was using his or her Fitbit. Survivors who completed a survey (n = 22) reported their Fitbit helped them self-monitor their exercise (72.7%, 16/22) and lead a more active lifestyle (63.6%, 14/22), but found it challenging to charge and not lose, forget about, or break the device. Conclusions: In the real-world setting, only a small subset of adolescent-aged survivors will initially consistently use a Fitbit and their interest diminishes over time. To maximize engagement, interventions incorporating wearable activity trackers likely need to include additional behavior change strategies.
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Affiliation(s)
- Rebecca Williamson Lewis
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Kristen E Howell
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Karen E Effinger
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Lillian R Meacham
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Karen Wasilewski-Masker
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Ann Mertens
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Jordan Gilleland Marchak
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, USA
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Mayorga-Vega D, Casado-Robles C, Guijarro-Romero S, Viciana J. Validity of activity wristbands for estimating daily physical activity in primary schoolchildren under free-living conditions: School-Fit study. Front Public Health 2023; 11:1211237. [PMID: 37554735 PMCID: PMC10405174 DOI: 10.3389/fpubh.2023.1211237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 07/10/2023] [Indexed: 08/10/2023] Open
Abstract
Introduction The use of activity wristbands to monitor and promote schoolchildren's physical activity (PA) is increasingly widespread. However, their validity has not been sufficiently studied, especially among primary schoolchildren. Consequently, the main purpose was to examine the validity of the daily steps and moderate-to-vigorous PA (MVPA) scores estimated by the activity wristbands Fitbit Ace 2, Garmin Vivofit Jr 2, and the Xiaomi Mi Band 5 in primary schoolchildren under free-living conditions. Materials and methods An initial sample of 67 schoolchildren (final sample = 62; 50% females), aged 9-12 years old (mean = 10.4 ± 1.0 years), participated in the present study. Each participant wore three activity wristbands (Fitbit Ace 2, Garmin Vivofit Jr 2, and Xiaomi Mi Band 5) on his/her non-dominant wrist and a research-grade accelerometer (ActiGraph wGT3X-BT) on his/her hip as the reference standard (number of steps and time in MVPA) during the waking time of one day. Results Results showed that the validity of the daily step scores estimated by the Garmin Vivofit Jr 2 and Xiaomi Mi Band 5 were good and acceptable (e.g., MAPE = 9.6/11.3%, and lower 95% IC of ICC = 0.87/0.73), respectively, as well as correctly classified schoolchildren as meeting or not meeting the daily 10,000/12,000-step-based recommendations, obtaining excellent/good and good/acceptable results (e.g., Garmin Vivofit Jr 2, k = 0.75/0.62; Xiaomi Mi Band 5, k = 0.73/0.53), respectively. However, the Fitbit Ace 2 did not show an acceptable validity (e.g., daily steps: MAPE = 21.1%, and lower 95% IC of ICC = 0.00; step-based recommendations: k = 0.48/0.36). None of the three activity wristbands showed an adequate validity for estimating daily MVPA (e.g., MAPE = 36.6-90.3%, and lower 95% IC of ICC = 0.00-0.41) and the validity for the MVPA-based recommendation tended to be considerably lower (e.g., k = -0.03-0.54). Conclusions The activity wristband Garmin Vivofit Jr 2 obtained the best validity for monitoring primary schoolchildren's daily steps, offering a feasible alternative to the research-grade accelerometers. Furthermore, this activity wristband could be used during PA promotion programs to provide accurate feedback to primary schoolchildren to ensure their accomplishment with the PA recommendations.
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Affiliation(s)
- Daniel Mayorga-Vega
- Departamento de Didáctica de las Lenguas, las Artes y el Deporte, Facultad de Ciencias de la Educación, Universidad de Málaga, Málaga, Spain
| | | | - Santiago Guijarro-Romero
- Department of Didactic of Musical, Plastic and Corporal Expression, University of Valladolid, Valladolid, Spain
| | - Jesús Viciana
- Department of Physical Education and Sport, University of Granada, Granada, Spain
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Diaz C, Caillaud C, Yacef K. Mining Sensor Data to Assess Changes in Physical Activity Behaviors in Health Interventions: Systematic Review. JMIR Med Inform 2023; 11:e41153. [PMID: 36877559 PMCID: PMC10028506 DOI: 10.2196/41153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 11/25/2022] [Accepted: 11/27/2022] [Indexed: 03/07/2023] Open
Abstract
BACKGROUND Sensors are increasingly used in health interventions to unobtrusively and continuously capture participants' physical activity in free-living conditions. The rich granularity of sensor data offers great potential for analyzing patterns and changes in physical activity behaviors. The use of specialized machine learning and data mining techniques to detect, extract, and analyze these patterns has increased, helping to better understand how participants' physical activity evolves. OBJECTIVE The aim of this systematic review was to identify and present the various data mining techniques employed to analyze changes in physical activity behaviors from sensors-derived data in health education and health promotion intervention studies. We addressed two main research questions: (1) What are the current techniques used for mining physical activity sensor data to detect behavior changes in health education or health promotion contexts? (2) What are the challenges and opportunities in mining physical activity sensor data for detecting physical activity behavior changes? METHODS The systematic review was performed in May 2021 using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We queried the Association for Computing Machinery (ACM), IEEE Xplore, ProQuest, Scopus, Web of Science, Education Resources Information Center (ERIC), and Springer literature databases for peer-reviewed references related to wearable machine learning to detect physical activity changes in health education. A total of 4388 references were initially retrieved from the databases. After removing duplicates and screening titles and abstracts, 285 references were subjected to full-text review, resulting in 19 articles included for analysis. RESULTS All studies used accelerometers, sometimes in combination with another sensor (37%). Data were collected over a period ranging from 4 days to 1 year (median 10 weeks) from a cohort size ranging between 10 and 11615 (median 74). Data preprocessing was mainly carried out using proprietary software, generally resulting in step counts and time spent in physical activity aggregated predominantly at the daily or minute level. The main features used as input for the data mining models were descriptive statistics of the preprocessed data. The most common data mining methods were classifiers, clusters, and decision-making algorithms, and these focused on personalization (58%) and analysis of physical activity behaviors (42%). CONCLUSIONS Mining sensor data offers great opportunities to analyze physical activity behavior changes, build models to better detect and interpret behavior changes, and allow for personalized feedback and support for participants, especially where larger sample sizes and longer recording times are available. Exploring different data aggregation levels can help detect subtle and sustained behavior changes. However, the literature suggests that there is still work remaining to improve the transparency, explicitness, and standardization of the data preprocessing and mining processes to establish best practices and make the detection methods easier to understand, scrutinize, and reproduce.
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Affiliation(s)
- Claudio Diaz
- School of Computer Science, The University of Sydney, Sydney, Australia
| | - Corinne Caillaud
- Charles Perkins Centre, School of Medical Sciences, The University of Sydney, Sydney, Australia
| | - Kalina Yacef
- School of Computer Science, The University of Sydney, Sydney, Australia
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10
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Schoeppe S, Waters K, Salmon J, Williams SL, Power D, Alley S, Rebar AL, Hayman M, Duncan MJ, Vandelanotte C. Experience and Satisfaction with a Family-Based Physical Activity Intervention Using Activity Trackers and Apps: A Qualitative Study. Int J Environ Res Public Health 2023; 20:3327. [PMID: 36834022 PMCID: PMC9963519 DOI: 10.3390/ijerph20043327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/07/2023] [Accepted: 02/09/2023] [Indexed: 06/18/2023]
Abstract
Wearable activity trackers and smartphone apps have been shown to increase physical activity in children and adults. However, interventions using activity trackers and apps have rarely been tested in whole families. This study examined the experience and satisfaction with an activity tracker and app intervention (Step it Up Family) to increase physical activity in whole families. Telephone interviews were conducted with Queensland-based families (n = 19) who participated in the Step it Up Family intervention (N = 40, single-arm, pre/post feasibility study) in 2017/2018. Using commercial activity trackers combined with apps, the intervention included an introductory session, individual and family-level goal setting, self-monitoring, family step challenges, and weekly motivational text messages. Qualitative content analysis was conducted to identify themes, categories and sub-categories. In summary, parents reported that children were engaged with the activity tracker and app features to reach their daily step goals. Some technical difficulties were experienced with app navigation, syncing of activity tracker data, and tracker band discomfort. Although families liked that the weekly text messages reminded them to be active, they did not find them very motivating. Using text messages for physical activity motivation in families requires further testing. Overall, the intervention was well-received by families for increasing physical activity motivation.
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Affiliation(s)
- Stephanie Schoeppe
- Physical Activity Research Group, Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton 4702, Australia
| | - Kim Waters
- Physical Activity Research Group, Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton 4702, Australia
| | - Jo Salmon
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong 3125, Australia
| | - Susan L. Williams
- Physical Activity Research Group, Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton 4702, Australia
| | - Deborah Power
- Physical Activity Research Group, Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton 4702, Australia
| | - Stephanie Alley
- Physical Activity Research Group, Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton 4702, Australia
| | - Amanda L. Rebar
- Physical Activity Research Group, Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton 4702, Australia
| | - Melanie Hayman
- Physical Activity Research Group, Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton 4702, Australia
| | - Mitch J. Duncan
- Priority Research Centre for Physical Activity and Nutrition, School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, Newcastle 2308, Australia
| | - Corneel Vandelanotte
- Physical Activity Research Group, Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton 4702, Australia
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Greco M, Angelucci A, Avidano G, Marelli G, Canali S, Aceto R, Lubian M, Oliva P, Piccioni F, Aliverti A, Cecconi M. Wearable Health Technology for Preoperative Risk Assessment in Elderly Patients: The WELCOME Study. Diagnostics (Basel) 2023; 13:diagnostics13040630. [PMID: 36832119 PMCID: PMC9955976 DOI: 10.3390/diagnostics13040630] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/03/2023] [Accepted: 02/05/2023] [Indexed: 02/11/2023] Open
Abstract
Preoperative identification of high-risk groups has been extensively studied to improve patients' outcomes. Wearable devices, which can track heart rate and physical activity data, are starting to be evaluated for patients' management. We hypothesized that commercial wearable devices (WD) may provide data associated with preoperative evaluation scales and tests, to identify patients with poor functional capacity at increased risk for complications. We conducted a prospective observational study including seventy-year-old patients undergoing two-hour surgeries under general anesthesia. Patients were asked to wear a WD for 7 days before surgery. WD data were compared to preoperatory clinical evaluation scales and with a 6-min walking test (6MWT). We enrolled 31 patients, with a mean age of 76.1 (SD ± 4.9) years. There were 11 (35%) ASA 3-4 patients. 6MWT results averaged 328.9 (SD ± 99.5) m. Daily steps and 𝑉𝑂2𝑚𝑎𝑥 as recorded using WD and were associated with 6MWT performance (R = 0.56, p = 0.001 and r = 0.58, p = 0.006, respectively) and clinical evaluation scales. This is the first study to evaluate WD as preoperative evaluation tools; we found a strong association between 6MWT, preoperative scales, and WD data. Low-cost wearable devices are a promising tool for the evaluation of cardiopulmonary fitness. Further research is needed to validate WD in this setting.
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Affiliation(s)
- Massimiliano Greco
- Department of Biomedical Sciences, Humanitas University, 20072 Milan, Italy
- Department of Anesthesia and Intensive Care, IRCCS Humanitas Research Hospital, 20089 Milan, Italy
- Correspondence:
| | - Alessandra Angelucci
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, 20133 Milan, Italy
| | - Gaia Avidano
- Department of Biomedical Sciences, Humanitas University, 20072 Milan, Italy
| | - Giovanni Marelli
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, 20133 Milan, Italy
| | - Stefano Canali
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, 20133 Milan, Italy
- META—Social Sciences and Humanities for Science and Technology, Politecnico di Milano, 20133 Milan, Italy
| | - Romina Aceto
- Department of Anesthesia and Intensive Care, IRCCS Humanitas Research Hospital, 20089 Milan, Italy
| | - Marta Lubian
- Department of Biomedical Sciences, Humanitas University, 20072 Milan, Italy
- Department of Anesthesia and Intensive Care, IRCCS Humanitas Research Hospital, 20089 Milan, Italy
| | - Paolo Oliva
- Clinical Engineering, IRCCS Humanitas Research Hospital, 20089 Milan, Italy
| | - Federico Piccioni
- Department of Anesthesia and Intensive Care, IRCCS Humanitas Research Hospital, 20089 Milan, Italy
| | - Andrea Aliverti
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, 20133 Milan, Italy
| | - Maurizio Cecconi
- Department of Biomedical Sciences, Humanitas University, 20072 Milan, Italy
- Department of Anesthesia and Intensive Care, IRCCS Humanitas Research Hospital, 20089 Milan, Italy
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Kukafka R, Evans K, Murnane E, Santoro E, Baiocchi M, Landay J, Delp S, Crum A. Effects of Wearable Fitness Trackers and Activity Adequacy Mindsets on Affect, Behavior, and Health: Longitudinal Randomized Controlled Trial. J Med Internet Res 2023; 25:e40529. [PMID: 36696172 PMCID: PMC9909519 DOI: 10.2196/40529] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 10/14/2022] [Accepted: 11/13/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND There is some initial evidence suggesting that mindsets about the adequacy and health consequences of one's physical activity (activity adequacy mindsets [AAMs]) can shape physical activity behavior, health, and well-being. However, it is unknown how to leverage these mindsets using wearable technology and other interventions. OBJECTIVE This research examined how wearable fitness trackers and meta-mindset interventions influence AAMs, affect, behavior, and health. METHODS A total of 162 community-dwelling adults were recruited via flyers and web-based platforms (ie, Craigslist and Nextdoor; final sample size after attrition or exclusion of 45 participants). Participants received an Apple Watch (Apple Inc) to wear for 5 weeks, which was equipped with an app that recorded step count and could display a (potentially manipulated) step count on the watch face. After a baseline week of receiving no feedback about step count, participants were randomly assigned to 1 of 4 experimental groups: they received either accurate step count (reference group; 41/162, 25.3%), 40% deflated step count (40/162, 24.7%), 40% inflated step count (40/162, 24.7%), or accurate step count+a web-based meta-mindset intervention teaching participants the value of adopting more positive AAMs (41/162, 25.3%). Participants were blinded to the condition. Outcome measures were taken in the laboratory by an experimenter at the beginning and end of participation and via web-based surveys in between. Longitudinal analysis examined changes within the accurate step count condition from baseline to treatment and compared them with changes in the deflated step count, inflated step count, and meta-mindset conditions. RESULTS Participants receiving accurate step counts perceived their activity as more adequate and healthier, adopted a healthier diet, and experienced improved mental health (Patient-Reported Outcomes Measurement Information System [PROMIS]-29) and aerobic capacity but also reduced functional health (PROMIS-29; compared with their no-step-count baseline). Participants exposed to deflated step counts perceived their activity as more inadequate; ate more unhealthily; and experienced more negative affect, reduced self-esteem and mental health, and increased blood pressure and heart rate (compared with participants receiving accurate step counts). Inflated step counts did not change AAM or most other outcomes (compared with accurate step counts). Participants receiving the meta-mindset intervention experienced improved AAM, affect, functional health, and self-reported physical activity (compared with participants receiving accurate step counts only). Actual step count did not change in either condition. CONCLUSIONS AAMs--induced by trackers or adopted deliberately--can influence affect, behavior, and health independently of actual physical activity. TRIAL REGISTRATION ClinicalTrials.gov NCT03939572; https://www.clinicaltrials.gov/ct2/show/NCT03939572.
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Affiliation(s)
| | - Kristopher Evans
- Department of Psychology, Stanford University, Stanford, CA, United States
| | - Elizabeth Murnane
- Department of Computer Science, Stanford University, Stanford, CA, United States
| | - Erik Santoro
- Department of Psychology, Stanford University, Stanford, CA, United States
| | - Michael Baiocchi
- Department of Epidemiology and Population Health, Stanford University, Stanford, CA, United States
| | - James Landay
- Department of Computer Science, Stanford University, Stanford, CA, United States
| | - Scott Delp
- Department of Mechanical Engineering, Department of Bioengineering, Stanford University, Stanford, CA, United States
| | - Alia Crum
- Department of Psychology, Stanford University, Stanford, CA, United States
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Otaka E, Oguchi K, Yagihashi K, Hoshino T, Munakata S, Hayakawa A, Otaka Y. Feasibility and efficacy of an activity-monitoring approach using pedometer in patients undergoing subacute rehabilitation: A pilot study. Front Rehabil Sci 2023; 4:1050638. [PMID: 37033197 PMCID: PMC10073503 DOI: 10.3389/fresc.2023.1050638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 03/06/2023] [Indexed: 04/11/2023]
Abstract
Wearable devices for the quantification of walking have recently been adopted for gait rehabilitation. To apply this method in subacute rehabilitation settings, this approach must be effective in these populations and implemented as a feasible method in terms of adherence and safety, especially the risk of falling. This study aimed to investigate the feasibility and efficacy of an activity monitoring approach in subacute rehabilitation using a commercially available pedometer validated with slow walking. This randomized controlled study with blinded assessors recruited 29 patients admitted to a rehabilitation ward. The participants were randomly assigned to either the feedback (intervention) or the no-feedback (control) group. Participants in both groups received at least 120 min of therapy sessions every day for 6 or 7 days per week while wearing pedometers on their unaffected ankles from the day they were permitted to walk independently till discharge. Only participants in the feedback group received weekly encouragement and the next goals. The primary outcome was the change in the 6-minute walking distance (Δ6MD). Feasibility (percentage of pedometer data acquisition days in the total observational period and the number of falls) and other efficacy outcomes (step counts, gait speed, 30-seconds chair stand test, Berg Balance Scale, and Timed Up and Go Test) were also evaluated. Regarding feasibility outcomes, the data acquisition rate was 94.1% and the number of falls during the observation period was one in the feedback group. Regarding efficacy outcomes, Δ6MD was not significantly greater in the feedback group [mean (standard deviation): 79.1 (51.7) m] than in the no-feedback group [86.1 (65.4) m] (p = 0.774) and the other five secondary outcomes showed no between-group difference. Considering the large number of steps per day in both groups [6,912 (4,751) and 5,600 (5,108) steps in the feedback and no-feedback group, respectively], the effect of the intended intervention might have been masked by the effect of simply wearing pedometers in the control group. This study revealed that the activity monitoring approach using an ankle-worn pedometer was practical in terms of adherence and safety. Further clinical trials are required to elucidate ways to effectively use wearable devices in subacute rehabilitation.
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Affiliation(s)
- Eri Otaka
- Department of Rehabilitation Medicine, Kariya Toyota General Hospital, Kariya, Japan
- Assistive Robot Center, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Kazuyo Oguchi
- Department of Rehabilitation Medicine, Kariya Toyota General Hospital, Kariya, Japan
| | - Kei Yagihashi
- Department of Rehabilitation Medicine, Kariya Toyota General Hospital, Kariya, Japan
| | - Takashi Hoshino
- Department of Rehabilitation Medicine, Kariya Toyota General Hospital, Kariya, Japan
| | - Sachiko Munakata
- Department of Rehabilitation Medicine, Kariya Toyota General Hospital, Kariya, Japan
| | - Atsuko Hayakawa
- Department of Rehabilitation Medicine, Kariya Toyota General Hospital, Kariya, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
- Correspondence: Yohei Otaka
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Özer G, Griep Y, Escartín J. A Matter of Health? A 24-Week Daily and Weekly Diary Study on Workplace Bullying Perpetrators' Psychological and Physical Health. Int J Environ Res Public Health 2022; 20:479. [PMID: 36612801 PMCID: PMC9819520 DOI: 10.3390/ijerph20010479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/18/2022] [Accepted: 12/23/2022] [Indexed: 06/17/2023]
Abstract
Workplace bullying (WB) studies focusing on perpetrators are increasing. Many processes, events, circumstances and individual states are being studied to understand and inhibit what causes some employees to become perpetrators. Using a 24-week diary design and drawing on the Conservation of Resources Theory, we investigated how sleep, physical activity (PA), and being bullied predicted perpetration on a within-level. On a between-level, we controlled for a supervisory position, psychological distress and mental illnesses over 38 employees from Spain and Turkey. Their average age was 38.84 years (SD = 11.75). They were from diverse sectors (15.8% in manufacturing, 15.8% in education, 13.2% in wholesale and retail trade, 13.2% in information and communication, 7.9% in health, 7.9% in other services and 26.3% from other sectors) with diverse professions such as finance manager, psychologist, graphic designer, academic, human resources professional, forensic doctor, IT and Administration head, municipality admin executive, waiter, and sales executives. Data collection was conducted over 24 consecutive work weeks, where only 31 participants were involved in perpetration (final observations = 720). We analyzed the data using multilevel structural equation modeling decomposed into within-and-between-person variance parts. The results indicated that on a within-level, PA as steps taken during the work week and being bullied positively predicted perpetration the same week, while sleep quality did not. By connecting sleep, physical exercise and WB literature, we draw attention to the health condition of perpetrators. Organizations should actively inhibit workplace bullying and be mindful of employees' physical activities at work or commuting to work. Managers should also be attentive to physical fatigue that employees may feel due to their responsibilities in their private lives and allow employees to rest and recuperate to inhibit negative behaviors at work.
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Affiliation(s)
- Gülüm Özer
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, 08035 Barcelona, Spain
| | - Yannick Griep
- Behavioural Science Institute, Radboud University, 6525 GD Nijmegen, The Netherlands
- Stress Research Institute, Stockholm University, 16407 Stockholm, Sweden
| | - Jordi Escartín
- Department of Social Psychology and Quantitative Psychology, University of Barcelona, 08035 Barcelona, Spain
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AF, UK
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15
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Leung T, Nahar van Venrooij LMW, Verdaasdonk EGG. Personal Devices to Monitor Physical Activity and Nutritional Intake After Colorectal Cancer Surgery: Feasibility Study. JMIR Perioper Med 2022; 5:e40352. [PMID: 36512385 PMCID: PMC9795396 DOI: 10.2196/40352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 09/02/2022] [Accepted: 09/06/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The use of self-monitoring devices is promising for improving perioperative physical activity and nutritional intake. OBJECTIVE This study aimed to assess the feasibility, usability, and acceptability of a physical activity tracker and digital food record in persons scheduled for colorectal cancer (CRC) surgery. METHODS This observational cohort study was conducted at a large training hospital between November 2019 and November 2020. The study population consisted of persons with CRC between 18- and 75 years of age who were able to use a smartphone or tablet and scheduled for elective surgery with curative intent. Excluded were persons not proficient in Dutch or following a protein-restricted diet. Participants used an activity tracker (Fitbit Charge 3) from 4 weeks before until 6 weeks after surgery. In the week before surgery (preoperative) and the fifth week after surgery (postoperative), participants also used a food record for 1 week. They shared their experience regarding usability (system usability scale, range 0-100) and acceptability (net promoter score, range -100 to +100). RESULTS In total, 28 persons were included (n=16, 57% male, mean age 61, SD 8 years), and 27 shared their experiences. Scores regarding the activity tracker were as follows: preoperative median system usability score, 85 (IQR 73-90); net promoter score, +65; postoperative median system usability score, 78 (IQR 68-85); net promotor score, +67. The net promoter scores regarding the food record were +37 (preoperative) and-7 (postoperative). CONCLUSIONS The perioperative use of a physical activity tracker is considered feasible, usable, and acceptable by persons with CRC in this study. Preoperatively, the use of a digital food record was acceptable, and postoperatively, the acceptability decreased.
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Cho S, Ensari I, Elhadad N, Weng C, Radin JM, Bent B, Desai P, Natarajan K. An interactive fitness-for-use data completeness tool to assess activity tracker data. J Am Med Inform Assoc 2022; 29:2032-2040. [PMID: 36173371 PMCID: PMC9667174 DOI: 10.1093/jamia/ocac166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 07/29/2022] [Accepted: 09/16/2022] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To design and evaluate an interactive data quality (DQ) characterization tool focused on fitness-for-use completeness measures to support researchers' assessment of a dataset. MATERIALS AND METHODS Design requirements were identified through a conceptual framework on DQ, literature review, and interviews. The prototype of the tool was developed based on the requirements gathered and was further refined by domain experts. The Fitness-for-Use Tool was evaluated through a within-subjects controlled experiment comparing it with a baseline tool that provides information on missing data based on intrinsic DQ measures. The tools were evaluated on task performance and perceived usability. RESULTS The Fitness-for-Use Tool allows users to define data completeness by customizing the measures and its thresholds to fit their research task and provides a data summary based on the customized definition. Using the Fitness-for-Use Tool, study participants were able to accurately complete fitness-for-use assessment in less time than when using the Intrinsic DQ Tool. The study participants perceived that the Fitness-for-Use Tool was more useful in determining the fitness-for-use of a dataset than the Intrinsic DQ Tool. DISCUSSION Incorporating fitness-for-use measures in a DQ characterization tool could provide data summary that meets researchers needs. The design features identified in this study has potential to be applied to other biomedical data types. CONCLUSION A tool that summarizes a dataset in terms of fitness-for-use dimensions and measures specific to a research question supports dataset assessment better than a tool that only presents information on intrinsic DQ measures.
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Affiliation(s)
- Sylvia Cho
- Department of Biomedical Informatics, Columbia University, New York, New York, USA
| | - Ipek Ensari
- Department of Artificial Intelligence and Human Health, Icahn School of Medicine, New York, New York, USA
- Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Noémie Elhadad
- Department of Biomedical Informatics, Columbia University, New York, New York, USA
- Data Science Institute, Columbia University, New York, New York, USA
| | - Chunhua Weng
- Department of Biomedical Informatics, Columbia University, New York, New York, USA
- Data Science Institute, Columbia University, New York, New York, USA
| | - Jennifer M Radin
- Scripps Research Translational Institute, La Jolla, California, USA
| | - Brinnae Bent
- Department of Biomedical Engineering, Duke University, Durham, North Carolina, USA
| | - Pooja Desai
- Department of Biomedical Informatics, Columbia University, New York, New York, USA
| | - Karthik Natarajan
- Department of Biomedical Informatics, Columbia University, New York, New York, USA
- Data Science Institute, Columbia University, New York, New York, USA
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Hojjatinia S, Lee AM, Hojjatinia S, Lagoa CM, Brunke-Reese D, Conroy DE. Physical Activity Dynamics During a Digital Messaging Intervention Changed After the Pandemic Declaration. Ann Behav Med 2022; 56:1188-1198. [PMID: 35972330 PMCID: PMC9384787 DOI: 10.1093/abm/kaac051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic adversely impacted physical activity, but little is known about how contextual changes following the pandemic declaration impacted either the dynamics of people's physical activity or their responses to micro-interventions for promoting physical activity. PURPOSE This paper explored the effect of the COVID-19 pandemic on the dynamics of physical activity responses to digital message interventions. METHODS Insufficiently-active young adults (18-29 years; N = 22) were recruited from November 2019 to January 2020 and wore a Fitbit smartwatch for 6 months. They received 0-6 messages/day via smartphone app notifications, timed and selected at random from three content libraries (Move More, Sit Less, and Inspirational Quotes). System identification techniques from control systems engineering were used to identify person-specific dynamical models of physical activity in response to messages before and after the pandemic declaration on March 13, 2020. RESULTS Daily step counts decreased significantly following the pandemic declaration on weekdays (Cohen's d = -1.40) but not on weekends (d = -0.26). The mean overall speed of the response describing physical activity (dominant pole magnitude) did not change significantly on either weekdays (d = -0.18) or weekends (d = -0.21). In contrast, there was limited rank-order consistency in specific features of intervention responses from before to after the pandemic declaration. CONCLUSIONS Generalizing models of behavioral dynamics across dramatically different environmental contexts (and participants) may lead to flawed decision rules for just-in-time physical activity interventions. Periodic model-based adaptations to person-specific decision rules (i.e., continuous tuning interventions) for digital messages are recommended when contexts change.
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Affiliation(s)
- Sahar Hojjatinia
- School of Electrical Engineering and Computer Science, The Pennsylvania State University, University Park, PA, USA
| | - Alexandra M Lee
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, USA
| | | | - Constantino M Lagoa
- School of Electrical Engineering and Computer Science, The Pennsylvania State University, University Park, PA, USA
| | - Deborah Brunke-Reese
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, USA
| | - David E Conroy
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, USA
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
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18
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Schoeppe S, Salmon J, Williams S, Power D, Waters K, Alley S, Rebar AL, Hayman M, Duncan MJ, Vandelanotte C. Feasibility of using activity trackers and apps to increase physical activity in whole families: The Step it Up Family intervention. Digit Health 2022; 8:20552076221129083. [PMID: 36225986 PMCID: PMC9548676 DOI: 10.1177/20552076221129083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 09/09/2022] [Indexed: 11/15/2022] Open
Abstract
Objective This study examined the feasibility of an activity tracker and app intervention to increase physical activity in whole families. Methods This was a single-arm feasibility study with pre-post-intervention measures. Between 2017 and 2018, 40 families (58 children aged 6-10 years, 39 mothers, 33 fathers) participated in the 6-week Step it Up Family programme in Queensland, Australia. It was delivered using Garmin activity trackers and apps, weekly motivational text messages and an introductory session. Online surveys and semi-structured interviews conducted with parents assessed intervention usage, acceptability, usability, perceived usefulness, use of physical activity self-management strategies and programme influence. Analyses included descriptive statistics, Wilcoxon signed-rank test and qualitative content analysis. Results Overall, 38 families completed the post-intervention survey (95% family retention; 90% children, 95% mothers, 88% fathers). Garmin activity tracker usage was high (i.e. nearly 24/7 during the 6 weeks intervention). Families also used the Garmin apps regularly (i.e. mostly 2-6 times per week). Further, 80% of mothers and 52% of fathers read the motivational mobile text messages. Usability and perceived usefulness of the Garmin activity trackers and apps were rated high. Both parents significantly increased their use of physical activity self-management strategies from pre to post-intervention. Parents expressed that the intervention had increased awareness of physical (in)activity in the family, encouraged to be active and promoted outdoor family activities. Conclusions Using activity trackers and apps to increase physical activity in the whole family was well received by children and parents which suggests that this intervention approach is feasible. However, further testing is needed amongst more diverse family populations. These early findings support the implementation of a randomised controlled trial to examine intervention efficacy.
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Affiliation(s)
- Stephanie Schoeppe
- School of Health, Medical and Applied Sciences, Appleton Institute, Physical Activity Research Group, Central Queensland University, Rockhampton, Australia,Stephanie Schoeppe, School of Health, Medical and Applied Sciences, Appleton Institute, Physical Activity Research Group, Central Queensland University, Building 7, Bruce Highway, Rockhampton, QLD 4702, Australia.
| | - Jo Salmon
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Susan Williams
- School of Health, Medical and Applied Sciences, Appleton Institute, Physical Activity Research Group, Central Queensland University, Rockhampton, Australia
| | - Deborah Power
- School of Health, Medical and Applied Sciences, Appleton Institute, Physical Activity Research Group, Central Queensland University, Rockhampton, Australia
| | - Kim Waters
- School of Health, Medical and Applied Sciences, Appleton Institute, Physical Activity Research Group, Central Queensland University, Rockhampton, Australia
| | - Stephanie Alley
- School of Health, Medical and Applied Sciences, Appleton Institute, Physical Activity Research Group, Central Queensland University, Rockhampton, Australia
| | - Amanda L. Rebar
- School of Health, Medical and Applied Sciences, Appleton Institute, Physical Activity Research Group, Central Queensland University, Rockhampton, Australia
| | - Melanie Hayman
- School of Health, Medical and Applied Sciences, Appleton Institute, Physical Activity Research Group, Central Queensland University, Rockhampton, Australia
| | - Mitch J Duncan
- College of Health, Medicine, and Wellbeing, School of Medicine & Public Health, The University of Newcastle, Newcastle, Australia
| | - Corneel Vandelanotte
- School of Health, Medical and Applied Sciences, Appleton Institute, Physical Activity Research Group, Central Queensland University, Rockhampton, Australia
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19
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Schmidt MD, Rathbun SL, Chu Z, Boudreaux BD, Hahn L, Novotny E, Johnsen K, Ahn SJ(G. Agreement between Fitbit and ActiGraph Estimates of Physical Activity in Young Children. Meas Phys Educ Exerc Sci 2022; 27:171-180. [PMID: 37377882 PMCID: PMC10292760 DOI: 10.1080/1091367x.2022.2125319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
Physical activity (PA) estimates from the Fitbit Flex 2 were compared to those from the ActiGraph GT9X Link in 123 elementary school children. Steps and intensity-specific estimates of PA and 3-month PA change were calculated using two different ActiGraph cut-points (Evenson and Romanzini). Fitbit estimates were 35% higher for steps compared to the ActiGraph. Fitbit and ActiGraph intensity-specific estimates were closest for sedentary and light PA while estimates of moderate and vigorous PA varied substantially depending upon the ActiGraph cut-points used. Spearman correlations between device estimates were higher for steps (rs=.70) than for moderate (rs =.54 to .55) or vigorous (rs =.29 to .48) PA. There was low concordance between devices in assessing PA changes over time. Agreement between Fitbit Flex 2 and ActiGraph estimates may depend upon the cut-points used to classify PA intensity. However, there is fair to good agreement between devices in ranking children's steps and MVPA.
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Affiliation(s)
| | | | - Zhixuan Chu
- Department of Epidemiology and Biostatistics, University of Georgia
| | | | - Lindsay Hahn
- Department of Communication, University at Buffalo, State University of New York
| | - Eric Novotny
- Grady College of Journalism & Mass Communication, University of Georgia
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20
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de Leeuwerk ME, Botjes M, van Vliet V, Geleijn E, de Groot V, van Wegen E, van der Schaaf M, Tuynman J, Dickhoff C, van der Leeden M. Self-monitoring of Physical Activity After Hospital Discharge in Patients Who Have Undergone Gastrointestinal or Lung Cancer Surgery: Mixed Methods Feasibility Study. JMIR Cancer 2022; 8:e35694. [PMID: 35749165 PMCID: PMC9270713 DOI: 10.2196/35694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/31/2022] [Accepted: 04/10/2022] [Indexed: 11/19/2022] Open
Abstract
Background Self-monitoring of physical activity (PA) using an accelerometer is a promising intervention to stimulate PA after hospital discharge. Objective This study aimed to evaluate the feasibility of PA self-monitoring after discharge in patients who have undergone gastrointestinal or lung cancer surgery. Methods A mixed methods study was conducted in which 41 patients with cancer scheduled for lobectomy, esophageal resection, or hyperthermic intraperitoneal chemotherapy were included. Preoperatively, patients received an ankle-worn accelerometer and the corresponding mobile health app to familiarize themselves with its use. The use was continued for up to 6 weeks after surgery. Feasibility criteria related to the study procedures, the System Usability Scale, and user experiences were established. In addition, 6 patients were selected to participate in semistructured interviews. Results The percentage of patients willing to participate in the study (68/90, 76%) and the final participation rate (57/90, 63%) were considered good. The retention rate was acceptable (41/57, 72%), whereas the rate of missing accelerometer data was relatively high (31%). The mean System Usability Scale score was good (77.3). Interviewed patients mentioned that the accelerometer and app were easy to use, motivated them to be more physically active, and provided postdischarge support. The technical shortcomings and comfort of the ankle straps should be improved. Conclusions Self-monitoring of PA after discharge appears to be feasible based on good system usability and predominantly positive user experiences in patients with cancer after lobectomy, esophageal resection, or hyperthermic intraperitoneal chemotherapy. Solving technical problems and improving the comfort of the ankle strap may reduce the number of dropouts and missing data in clinical use and follow-up studies.
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Affiliation(s)
- Marijke Elizabeth de Leeuwerk
- Rehabilitation Medicine, Amsterdam University Medical Centers location Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Ageing & Vitality, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Martine Botjes
- Rehabilitation Medicine, Amsterdam University Medical Centers location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Vincent van Vliet
- Rehabilitation Medicine, Amsterdam University Medical Centers location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Edwin Geleijn
- Rehabilitation Medicine, Amsterdam University Medical Centers location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Vincent de Groot
- Rehabilitation Medicine, Amsterdam University Medical Centers location Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Rehabilitation & Development, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Erwin van Wegen
- Rehabilitation Medicine, Amsterdam University Medical Centers location Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Ageing & Vitality, Amsterdam Movement Sciences, Amsterdam, Netherlands.,Rehabilitation & Development, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Marike van der Schaaf
- Ageing & Vitality, Amsterdam Movement Sciences, Amsterdam, Netherlands.,Rehabilitation Medicine, Amsterdam University Medical Centers location University of Amsterdam, Amsterdam, Netherlands.,Center of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Jurriaan Tuynman
- General Surgery, Amsterdam University Medical Centers location Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Cancer Centre Amsterdam, Treatment and Quality of Life, Amsterdam, Netherlands
| | - Chris Dickhoff
- Cancer Centre Amsterdam, Treatment and Quality of Life, Amsterdam, Netherlands.,Cardio-Thoracic Surgery, Amsterdam University Medical Centers location Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Marike van der Leeden
- Rehabilitation Medicine, Amsterdam University Medical Centers location Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Ageing & Vitality, Amsterdam Movement Sciences, Amsterdam, Netherlands
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21
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Seth M, Pohlig RT, Beisheim-Ryan EH, Stauffer SJ, Horne JR, Hicks GE, Sions JM. Residual and sound limb hip strength distinguish between sedentary and nonsedentary adults with transtibial amputation. Int J Rehabil Res 2022; 45:137-145. [PMID: 35131977 PMCID: PMC9086098 DOI: 10.1097/mrr.0000000000000520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Following a transtibial amputation (TTA), physical activity has known benefits for health and quality of life. Adults post-TTA, however, demonstrate reduced physical activity, predisposing them to adverse health outcomes. Identifying adults at the risk of sedentarism post-TTA via commonly used, objective clinical measures may enhance clinical decisions, including prosthesis prescription. The study's purpose was to determine whether residual and sound limb hip strength distinguishes between sedentary and nonsedentary adults post-TTA. A secondary analysis of a cross-sectional dataset (n = 44) was conducted. Participant residual and sound limb hip flexion, extension, abduction and adduction strength were assessed via handheld dynamometry. Physical activity was monitored for 7 days and participants were classified as sedentary (<5000 steps/day; n = 13) or nonsedentary (≥5000 steps/day; n = 31). Receiver operating curves revealed that residual and sound limb hip extension, abduction and adduction strength distinguished between sedentary and nonsedentary adults post-TTA (P < 0.050). Preliminary cut-points for hip strength measures to classify adults at the risk of sedentarism were determined. A hip strength composite score (0-6) estimates a 2.2× increased odds of being sedentary with each additional hip strength deficit. Post-TTA, residual and sound limb hip strength can help identify adults at risk of sedentarism to aid clinical decision making, including prosthesis prescription.
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Affiliation(s)
- Mayank Seth
- Delaware Limb Loss Studies, Department of Physical Therapy, University of Delaware, Newark DE, USA
| | - Ryan T Pohlig
- Biostatistics Core, University of Delaware, Newark, DE, USA
| | - Emma H Beisheim-Ryan
- Delaware Limb Loss Studies, Department of Physical Therapy, University of Delaware, Newark DE, USA
| | - Samantha J Stauffer
- Delaware Limb Loss Studies, Department of Physical Therapy, University of Delaware, Newark DE, USA
- Independence Prosthetics-Orthotics, Inc., Newark, DE, USA
| | - John R Horne
- Independence Prosthetics-Orthotics, Inc., Newark, DE, USA
| | - Gregory E Hicks
- Delaware Spine Studies, Department of Physical Therapy, University of Delaware, Newark DE, USA
| | - Jaclyn Megan Sions
- Delaware Limb Loss Studies, Department of Physical Therapy, University of Delaware, Newark DE, USA
- Delaware Spine Studies, Department of Physical Therapy, University of Delaware, Newark DE, USA
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22
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Henriksen A, Svartdal F, Grimsgaard S, Hartvigsen G, Hopstock LA. Polar Vantage and Oura Physical Activity and Sleep Trackers: Validation and Comparison Study. JMIR Form Res 2022; 6:e27248. [PMID: 35622397 PMCID: PMC9187966 DOI: 10.2196/27248] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 05/10/2021] [Accepted: 03/15/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Consumer-based activity trackers are increasingly used in research, as they have the potential to promote increased physical activity and can be used for estimating physical activity among participants. However, the accuracy of newer consumer-based devices is mostly unknown, and validation studies are needed. OBJECTIVE The objective of this study was to compare the Polar Vantage watch (Polar Electro Oy) and Oura ring (generation 2; Ōura Health Oy) activity trackers to research-based instruments for measuring physical activity, total energy expenditure, resting heart rate, and sleep duration in free-living adults. METHODS A total of 21 participants wore 2 consumer-based activity trackers (Polar watch and Oura ring), an ActiGraph accelerometer (ActiGraph LLC), and an Actiheart accelerometer and heart rate monitor (CamNtech Ltd) and completed a sleep diary for up to 7 days. We assessed Polar watch and Oura ring validity and comparability for measuring physical activity, total energy expenditure, resting heart rate (Oura), and sleep duration. We analyzed repeated measures correlations, Bland-Altman plots, and mean absolute percentage errors. RESULTS The Polar watch and Oura ring values strongly correlated (P<.001) with the ActiGraph values for steps (Polar: r=0.75, 95% CI 0.54-0.92; Oura: r=0.77, 95% CI 0.62-0.87), moderate-to-vigorous physical activity (Polar: r=0.76, 95% CI 0.62-0.88; Oura: r=0.70, 95% CI 0.49-0.82), and total energy expenditure (Polar: r=0.69, 95% CI 0.48-0.88; Oura: r=0.70, 95% CI 0.51-0.83) and strongly or very strongly correlated (P<.001) with the sleep diary-derived sleep durations (Polar: r=0.74, 95% CI 0.56-0.88; Oura: r=0.82, 95% CI 0.68-0.91). Oura ring-derived resting heart rates had a very strong correlation (P<.001) with the Actiheart-derived resting heart rates (r=0.9, 95% CI 0.85-0.96). However, the mean absolute percentage error was high for all variables except Oura ring-derived sleep duration (10%) and resting heart rate (3%), which the Oura ring underreported on average by 1 beat per minute. CONCLUSIONS The Oura ring can potentially be used as an alternative to the Actiheart to measure resting heart rate. As for sleep duration, the Polar watch and Oura ring can potentially be used as replacements for a manual sleep diary, depending on the acceptable error. Neither the Polar watch nor the Oura ring can replace the ActiGraph when it comes to measuring steps, moderate-to-vigorous physical activity, and total energy expenditure, but they may be used as additional sources of physical activity measures in some settings. On average, the Polar Vantage watch reported higher outputs compared to those reported by the Oura ring for steps, moderate-to-vigorous physical activity, and total energy expenditure.
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Affiliation(s)
- André Henriksen
- Department of Computer Science, UiT The Arctic University of Norway, Troms, Norway
| | - Frode Svartdal
- Department of Psychology, UiT The Arctic University of Norway, Tromsø, Norway
| | - Sameline Grimsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Gunnar Hartvigsen
- Department of Computer Science, UiT The Arctic University of Norway, Troms, Norway.,Department of Health and Nursing Sciences, University of Agder, Grimstad, Norway
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23
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Kurt Peker Y, Bello G, Perez AJ. On the Security of Bluetooth Low Energy in Two Consumer Wearable Heart Rate Monitors/Sensing Devices. Sensors (Basel) 2022; 22:s22030988. [PMID: 35161734 PMCID: PMC8839540 DOI: 10.3390/s22030988] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/23/2022] [Accepted: 01/24/2022] [Indexed: 11/20/2022]
Abstract
Since its inception in 2013, Bluetooth Low Energy (BLE) has become the standard for short-distance wireless communication in many consumer devices, as well as special-purpose devices. In this study, we analyze the security features available in Bluetooth LE standards and evaluate the features implemented in two BLE wearable devices (a Fitbit heart rate wristband and a Polar heart rate chest wearable) and a BLE keyboard to explore which security features in the BLE standards are implemented in the devices. In this study, we used the ComProbe Bluetooth Protocol Analyzer, along with the ComProbe software to capture the BLE traffic of these three devices. We found that even though the standards provide security mechanisms, because the Bluetooth Special Interest Group does not require that manufacturers fully comply with the standards, some manufacturers fail to implement proper security mechanisms. The circumvention of security in Bluetooth devices could leak private data that could be exploited by rogue actors/hackers, thus creating security, privacy, and, possibly, safety issues for consumers and the public. We propose the design of a Bluetooth Security Facts Label (BSFL) to be included on a Bluetooth/BLE enabled device’s commercial packaging and conclude that there should be better mechanisms for informing users about the security and privacy provisions of the devices they acquire and use and to educate the public on protection of their privacy when buying a connected device.
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24
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Domingos C, Costa P, Santos NC, Pêgo JM. Usability, Acceptability, and Satisfaction of a Wearable Activity Tracker in Older Adults: Observational Study in a Real-Life Context in Northern Portugal. J Med Internet Res 2022; 24:e26652. [PMID: 35080503 PMCID: PMC8829694 DOI: 10.2196/26652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 03/24/2021] [Accepted: 07/05/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The use of activity trackers has significantly increased over the last few years. This technology has the potential to improve the levels of physical activity and health-related behaviors in older adults. However, despite the potential benefits, the rate of adoption remains low among older adults. Therefore, understanding how technology is perceived may potentially offer insight to promote its use. OBJECTIVE This study aimed to (1) assess acceptability, usability, and user satisfaction with the Xiaomi Mi Band 2 in Portuguese community-dwelling older adults in a real-world context; (2) explore the mediating effect of the usability on the relationship between user characteristics and satisfaction; and (3) examine the moderating effect of user characteristics on the relationship between usability and user satisfaction. METHODS Older adults used the Xiaomi Mi Band 2 over 15 days. The user experience was evaluated through the Technology Acceptance Model 3, System Usability Scale, and User Satisfaction Evaluation Questionnaire. An integrated framework for usability and user satisfaction was used to explore user experience. Statistical data analysis included descriptive data analysis, reliability analysis, confirmatory factor analysis, and mediation and moderation analyses. RESULTS A sample of 110 older adults with an average age of 68.41 years (SD 3.11) completed the user experience questionnaires. Mean user acceptance was very high-perceived ease of use: 6.45 (SD 0.78); perceptions of external control: 6.74 (SD 0.55); computer anxiety: 6.85 (SD 0.47); and behavioral intention: 6.60 (SD 0.97). The usability was excellent with an average score of 92.70 (SD 10.73), and user satisfaction was classified as a good experience 23.30 (SD 2.40). The mediation analysis confirmed the direct positive effect of usability on satisfaction (β=.530; P<.01) and the direct negative effect of depression on usability (β=-.369; P<.01). Lastly, the indirect effect of usability on user satisfaction was higher in individuals with lower Geriatric Depression Scale levels. CONCLUSIONS Findings demonstrate that the Xiaomi Mi Band 2 is suitable for older adults. Furthermore, the results confirmed usability as a determinant of satisfaction with the technology and extended the existing knowledge about wearable activity trackers in older adults.
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Affiliation(s)
- Célia Domingos
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal.,iCognitus4ALL - IT Solutions, Braga, Portugal.,Clinical Academic Center - 2CA-B, Braga, Portugal
| | - Patrício Costa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Clinical Academic Center - 2CA-B, Braga, Portugal
| | - Nadine Correia Santos
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Clinical Academic Center - 2CA-B, Braga, Portugal.,Associação Centro de Medicina P5, School of Medicine, University of Minho, Braga, Portugal
| | - José Miguel Pêgo
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal.,iCognitus4ALL - IT Solutions, Braga, Portugal.,Clinical Academic Center - 2CA-B, Braga, Portugal
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25
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Huhn S, Axt M, Gunga HC, Maggioni MA, Munga S, Obor D, Sié A, Boudo V, Bunker A, Sauerborn R, Bärnighausen T, Barteit S. The Impact of Wearable Technologies in Health Research: Scoping Review. JMIR Mhealth Uhealth 2022; 10:e34384. [PMID: 35076409 PMCID: PMC8826148 DOI: 10.2196/34384] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/23/2021] [Accepted: 12/17/2021] [Indexed: 12/23/2022] Open
Abstract
Background Wearable devices hold great promise, particularly for data generation for cutting-edge health research, and their demand has risen substantially in recent years. However, there is a shortage of aggregated insights into how wearables have been used in health research. Objective In this review, we aim to broadly overview and categorize the current research conducted with affordable wearable devices for health research. Methods We performed a scoping review to understand the use of affordable, consumer-grade wearables for health research from a population health perspective using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) framework. A total of 7499 articles were found in 4 medical databases (PubMed, Ovid, Web of Science, and CINAHL). Studies were eligible if they used noninvasive wearables: worn on the wrist, arm, hip, and chest; measured vital signs; and analyzed the collected data quantitatively. We excluded studies that did not use wearables for outcome assessment and prototype studies, devices that cost >€500 (US $570), or obtrusive smart clothing. Results We included 179 studies using 189 wearable devices covering 10,835,733 participants. Most studies were observational (128/179, 71.5%), conducted in 2020 (56/179, 31.3%) and in North America (94/179, 52.5%), and 93% (10,104,217/10,835,733) of the participants were part of global health studies. The most popular wearables were fitness trackers (86/189, 45.5%) and accelerometer wearables, which primarily measure movement (49/189, 25.9%). Typical measurements included steps (95/179, 53.1%), heart rate (HR; 55/179, 30.7%), and sleep duration (51/179, 28.5%). Other devices measured blood pressure (3/179, 1.7%), skin temperature (3/179, 1.7%), oximetry (3/179, 1.7%), or respiratory rate (2/179, 1.1%). The wearables were mostly worn on the wrist (138/189, 73%) and cost <€200 (US $228; 120/189, 63.5%). The aims and approaches of all 179 studies revealed six prominent uses for wearables, comprising correlations—wearable and other physiological data (40/179, 22.3%), method evaluations (with subgroups; 40/179, 22.3%), population-based research (31/179, 17.3%), experimental outcome assessment (30/179, 16.8%), prognostic forecasting (28/179, 15.6%), and explorative analysis of big data sets (10/179, 5.6%). The most frequent strengths of affordable wearables were validation, accuracy, and clinical certification (104/179, 58.1%). Conclusions Wearables showed an increasingly diverse field of application such as COVID-19 prediction, fertility tracking, heat-related illness, drug effects, and psychological interventions; they also included underrepresented populations, such as individuals with rare diseases. There is a lack of research on wearable devices in low-resource contexts. Fueled by the COVID-19 pandemic, we see a shift toward more large-sized, web-based studies where wearables increased insights into the developing pandemic, including forecasting models and the effects of the pandemic. Some studies have indicated that big data extracted from wearables may potentially transform the understanding of population health dynamics and the ability to forecast health trends.
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Affiliation(s)
- Sophie Huhn
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
| | - Miriam Axt
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
| | - Hanns-Christian Gunga
- Charité - Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environment, Berlin, Germany
| | - Martina Anna Maggioni
- Charité - Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environment, Berlin, Germany.,Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy
| | | | - David Obor
- Kenya Medical Research Institute, Kisumu, Kenya
| | - Ali Sié
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany.,Centre de Recherche en Santé Nouna, Nouna, Burkina Faso
| | | | - Aditi Bunker
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
| | - Rainer Sauerborn
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
| | - Till Bärnighausen
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany.,Harvard Center for Population and Development Studies, Cambridge, MA, United States.,Africa Health Research Institute, KwaZulu-Natal, South Africa
| | - Sandra Barteit
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
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Cho S, Weng C, Kahn MG, Natarajan K. Identifying Data Quality Dimensions for Person-Generated Wearable Device Data: Multi-Method Study. JMIR Mhealth Uhealth 2021; 9:e31618. [PMID: 34941540 PMCID: PMC8738984 DOI: 10.2196/31618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/27/2021] [Accepted: 11/11/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND There is a growing interest in using person-generated wearable device data for biomedical research, but there are also concerns regarding the quality of data such as missing or incorrect data. This emphasizes the importance of assessing data quality before conducting research. In order to perform data quality assessments, it is essential to define what data quality means for person-generated wearable device data by identifying the data quality dimensions. OBJECTIVE This study aims to identify data quality dimensions for person-generated wearable device data for research purposes. METHODS This study was conducted in 3 phases: literature review, survey, and focus group discussion. The literature review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline to identify factors affecting data quality and its associated data quality challenges. In addition, we conducted a survey to confirm and complement results from the literature review and to understand researchers' perceptions on data quality dimensions that were previously identified as dimensions for the secondary use of electronic health record (EHR) data. We sent the survey to researchers with experience in analyzing wearable device data. Focus group discussion sessions were conducted with domain experts to derive data quality dimensions for person-generated wearable device data. On the basis of the results from the literature review and survey, a facilitator proposed potential data quality dimensions relevant to person-generated wearable device data, and the domain experts accepted or rejected the suggested dimensions. RESULTS In total, 19 studies were included in the literature review, and 3 major themes emerged: device- and technical-related, user-related, and data governance-related factors. The associated data quality problems were incomplete data, incorrect data, and heterogeneous data. A total of 20 respondents answered the survey. The major data quality challenges faced by researchers were completeness, accuracy, and plausibility. The importance ratings on data quality dimensions in an existing framework showed that the dimensions for secondary use of EHR data are applicable to person-generated wearable device data. There were 3 focus group sessions with domain experts in data quality and wearable device research. The experts concluded that intrinsic data quality features, such as conformance, completeness, and plausibility, and contextual and fitness-for-use data quality features, such as completeness (breadth and density) and temporal data granularity, are important data quality dimensions for assessing person-generated wearable device data for research purposes. CONCLUSIONS In this study, intrinsic and contextual and fitness-for-use data quality dimensions for person-generated wearable device data were identified. The dimensions were adapted from data quality terminologies and frameworks for the secondary use of EHR data with a few modifications. Further research on how data quality can be assessed with respect to each dimension is needed.
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Affiliation(s)
- Sylvia Cho
- Department of Biomedical Informatics, Columbia University, New York, NY, United States
| | - Chunhua Weng
- Department of Biomedical Informatics, Columbia University, New York, NY, United States
| | - Michael G Kahn
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Karthik Natarajan
- Department of Biomedical Informatics, Columbia University, New York, NY, United States
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Abdelhamid M. Fitness Tracker Information and Privacy Management: Empirical Study. J Med Internet Res 2021; 23:e23059. [PMID: 34783672 PMCID: PMC8663694 DOI: 10.2196/23059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 02/03/2021] [Accepted: 09/18/2021] [Indexed: 01/01/2023] Open
Abstract
Background Fitness trackers allow users to collect, manage, track, and monitor fitness-related activities, such as distance walked, calorie intake, sleep quality, and heart rate. Fitness trackers have become increasingly popular in the past decade. One in five Americans use a device or an app to track their fitness-related activities. These devices generate massive and important data that could help physicians make better assessments of their patients’ health if shared with health providers. This ultimately could lead to better health outcomes and perhaps even lower costs for patients. However, sharing personal fitness information with health care providers has drawbacks, mainly related to the risk of privacy loss and information misuse. Objective This study investigates the influence of granting users granular privacy control on their willingness to share fitness information. Methods The study used 270 valid responses collected from Mtrurkers through Amazon Mechanical Turk (MTurk). Participants were randomly assigned to one of two groups. The conceptual model was tested using structural equation modeling (SEM). The dependent variable was the intention to share fitness information. The independent variables were perceived risk, perceived benefits, and trust in the system. Results SEM explained about 60% of the variance in the dependent variable. Three of the four hypotheses were supported. Perceived risk and trust in the system had a significant relationship with the dependent variable, while trust in the system was not significant. Conclusions The findings show that people are willing to share their fitness information if they have granular privacy control. This study has practical and theoretical implications. It integrates communication privacy management (CPM) theory with the privacy calculus model.
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Affiliation(s)
- Mohamed Abdelhamid
- Department of Information Systems, California State University, Long Beach, Long Beach, CA, United States
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Miranda FL, Fernandes CH, Meirelles LM, Faloppa F, Ejnisman B, Cohen M. Translation and Cultural Adaptation to Brazilian Portuguese of the Children's Physical Activity Questionnaire (C-PAQ). Rev Bras Ortop 2021; 56:574-578. [PMID: 34733428 PMCID: PMC8558940 DOI: 10.1055/s-0041-1736414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 06/15/2021] [Indexed: 11/26/2022] Open
Abstract
Objective To perform the translation and cultural adaptation to Brazilian Portuguese of the Children's Physical Activity Questionnaire Methods The process involved the stages of translation, synthesis, back-translation, and revision by the translation group. A prefinal version of the questionnaire was then created, and, subsequently, the final version. Results Due to the lifestyle of the population, eight activities described in the questionnaire were changed to adapt it to Brazilian culture: six sports activities and two leisure activities. Eight parents/legal guardians answered the questionnaire during the pretest, quickly, without inconsistencies, and without reporting difficulties in understanding when the final interview was conducted. Conclusion The translation and cultural adaptation of the Children's Physical Activity Questionnaire to Brazilian Portuguese resulted in the version called C-PAQ.PT.
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Affiliation(s)
- Fernando Leite Miranda
- Programa de Pós-graduação em Ciências da Saúde Aplicada ao Esporte e à Atividade Física, Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil
| | - Carlos Henrique Fernandes
- Programa de Pós-graduação em Ciências da Saúde Aplicada ao Esporte e à Atividade Física, Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil
- Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil
| | - Lia Miyamoto Meirelles
- Programa de Pós-graduação em Ciências da Saúde Aplicada ao Esporte e à Atividade Física, Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil
| | - Flavio Faloppa
- Programa de Pós-graduação em Ciências da Saúde Aplicada ao Esporte e à Atividade Física, Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil
- Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil
| | - Benno Ejnisman
- Programa de Pós-graduação em Ciências da Saúde Aplicada ao Esporte e à Atividade Física, Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil
- Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil
| | - Moises Cohen
- Programa de Pós-graduação em Ciências da Saúde Aplicada ao Esporte e à Atividade Física, Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil
- Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil
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Gilgen-Ammann R, Roos L, Wyss T, Veenstra BJ, Delves SK, Beeler N, Buller MJ, Friedl KE. Validation of ambulatory monitoring devices to measure energy expenditure and heart rate in a military setting. Physiol Meas 2021; 42. [PMID: 34340217 DOI: 10.1088/1361-6579/ac19f9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 08/02/2021] [Indexed: 11/12/2022]
Abstract
Objectives.To investigate the validity of different devices and algorithms used in military organizations worldwide to assess physical activity energy expenditure (PAEE) and heart rate (HR) among soldiers.Design.Device validation study.Methods. Twenty-three male participants serving their mandatory military service accomplished, firstly, nine different military specific activities indoors, and secondly, a normal military routine outdoors. Participants wore simultaneously an ActiHeart, Everion, MetaMax 3B, Garmin Fenix 3, Hidalgo EQ02, and PADIS 2.0 system. The PAEE and HR data of each system were compared to the criterion measures MetaMax 3B and Hidalgo EQ02, respectively.Results. Overall, the recorded systematic errors in PAEE estimation ranged from 0.1 (±1.8) kcal.min-1to -1.7 (±1.8) kcal.min-1for the systems PADIS 2.0 and Hidalgo EQ02 running the Royal Dutch Army algorithm, respectively, and in the HR assessment ranged from -0.1 (±2.1) b.min-1to 0.8 (±3.0) b.min-1for the PADIS 2.0 and ActiHeart systems, respectively. The mean absolute percentage error (MAPE) in PAEE estimation ranged from 29.9% to 75.1%, with only the Everion system showing an overall MAPE <30%, but all investigated devices reported overall MAPE <1.4% in the HR assessment.Conclusions. The present study demonstrated poor to moderate validity in terms of PAEE estimation, but excellent validity in all investigated devices in terms of HR assessment. Overall, the Everion performed among the best in both parameters and with a device placement on the upper arm, the Everion system is particularly useful during military service, as it does not interfere with other relevant equipment.
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Affiliation(s)
- Rahel Gilgen-Ammann
- Swiss Federal Institute of Sport Magglingen SFISM, Hauptstrasse 247, Magglingen, Switzerland
| | - Lilian Roos
- Swiss Federal Institute of Sport Magglingen SFISM, Hauptstrasse 247, Magglingen, Switzerland
| | - Thomas Wyss
- Swiss Federal Institute of Sport Magglingen SFISM, Hauptstrasse 247, Magglingen, Switzerland
| | - Bertil J Veenstra
- Institute of Training Medicine & Training Physiology, MOD/TGTF, Herculeslaan 1, Utrecht, The Netherlands
| | - Simon K Delves
- Institute of Naval Medicine, Crescent Rd, Alverstoke, Hampshire, United Kingdom
| | - Nadja Beeler
- Swiss Federal Institute of Sport Magglingen SFISM, Hauptstrasse 247, Magglingen, Switzerland
| | - Mark J Buller
- United States Army Research Institute of Environmental Medicine, 10 General Greene Avenue, Natick, Massachusetts, United States of America
| | - Karl E Friedl
- United States Army Research Institute of Environmental Medicine, 10 General Greene Avenue, Natick, Massachusetts, United States of America
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Bardus M, Borgi C, El-Harakeh M, Gherbal T, Kharroubi S, Fares EJ. Exploring the Use of Mobile and Wearable Technology among University Student Athletes in Lebanon: A Cross-Sectional Study. Sensors (Basel) 2021; 21:4472. [PMID: 34208798 DOI: 10.3390/s21134472] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/02/2021] [Accepted: 06/04/2021] [Indexed: 11/17/2022]
Abstract
The markets of commercial wearables and health and fitness apps are constantly growing globally, especially among young adults and athletes, to track physical activity, energy expenditure and health. Despite their wide availability, evidence on use comes predominantly from the United States or Global North, with none targeting college student-athletes in low- and middle-income countries. This study was aimed to explore the use of these technologies among student-athletes at the American University of Beirut (AUB). We conducted a cross-sectional survey of 482 participants (average age 20 years) enrolled in 24 teams during Fall 2018; 230 students successfully completed the web-based survey, and 200 provided valid data. Fifty-three (26.5%) have owned a fitness tracker, mostly for self-monitoring. The most popular were Fitbit, Apple Watch, and Garmin. Similarly, 82 students (40%) used apps, primarily MyFitnessPal, Apple Health, and Samsung Health. Nevertheless, many participants discontinued use due to loss of interest or technical issues (breaking, usability, obsolescence, or lack of engagement). Wearable devices were considered superior to mobile phones alone as physical activity monitors. However, forming regular habits made self-monitoring via technology irrelevant. Further research is needed to better understand what motivates continuous use among student-athletes, who could use trackers to improve athletic performance and overall health.
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Faust L, Feldman K, Lin S, Mattingly S, D'Mello S, Chawla NV. Examining Response to Negative Life Events Through Fitness Tracker Data. Front Digit Health 2021; 3:659088. [PMID: 34713131 PMCID: PMC8521839 DOI: 10.3389/fdgth.2021.659088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 03/24/2021] [Indexed: 11/29/2022] Open
Abstract
Negative life events, such as the death of a loved one, are an unavoidable part of life. These events can be overwhelmingly stressful and may lead to the development of mental health disorders. To mitigate these adverse developments, prior literature has utilized measures of psychological responses to negative life events to better understand their effects on mental health. However, psychological changes represent only one aspect of an individual's potential response. We posit measuring additional dimensions of health, such as physical health, may also be beneficial, as physical health itself may be affected by negative life events and measuring its response could provide context to changes in mental health. Therefore, the primary aim of this work was to quantify how an individual's physical health changes in response to negative life events by testing for deviations in their physiological and behavioral state (PB-state). After capturing post-event, PB-state responses, our second aim sought to contextualize changes within known factors of psychological response to negative life events, namely coping strategies. To do so, we utilized a cohort of professionals across the United States monitored for 1 year and who experienced a negative life event while under observation. Garmin Vivosmart-3 devices provided a multidimensional representation of one's PB-state by collecting measures of resting heart rate, physical activity, and sleep. To test for deviations in PB-state following negative life events, One-Class Support Vector Machines were trained on a window of time prior to the event, which established a PB-state baseline. The model then evaluated participant's PB-state on the day of the life event and each day that followed, assigning each day a level of deviance relative to the participant's baseline. Resulting response curves were then examined in association with the use of various coping strategies using Bayesian gamma-hurdle regression models. The results from our objectives suggest that physical determinants of health also deviate in response to negative life events and that these deviations can be mitigated through different coping strategies. Taken together, these observations stress the need to examine physical determinants of health alongside psychological determinants when investigating the effects of negative life events.
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Affiliation(s)
- Louis Faust
- Department of Computer Science & Engineering, University of Notre Dame, Notre Dame, IN, United States
| | - Keith Feldman
- Children's Mercy Kansas City, Kansas City, MO, United States
- Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, United States
| | - Suwen Lin
- Department of Computer Science & Engineering, University of Notre Dame, Notre Dame, IN, United States
| | - Stephen Mattingly
- Department of Computer Science & Engineering, University of Notre Dame, Notre Dame, IN, United States
| | - Sidney D'Mello
- Institute of Cognitive Science, University of Colorado, Boulder, CO, United States
| | - Nitesh V. Chawla
- Department of Computer Science & Engineering, University of Notre Dame, Notre Dame, IN, United States
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Cho SJ, Tian Y. Investigating the role of communication between descriptive norms and exercise intentions and behaviors: findings among fitness tracker users. J Am Coll Health 2021; 69:452-458. [PMID: 31662053 DOI: 10.1080/07448481.2019.1679819] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 08/28/2019] [Accepted: 10/06/2019] [Indexed: 06/10/2023]
Abstract
This study investigates the relationship between fitness tracker users' communication of exercise information and their exercise intentions and behaviors among college students. Participants: Data were collected from 186 undergraduate students. Methods: A quantitative online survey was conducted. Descriptive norm (perceptions of prevalence of others' behaviors), communication (including exercise information giving and exercise information receiving), exercise behaviors, and exercise intentions were measured with reliable scales. Results: Both exercise information giving and information receiving were positively associated with exercise behaviors and intentions. Information giving moderated the association between descriptive norms and exercise intentions and behaviors, while information receiving moderated the association between descriptive norms and exercise intentions. Conclusion: The interaction effect between descriptive norm and communication suggests that health educators and campaign designers should focus on descriptive norm of exercise for college students who have limited communication activities. It is important to find innovative ways to promote positive health behaviors.
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Affiliation(s)
- Suahn Jang Cho
- Department of Communication & Media, University of Missouri-St. Louis, St. Louis, Missouri, USA
| | - Yan Tian
- Department of Communication & Media, University of Missouri-St. Louis, St. Louis, Missouri, USA
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No JH, Kim K, Kim YB, Suh DH, Yang EJ, Hwang H, Yoo S. Effects of an activity tracker with feedback on physical activity in women after midline laparotomy: A randomized controlled trial. J Obstet Gynaecol Res 2021; 47:2544-2550. [PMID: 33899302 DOI: 10.1111/jog.14807] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 03/19/2021] [Accepted: 04/10/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE To investigate whether the use of an activity tracker with feedback increases physical activity and is safe in patients who underwent a midline laparotomy for gynecologic disorders. METHODS Patients who were planned to undergo a midline laparotomy for gynecologic diseases wore an activity tracker at baseline and from postoperative days 1-6. Patients in the experimental arm could monitor their step counts and were encouraged to achieve the individualized step-count goal daily. In contrast, patients in the control arm did not monitor their step-counts and received the usual encouragement for ambulation. The primary endpoint was the percentage of the average step-count at postoperative days 4-5 divided by the baseline activity count. RESULTS Seventy-three patients were randomized; 63 patients underwent a surgery and wore an activity tracker; 53 patients were evaluable for primary endpoint. The activity recovery rate was significantly higher in the experimental arm compared to the control arm (71% vs 41%, p < 0.01). However, the study arm was not significantly associated with the activity recovery rate in multivariate analysis. The brief pain inventory score, brief fatigue inventory score, day of first flatus, day of soft blend diet initiation, ileus incidence, and length of postoperative hospital stay were similar between arms. The incidence of wound dehiscence and other adverse events were similar between arms. There were no grade 3 of 4 adverse events. CONCLUSION The use of an activity tracker with feedback is safe and may increase physical activity in patients who have undergone major gynecologic surgery.
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Affiliation(s)
- Jae Hong No
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Kidong Kim
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Yong Beom Kim
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Dong Hoon Suh
- Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Eun Joo Yang
- Department of Rehabilitation, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Hee Hwang
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, South Korea.,Office of eHealth Research and Businesses, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Sooyoung Yoo
- Office of eHealth Research and Businesses, Seoul National University Bundang Hospital, Seongnam, South Korea
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De La Torre S, Spruijt-Metz D, Farias AJ. Associations Among Wearable Activity Tracker Use, Exercise Motivation, and Physical Activity in a Cohort of Cancer Survivors: Secondary Data Analysis of the Health Information National Trends Survey. JMIR Cancer 2021; 7:e24828. [PMID: 33843595 PMCID: PMC8076994 DOI: 10.2196/24828] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 01/17/2021] [Accepted: 02/23/2021] [Indexed: 12/13/2022] Open
Abstract
Background Cancer survivors who meet physical activity (PA) recommendations (≥150 minutes of moderate-to-vigorous physical activity [MVPA] per week) experience better health outcomes. With the growing availability of wearable activity trackers (WATs), it may be easier to track PA. However, it is unknown what motivates survivors to use these devices. Objective The aim of this study is to investigate the associations among motivations for exercise, previous WAT use for tracking a health goal or activity, and meeting the recommended amount of PA among a cohort of cancer survivors. Methods Data on WAT users who reported having a previous cancer diagnosis were analyzed from the National Cancer Institute’s Health Information National Trends Survey 5 Cycle 3. All survivors with complete information on demographics, exercise motivations (internal guilt, external pressure, physical appearance, and exercise enjoyment), previous WAT use (yes or no), and minutes of MVPA per week (N=608) were included. Multivariate logistic regression models were used to test these associations. A separate cluster analysis was conducted to identify the profiles of exercise motivation that were associated with reporting WAT use. Results The mean age of the cohort was 66.9 years (SD 12.1). The majority were non-Hispanic White (473/608, 78.8%) and female (322/608, 54.9%), and skin cancer was the most commonly reported diagnosed cancer (154/608, 27.8%). Survivors who reported using WATs to track a health goal or activity were 1.6 times more likely to meet MVPA recommendations than those who did not use WATs (odds ratio [OR] 1.65, 95% CI 1.03-2.65; P=.04). When exercise motivations were assessed independently, survivors who reported not feeling any internal guilt as an exercise motivation were 73% less likely to report having used a WAT than those who felt any internal guilt (OR 0.27, 95% CI 0.14-0.54; P<.001). A total of 3 distinct motivational profiles emerged from the cluster analysis. WAT users had an increased probability of membership in profile 3, which was characterized as being strongly motivated to exercise by internal guilt, physical appearance, and exercise enjoyment (OR 4.5, 95% CI 2.1-9.7; P<.001). Conclusions Among this cohort, survivors who reported using WATs to track a health goal or activity were significantly more likely to report meeting PA recommendations. Survivors who reported feeling internal guilt as an exercise motivation were significantly more likely to report using WATs to track a health goal or activity. When examining clusters of motivation, survivors who reported previous WAT use were more likely to report being motivated to exercise by a mix of intrinsic and extrinsic motivations, including internal guilt, exercise enjoyment, and physical appearance. Given the health benefits of PA for cancer survivors, technology-focused interventions that use WATs and target exercise motivation may aid in cancer survivors meeting the level of recommended PA.
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Affiliation(s)
- Steven De La Torre
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Donna Spruijt-Metz
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.,Dornsife Center for Economic and Social Research, University of Southern California, Los Angeles, CA, United States.,Department of Psychology, University of Southern California, Los Angeles, CA, United States
| | - Albert J Farias
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.,Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
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Wyatt KD, Poole LR, Mullan AF, Kopecky SL, Heaton HA. Clinical evaluation and diagnostic yield following evaluation of abnormal pulse detected using Apple Watch. J Am Med Inform Assoc 2021; 27:1359-1363. [PMID: 32979046 PMCID: PMC7526465 DOI: 10.1093/jamia/ocaa137] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 04/09/2020] [Accepted: 06/25/2020] [Indexed: 11/24/2022] Open
Abstract
Objective The study sought to characterize the evaluation of patients who present following detection of an abnormal pulse using Apple Watch. Materials and Methods We conducted a retrospective review of patients evaluated for abnormal pulse detected using Apple Watch over a 4-month period. Results Among 264 included patients, clinical documentation for 41 (15.5%) explicitly noted an abnormal pulse alert. Preexisting atrial fibrillation was noted in 58 (22.0%). Most commonly performed testing included 12-lead echocardiography (n = 158; 59.8%), Holter monitor (n = 77; 29.2%), and chest x-ray (n = 64; 24.2%). A clinically actionable cardiovascular diagnosis of interest was established in only 30 (11.4%) patients, including 6 of 41 (15%) patients who received an explicit alert. Discussion False positive screening results may lead to overutilization of healthcare resources. Conclusions The Food and Drug Administration and Apple should consider the unintended consequences of widespread screening for asymptomatic (“silent”) atrial fibrillation and use of the Apple Watch abnormal pulse detection functionality by populations in whom the device has not been adequately studied.
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Affiliation(s)
- Kirk D Wyatt
- Division of Pediatric Hematology/Oncology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Lisa R Poole
- Department of Emergency Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Aidan F Mullan
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, USA
| | - Stephen L Kopecky
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Heather A Heaton
- Department of Emergency Medicine, Mayo Clinic, Rochester, Minnesota, USA
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Domingos C, Correia Santos N, Pêgo JM. Association between Self-Reported and Accelerometer-Based Estimates of Physical Activity in Portuguese Older Adults. Sensors (Basel) 2021; 21:2258. [PMID: 33804834 DOI: 10.3390/s21072258] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/11/2021] [Accepted: 03/15/2021] [Indexed: 12/13/2022]
Abstract
Accurate assessment of physical activity (PA) is crucial in interventions promoting it and in studies exploring its association with health status. Currently, there is a wide range of assessment tools available, including subjective and objective measures. This study compared accelerometer-based estimates of PA with self-report PA data in older adults. Additionally, the associations between PA and health outcomes and PA profiles were analyzed. Participants (n = 110) wore a Xiaomi Mi Band 2® for fifteen consecutive days. Self-reported PA was assessed using the International Physical Activity Questionnaire (IPAQ) and the Yale Physical Activity Survey (YPAS). The Spearman correlation coefficient was used to compare self-reported and accelerometer-measured PA and associations between PA and health. Bland–Altman plots were performed to assess the agreement between methods. Results highlight a large variation between self-reported and Xiaomi Mi Band 2® estimates, with poor general agreement. The highest difference was found for sedentary time. Low positive correlations were observed for IPAQ estimates (sedentary, vigorous, and total PA) and moderate for YPAS vigorous estimates. Finally, self-reported and objectively measured PA associated differently with health outcomes. Summarily, although accelerometry has the advantage of being an accurate method, self-report questionnaires could provide valuable information about the context of the activity.
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Cho S, Ensari I, Weng C, Kahn MG, Natarajan K. Factors Affecting the Quality of Person-Generated Wearable Device Data and Associated Challenges: Rapid Systematic Review. JMIR Mhealth Uhealth 2021; 9:e20738. [PMID: 33739294 PMCID: PMC8294465 DOI: 10.2196/20738] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 12/07/2020] [Accepted: 02/18/2021] [Indexed: 12/16/2022] Open
Abstract
Background There is increasing interest in reusing person-generated wearable device data for research purposes, which raises concerns about data quality. However, the amount of literature on data quality challenges, specifically those for person-generated wearable device data, is sparse. Objective This study aims to systematically review the literature on factors affecting the quality of person-generated wearable device data and their associated intrinsic data quality challenges for research. Methods The literature was searched in the PubMed, Association for Computing Machinery, Institute of Electrical and Electronics Engineers, and Google Scholar databases by using search terms related to wearable devices and data quality. By using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, studies were reviewed to identify factors affecting the quality of wearable device data. Studies were eligible if they included content on the data quality of wearable devices, such as fitness trackers and sleep monitors. Both research-grade and consumer-grade wearable devices were included in the review. Relevant content was annotated and iteratively categorized into semantically similar factors until a consensus was reached. If any data quality challenges were mentioned in the study, those contents were extracted and categorized as well. Results A total of 19 papers were included in this review. We identified three high-level factors that affect data quality—device- and technical-related factors, user-related factors, and data governance-related factors. Device- and technical-related factors include problems with hardware, software, and the connectivity of the device; user-related factors include device nonwear and user error; and data governance-related factors include a lack of standardization. The identified factors can potentially lead to intrinsic data quality challenges, such as incomplete, incorrect, and heterogeneous data. Although missing and incorrect data are widely known data quality challenges for wearable devices, the heterogeneity of data is another aspect of data quality that should be considered for wearable devices. Heterogeneity in wearable device data exists at three levels: heterogeneity in data generated by a single person using a single device (within-person heterogeneity); heterogeneity in data generated by multiple people who use the same brand, model, and version of a device (between-person heterogeneity); and heterogeneity in data generated from multiple people using different devices (between-person heterogeneity), which would apply especially to data collected under a bring-your-own-device policy. Conclusions Our study identifies potential intrinsic data quality challenges that could occur when analyzing wearable device data for research and three major contributing factors for these challenges. As poor data quality can compromise the reliability and accuracy of research results, further investigation is needed on how to address the data quality challenges of wearable devices.
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Affiliation(s)
- Sylvia Cho
- Department of Biomedical informatics, Columbia University, New York, NY, United States
| | - Ipek Ensari
- Data Science Institute, Columbia University, New York, NY, United States
| | - Chunhua Weng
- Department of Biomedical informatics, Columbia University, New York, NY, United States
| | - Michael G Kahn
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Denver, CO, United States
| | - Karthik Natarajan
- Department of Biomedical informatics, Columbia University, New York, NY, United States.,Data Science Institute, Columbia University, New York, NY, United States
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Balbim GM, Marques IG, Marquez DX, Patel D, Sharp LK, Kitsiou S, Nyenhuis SM. Using Fitbit as an mHealth Intervention Tool to Promote Physical Activity: Potential Challenges and Solutions. JMIR Mhealth Uhealth 2021; 9:e25289. [PMID: 33646135 PMCID: PMC7961407 DOI: 10.2196/25289] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 01/11/2021] [Accepted: 01/20/2021] [Indexed: 01/05/2023] Open
Abstract
Consumer-based physical activity (PA) trackers, also known as wearables, are increasingly being used in research studies as intervention or measurement tools. One of the most popular and widely used brands of PA trackers is Fitbit. Since the release of the first Fitbit in 2009, hundreds of experimental studies have used Fitbit devices to facilitate PA self-monitoring and behavior change via goal setting and feedback tools. Fitbit’s ability to capture large volumes of PA and physiological data in real time creates enormous opportunities for researchers. At the same time, however, it introduces a number of challenges (eg, technological, operational, logistical), most of which are not sufficiently described in study publications. Currently, there are no technical reports, guidelines, nor other types of publications discussing some of these challenges and offering guidance to researchers on how to best incorporate Fitbit devices in their study design and intervention to achieve their research goals. As a result, researchers are often left alone to discover and address some of these issues during the study through “trial and error.” This paper aims to address this gap. Drawing on our cumulative experience of conducting multiple studies with various Fitbit PA trackers over the years, we present and discuss various key challenges associated with the use of Fitbit PA trackers in research studies. Difficulties with the use of Fitbit PA trackers are encountered throughout the entire research process. Challenges and solutions are categorized in 4 main categories: study preparation, intervention delivery, data collection and analysis, and study closeout. Subsequently, we describe a number of empirically tested strategies used in 4 of our interventional studies involving participants from a broad range of demographic characteristics, racial/ethnic backgrounds, and literacy levels. Researchers should be prepared to address challenges and issues in a timely fashion to ensure that the Fitbit effectively assists participants and researchers in achieving research and outcome goals.
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Affiliation(s)
- Guilherme M Balbim
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States
| | - Isabela G Marques
- Rheumatology Division, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - David X Marquez
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States
| | - Darshilmukesh Patel
- Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Lisa K Sharp
- College of Pharmacy, University of Illinois at Chicago, Chicago, IL, United States
| | - Spyros Kitsiou
- Department of Biomedical and Health Information Sciences, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, United States
| | - Sharmilee M Nyenhuis
- Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Illinois at Chicago, Chicago, IL, United States
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Kim B, Hunt M, Muscedere J, Maslove DM, Lee J. Using Consumer-Grade Physical Activity Trackers to Measure Frailty Transitions in Older Critical Care Survivors: Exploratory Observational Study. JMIR Aging 2021; 4:e19859. [PMID: 33620323 PMCID: PMC8081159 DOI: 10.2196/19859] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 11/30/2020] [Accepted: 12/19/2020] [Indexed: 01/16/2023] Open
Abstract
Background Critical illness has been suggested as a sentinel event for frailty development in at-risk older adults. Frail critical illness survivors are affected by increased adverse health outcomes, but monitoring the recovery after intensive care unit (ICU) discharge is challenging. Clinicians and funders of health care systems envision an increased role of wearable devices in monitoring clinically relevant measures, as sensor technology is advancing rapidly. The use of wearable devices has also generated great interest among older patients, and they are the fastest growing group of consumer-grade wearable device users. Recent research studies indicate that consumer-grade wearable devices offer the possibility of measuring frailty. Objective This study aims to examine the data collected from wearable devices for the progression of frailty among critical illness survivors. Methods An observational study was conducted with 12 older survivors of critical illness from Kingston General Hospital in Canada. Frailty was measured using the Clinical Frailty Scale (CFS) at ICU admission, hospital discharge, and 4-week follow-up. A wearable device was worn between hospital discharge and 4-week follow-up. The wearable device collected data on step count, physical activity, sleep, and heart rate (HR). Patient assessments were reviewed, including the severity of illness, cognition level, delirium, activities of daily living, and comorbidity. Results The CFS scores increased significantly following critical illness compared with the pre-ICU frailty level (P=.02; d=−0.53). Survivors who were frail over the 4-week follow-up period had significantly lower daily step counts than survivors who were not frail (P=.02; d=1.81). There was no difference in sleep and HR measures. Daily step count was strongly correlated with the CFS at 4-week follow-up (r=−0.72; P=.04). The average HR was strongly correlated with the CFS at hospital discharge (r=−0.72; P=.046). The HR SD was strongly correlated (r=0.78; P=.02) with the change in CFS from ICU admission to 4-week follow-up. No association was found between the CFS and sleep measures. The pattern of increasing step count over the 4-week follow-up period was correlated with worsening of frailty (r=.62; P=.03). Conclusions This study demonstrated an association between frailty and data generated from a consumer-grade wearable device. Daily step count and HR showed a strong association with the frailty progression of the survivors of critical illness over time. Understanding this association could unlock a new avenue for clinicians to monitor and identify a vulnerable subset of the older adult population that might benefit from an early intervention.
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Affiliation(s)
- Ben Kim
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Miranda Hunt
- Department of Critical Care Medicine, Queen's University, Kingston, ON, Canada
| | - John Muscedere
- Department of Critical Care Medicine, Queen's University, Kingston, ON, Canada
| | - David M Maslove
- Department of Critical Care Medicine, Queen's University, Kingston, ON, Canada
| | - Joon Lee
- Data Intelligence for Health Lab, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Kalanadhabhatta M, Rahman T, Ganesan D. Effect of Sleep and Biobehavioral Patterns on Multidimensional Cognitive Performance: Longitudinal, In-the-Wild Study. J Med Internet Res 2021; 23:e23936. [PMID: 33599622 PMCID: PMC7932844 DOI: 10.2196/23936] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/28/2020] [Accepted: 01/20/2021] [Indexed: 01/09/2023] Open
Abstract
Background With nearly 20% of the US adult population using fitness trackers, there is an increasing focus on how physiological data from these devices can provide actionable insights about workplace performance. However, in-the-wild studies that understand how these metrics correlate with cognitive performance measures across a diverse population are lacking, and claims made by device manufacturers are vague. While there has been extensive research leading to a variety of theories on how physiological measures affect cognitive performance, virtually all such studies have been conducted in highly controlled settings and their validity in the real world is poorly understood. Objective We seek to bridge this gap by evaluating prevailing theories on the effects of a variety of sleep, activity, and heart rate parameters on cognitive performance against data collected in real-world settings. Methods We used a Fitbit Charge 3 and a smartphone app to collect different physiological and neurobehavioral task data, respectively, as part of our 6-week-long in-the-wild study. We collected data from 24 participants across multiple population groups (shift workers, regular workers, and graduate students) on different performance measures (vigilant attention and cognitive throughput). Simultaneously, we used a fitness tracker to unobtrusively obtain physiological measures that could influence these performance measures, including over 900 nights of sleep and over 1 million minutes of heart rate and physical activity metrics. We performed a repeated measures correlation (rrm) analysis to investigate which sleep and physiological markers show association with each performance measure. We also report how our findings relate to existing theories and previous observations from controlled studies. Results Daytime alertness was found to be significantly correlated with total sleep duration on the previous night (rrm=0.17, P<.001) as well as the duration of rapid eye movement (rrm=0.12, P<.001) and light sleep (rrm=0.15, P<.001). Cognitive throughput, by contrast, was not found to be significantly correlated with sleep duration but with sleep timing—a circadian phase shift toward a later sleep time corresponded with lower cognitive throughput on the following day (rrm=–0.13, P<.001). Both measures show circadian variations, but only alertness showed a decline (rrm=–0.1, P<.001) as a result of homeostatic pressure. Both heart rate and physical activity correlate positively with alertness as well as cognitive throughput. Conclusions Our findings reveal that there are significant differences in terms of which sleep-related physiological metrics influence each of the 2 performance measures. This makes the case for more targeted in-the-wild studies investigating how physiological measures from self-tracking data influence, or can be used to predict, specific aspects of cognitive performance.
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Affiliation(s)
- Manasa Kalanadhabhatta
- College of Information and Computer Sciences, University of Massachusetts Amherst, Amherst, MA, United States
| | - Tauhidur Rahman
- College of Information and Computer Sciences, University of Massachusetts Amherst, Amherst, MA, United States
| | - Deepak Ganesan
- College of Information and Computer Sciences, University of Massachusetts Amherst, Amherst, MA, United States
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McCarthy H, Potts HWW, Fisher A. Physical Activity Behavior Before, During, and After COVID-19 Restrictions: Longitudinal Smartphone-Tracking Study of Adults in the United Kingdom. J Med Internet Res 2021; 23:e23701. [PMID: 33347421 PMCID: PMC7861037 DOI: 10.2196/23701] [Citation(s) in RCA: 105] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 10/09/2020] [Accepted: 10/25/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic led to the implementation of worldwide restrictive measures to reduce social contact and viral spread. These measures have been reported to have a negative effect on physical activity (PA). Studies of PA during the pandemic have primarily used self-reported data. The single academic study that used tracked data did not report on demographics. OBJECTIVE This study aimed to explore patterns of smartphone-tracked activity before, during, and immediately after lockdown in the United Kingdom, and examine differences by sociodemographic characteristics and prior levels of PA. METHODS Tracked longitudinal weekly minutes of PA were captured using the BetterPoints smartphone app between January and June 2020. Data were plotted by week, demographics, and activity levels at baseline. Nonparametric tests of difference were used to assess mean and median weekly minutes of activity at significant points before and during the lockdown, and as the lockdown was eased. Changes over time by demographics (age, gender, Index of Multiple Deprivation, baseline activity levels) were examined using generalized estimating equations (GEEs). RESULTS There were 5395 users with a mean age of 41 years (SD 12) and 61% (n=3274) were female. At baseline, 26% (n=1422) of users were inactive, 23% (n=1240) were fairly active, and 51% (n=2733) were active. There was a relatively even spread across deprivation deciles (31% [n=1693] in the least deprived deciles and 23% in the most [n=1261]). We found significant changes in PA from the week before the first case of COVID-19 was announced (baseline) to the week that social distancing restrictions were relaxed (Friedman test: χ22=2331, P<.001). By the first full week of lockdown, the median change in PA was 57 minutes less than baseline. This represents a 37% reduction in weekly minutes of PA. Overall, 63% of people decreased their level of activity between baseline and the first week of COVID-19 restrictions. Younger people showed more PA before lockdown but the least PA after lockdown. In contrast, those aged >65 years appeared to remain more active throughout and increased their activity levels as soon as lockdown was eased. Levels of PA among those classed as active at baseline showed a larger drop compared with those considered to be fairly active or inactive. Socioeconomic group and gender did not appear to be associated with changes in PA. CONCLUSIONS Our tracked PA data suggests a significant drop in PA during the United Kingdom's COVID-19 lockdown. Significant differences by age group and prior PA levels suggests that the government's response to COVID-19 needs to be sensitive to these individual differences and the government should react accordingly. Specifically, it should consider the impact on younger age groups, encourage everyone to increase their PA, and not assume that people will recover prior levels of PA on their own.
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Affiliation(s)
| | - Henry W W Potts
- Institute of Health Informatics, University College London, London, United Kingdom
| | - Abigail Fisher
- Department of Behavioural Science and Health, University College London, London, United Kingdom
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Abstract
The evolution of technology makes it likely that a large number of people will invest in and use health-related mobile applications and wearable devices. Yet the question remains: Do these technology-based interventions modify health behavior and improve health…and are we getting our money's worth? The vast majority of studies concerning health-related apps and wearable devices have small sample sizes and short time spans of 6 months or less, so it is not clear if these durations were determined by lack of consistent use over time. Furthermore, many of the most popular applications have not been subjected to randomized trials. Overall, the small demonstrated improvements in outcomes are often associated with professional involvement from clinicians, coaches, or diabetes educators provided in conjunction with use of mobile health (mHealth) platforms. This paper explores the use of mHealth technologies that address cardiovascular disease/prevention (eg, diabetes, diet, physical activity, and associated weight loss) and discusses the lack of adequate evidence to support even minimal patient investment in mobile applications or wearable devices at this time.
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Affiliation(s)
| | - Arthur Garson
- UNIVERSITY OF TEXAS SCHOOL OF PUBLIC HEALTH, HOUSTON, TEXAS
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Simmich J, Mandrusiak A, Smith ST, Hartley N, Russell TG. A Co-Designed Active Video Game for Physical Activity Promotion in People With Chronic Obstructive Pulmonary Disease: Pilot Trial. JMIR Serious Games 2021; 9:e23069. [PMID: 33502321 PMCID: PMC7875701 DOI: 10.2196/23069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 11/12/2020] [Accepted: 11/26/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND People with chronic obstructive pulmonary disease (COPD) who are less active have lower quality of life, greater risk of exacerbations, and greater mortality than those who are more active. The effectiveness of physical activity interventions may facilitate the addition of game elements to improve engagement. The use of a co-design approach with people with COPD and clinicians as co-designers may also improve the effectiveness of the intervention. OBJECTIVE The primary aim of this study is to evaluate the feasibility of a co-designed mobile game by examining the usage of the game, subjective measures of game engagement, and adherence to wearing activity trackers. The secondary aim of this study is to estimate the effect of the game on daily steps and daily moderate-to-vigorous physical activity (MVPA). METHODS Participants with COPD who were taking part in the co-design of the active video game (n=9) acted as the experiment group, spending 3 weeks testing the game they helped to develop. Daily steps and MVPA were compared with a control group (n=9) of participants who did not co-design or test the game. RESULTS Most participants (8/9, 89%) engaged with the game after downloading it. Participants used the game to record physical activity on 58.6% (82/141) of the days the game was available. The highest scores on the Intrinsic Motivation Inventory were seen for the value and usefulness subscale, with a mean of 6.38 (SD 0.6). Adherence to wearing Fitbit was high, with participants in both groups recording steps on >80% of days. Usage of the game was positively correlated with changes in daily steps but not with MVPA. CONCLUSIONS The co-designed mobile app shows promise as an intervention and should be evaluated in a larger-scale trial in this population.
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Affiliation(s)
- Joshua Simmich
- Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia
| | - Allison Mandrusiak
- Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia
| | - Stuart Trevor Smith
- School of Health and Human Sciences, Southern Cross University, Coffs Harbour, Australia
| | - Nicole Hartley
- Faculty of Business, Economics and Law, The University of Queensland, Brisbane, Australia
| | - Trevor Glen Russell
- Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Australia
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Peng W, Li L, Kononova A, Cotten S, Kamp K, Bowen M. Habit Formation in Wearable Activity Tracker Use Among Older Adults: Qualitative Study. JMIR Mhealth Uhealth 2021; 9:e22488. [PMID: 33464216 PMCID: PMC7854033 DOI: 10.2196/22488] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 11/03/2020] [Accepted: 11/30/2020] [Indexed: 01/19/2023] Open
Abstract
Background Wearable activity trackers are popular devices used to motivate behavior change. Wearable activity trackers are especially beneficial for encouraging light physical activity such as walking, which is an ideal behavior for older adults or individuals who cannot be physically active at moderate and vigorous levels. A common problem is that people do not continue to use these wearable devices, with initial behavioral change gains eroding as people disengage. Limited research is available regarding the continued use of wearable activity trackers. The habit formation literature may provide insights into the long-term use of wearables and other health informatics devices. Objective This study aims to uncover the mechanism underlying the long-term continued use of wearable devices among older adults through the theoretical lens of habit formation. Methods In-depth interviews were conducted with 20 participants who were aged 65 years or older and had used wearable activity trackers for more than 6 months to understand their experiences and the strategies they employed to support continued use. Results Thematic analysis of data revealed 8 themes related to habit formation, including aspects in initiation and goal setting, use of contextual cues, action planning, and coping planning. Long-term users tended to have meaningful initiation of wearable activity trackers. They usually started with a small behavioral change goal and gradually increased it. They used consistent time and locational cues to make the use of wearable activity trackers routine. Long-term users also used creative contextual cues and reminders to facilitate action planning, engaged in coping planning to deal with anticipated problems, and had a positive mindset and inventive strategies for managing unfulfillment and lapses. Conclusions The results of this qualitative study of long-term users of wearable activity trackers suggest specific ways to enhance long-term habit formation among older adults. These best practices by long-term users can inform the future design of technology-based behavior interventions.
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Affiliation(s)
- Wei Peng
- College of Communication Arts and Sciences, Michigan State University, East Lansing, MI, United States
| | - Lin Li
- College of Communication Arts and Sciences, Michigan State University, East Lansing, MI, United States
| | - Anastasia Kononova
- College of Communication Arts and Sciences, Michigan State University, East Lansing, MI, United States
| | | | - Kendra Kamp
- University of Washington, Seattle, WA, United States
| | - Marie Bowen
- State of Michigan, Lansing, MI, United States
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Brickwood KJ, Ahuja KDK, Watson G, O'Brien JA, Williams AD. Effects of Activity Tracker Use With Health Professional Support or Telephone Counseling on Maintenance of Physical Activity and Health Outcomes in Older Adults: Randomized Controlled Trial. JMIR Mhealth Uhealth 2021; 9:e18686. [PMID: 33399541 PMCID: PMC7815450 DOI: 10.2196/18686] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 08/07/2020] [Accepted: 10/15/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Despite a range of efforts to increase physical activity participation in Australia, inactivity levels in older adults have remained high over recent decades, contributing to increased rates of chronic health conditions. Lifestyle interventions, including telephone counseling (TC), improve physical activity participation and associated health outcomes over the short term; however, ongoing feedback and support is required to maintain these changes. Newer technologies such as wearable activity trackers (ATs) may offer an alternative method for providing ongoing support. OBJECTIVE This study aims to investigate whether newer technologies such as wearable ATs assist in providing ongoing support to maintain physical activity levels and health outcomes. METHODS Older adults aged >60 years who had just completed a 12-week face-to-face individualized community exercise program in Tasmania, Australia, participated in the study. They were randomized to receive AT, TC, or usual care (UC). All groups received a home exercise program and an optional referral to a community-based exercise program. The AT group also received an AT and text message feedback from an accredited exercise physiologist (AEP). The TC group received phone calls from an AEP throughout the 12-month intervention. The primary outcome was daily steps measured by an ActivPAL (TM) accelerometer at baseline and at 3, 6, and 12 months. Secondary outcome measures included body composition, blood pressure, 10-time sit-to-stand (TTSTS) test, timed up and go test, and cardiorespiratory fitness. This trial was approved by the Tasmanian Health and Medical Human Research Ethics Committee (H0014713). RESULTS A total of 117 participants were randomized to the study (AT, n=37; TC, n=38; UC, n=42). At baseline, the participants (75/117, 64.1% female; mean age 72.4 years, SD 6.4) completed an average of 6136 steps (SD 2985) per day. Although there were no significant differences between groups, the TC and AT groups maintained daily step counts (mean difference [MD] -79 steps, 95% CI -823 to 663 steps; P=.81; and MD -588 steps, 95% CI -1359 to 182 steps; P=.09), and UC showed a reduction in daily steps (MD 981 steps, 95% CI -1668 to -294 steps; P=.003) during the 12-month period. Diastolic blood pressure was significantly higher after AT than after UC (MD 5.62 mm Hg, 95% CI 1.30 to 9.94 mm Hg; P=.01), and TTSTS was significantly slower on TC compared with UC (MD 2.36 seconds, 95% CI -0.14 to 4.87 seconds; P=.03). CONCLUSIONS The use of an AT with AEP support or TC is effective at maintaining daily step count in older adults over a 12-month period, suggesting that wearable ATs are as effective as TC. Further research to investigate which option is more cost-effective would be beneficial. TRIAL REGISTRATION Australian New Zealand Clinical Trial Registry ACTRN12615001104549; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=369118.
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Affiliation(s)
- Katie-Jane Brickwood
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Australia
| | - Kiran D K Ahuja
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Australia
| | - Greig Watson
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Australia
| | - Jane A O'Brien
- School of Nursing, College of Health and Medicine, University of Tasmania, Launceston, Australia
| | - Andrew D Williams
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Australia
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Simmich J, Mandrusiak A, Russell T, Smith S, Hartley N. Perspectives of older adults with chronic disease on the use of wearable technology and video games for physical activity. Digit Health 2021; 7:20552076211019900. [PMID: 34104468 PMCID: PMC8168030 DOI: 10.1177/20552076211019900] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 05/01/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND There is increasing interest in technology to deliver physical rehabilitation and allow clinicians to monitor progress. Examples include wearable activity trackers and active video games (AVGs), where physical activity is required to play the game. However, few studies have explored what may influence the effectiveness of these as technology-based physical activity interventions in older adults with chronic diseases. OBJECTIVE This study aimed to explore: 1) perceptions about wearable physical activity trackers; 2) perceptions about using technology to share physical activity information with clinicians; 3) barriers and motivators to playing games, including AVGs for rehabilitation. METHODS Qualitative study based on semi-structured interviews with older adults (n = 19) with chronic obstructive pulmonary disease (COPD). RESULTS Wearable activity trackers were perceived as useful to quantify activity, facilitate goal-setting, visualize long-term improvements and provide reminders. Participants generally wished to share data with their clinicians to gain greater accountability, receive useful feedback and improve the quality of clinical care. Participants were motivated to play games (including AVGs) by seeking fun, social interaction and health benefits. Some felt that AVGs were of no benefit or were too difficult. Competition was both a motivator and a barrier. CONCLUSIONS The findings of the present study seek to inform the design of technology to encourage physical activity in older adults with chronic diseases.
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Affiliation(s)
- Joshua Simmich
- Faculty of Health and Behavioural Sciences, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
| | - Allison Mandrusiak
- Faculty of Health and Behavioural Sciences, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
| | - Trevor Russell
- Faculty of Health and Behavioural Sciences, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
| | - Stuart Smith
- School of Health and Human Sciences, Southern Cross University, Coffs Harbour, Australia
| | - Nicole Hartley
- Faculty of Business, Economics and Law, The University of Queensland, St Lucia, Australia
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Connelly K, Molchan H, Bidanta R, Siddh S, Lowens B, Caine K, Demiris G, Siek K, Reeder B. Evaluation framework for selecting wearable activity monitors for research. Mhealth 2021; 7:6. [PMID: 33634189 PMCID: PMC7882259 DOI: 10.21037/mhealth-19-253] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Accepted: 05/21/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Wearable devices that support activity tracking and other measurements hold great potential to increase awareness of health behaviors and support the management of chronic health conditions. There is a scarcity of guidance for researchers of all disciplines when planning new studies to evaluate and select technologies appropriate for study purpose, population, and overall context. The aim of this study was to develop and test an evaluation framework to rapidly and systematically evaluate and select consumer-grade wearable devices that serve individual study needs in preparation for evaluations with target populations. METHODS The wearable evaluation framework was defined based on published literature and past research experiences of the research team. We tested the framework with example case studies to select devices for two different research projects focused on aging-in-place and gestational diabetes. We show how knowledge of target population and research goals help prioritize application of the criteria to inform device selection and how project requirements inform sequence of criteria application. RESULTS The framework for wearable device evaluation includes 27 distinct evaluation criteria: 12 for everyday use by users, 6 on device functionality, and 9 on infrastructure for developing the research infrastructure required to obtain the data. We evaluated 10 devices from four vendors. After prioritizing the framework criteria based on the two example case studies, we selected the Withings Steele HR, Garmin Vivosmart HR+ and Garmin Forerunner 35 for further evaluation through user studies with the target populations. CONCLUSIONS The aim of this paper was to develop and test a framework for researchers to rapidly evaluate suitability of consumer grade wearable devices for specific research projects. The use of this evaluation framework is not intended to identify a definitive single best device, but to systematically narrow the field of potential device candidates for testing with target study populations. Future work will include application of the framework within different research projects for further refinement.
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Affiliation(s)
- Kay Connelly
- Luddy School of Informatics, Computing, and Engineering, Indiana University, Bloomington, Indiana
| | - Haley Molchan
- Luddy School of Informatics, Computing, and Engineering, Indiana University, Bloomington, Indiana
| | - Rashmi Bidanta
- Luddy School of Informatics, Computing, and Engineering, Indiana University, Bloomington, Indiana
| | - Sudhanshu Siddh
- Luddy School of Informatics, Computing, and Engineering, Indiana University, Bloomington, Indiana
| | - Byron Lowens
- School of Computing, Clemson University, Clemson, South Carolina, USA
| | - Kelly Caine
- School of Computing, Clemson University, Clemson, South Carolina, USA
| | - George Demiris
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Katie Siek
- Luddy School of Informatics, Computing, and Engineering, Indiana University, Bloomington, Indiana
| | - Blaine Reeder
- Sinclair School of Nursing, University of Missouri, Columbia, Missouri, USA
- University of Missouri Institute for Data Science and Informatics, University of Missouri, Columbia, Missouri, USA
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Beagle AJ, Tison GH, Aschbacher K, Olgin JE, Marcus GM, Pletcher MJ. Comparison of the Physical Activity Measured by a Consumer Wearable Activity Tracker and That Measured by Self-Report: Cross-Sectional Analysis of the Health eHeart Study. JMIR Mhealth Uhealth 2020; 8:e22090. [PMID: 33372896 PMCID: PMC7803477 DOI: 10.2196/22090] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 10/20/2020] [Accepted: 11/12/2020] [Indexed: 11/13/2022] Open
Abstract
Background Commercially acquired wearable activity trackers such as the Fitbit provide objective, accurate measurements of physically active time and step counts, but it is unclear whether these measurements are more clinically meaningful than self-reported physical activity. Objective The aim of this study was to compare self-reported physical activity to Fitbit-measured step counts and then determine which is a stronger predictor of BMI by using data collected over the same period reflecting comparable physical activities. Methods We performed a cross-sectional analysis of data collected by the Health eHeart Study, a large mobile health study of cardiovascular health and disease. Adults who linked commercially acquired Fitbits used in free-living conditions with the Health eHeart Study and completed an International Physical Activity Questionnaire (IPAQ) between 2013 and 2019 were enrolled (N=1498). Fitbit step counts were used to quantify time by activity intensity in a manner comparable to the IPAQ classifications of total active time and time spent being sedentary, walking, or doing moderate activities or vigorous activities. Fitbit steps per day were computed as a measure of the overall activity for exploratory comparisons with IPAQ-measured overall activity (metabolic equivalent of task [MET]-h/wk). Measurements of physical activity were directly compared by Spearman rank correlation. Strengths of associations with BMI for Fitbit versus IPAQ measurements were compared using multivariable robust regression in the subset of participants with BMI and covariates measured. Results Correlations between synchronous paired measurements from Fitbits and the IPAQ ranged in strength from weak to moderate (0.09-0.48). In the subset with BMI and covariates measured (n=586), Fitbit-derived predictors were generally stronger predictors of BMI than self-reported predictors. For example, an additional hour of Fitbit-measured vigorous activity per week was associated with nearly a full point reduction in BMI (–0.84 kg/m2, 95% CI –1.35 to –0.32) in adjusted analyses, whereas the association between self-reported vigorous activity measured by IPAQ and BMI was substantially smaller in magnitude (–0.17 kg/m2, 95% CI –0.34 to –0.00; P<.001 versus Fitbit) and was dominated by the Fitbit-derived predictor when compared head-to-head in a single adjusted multivariable model. Similar patterns of associations with BMI, with Fitbit dominating self-report, were seen for moderate activity and total active time and in comparisons between overall Fitbit steps per day and IPAQ MET-h/wk on standardized scales. Conclusions Fitbit-measured physical activity was more strongly associated with BMI than self-reported physical activity, particularly for moderate activity, vigorous activity, and summary measures of total activity. Consumer-marketed wearable activity trackers such as the Fitbit may be useful for measuring health-relevant physical activity in clinical practice and research.
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Affiliation(s)
- Alexander J Beagle
- Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Geoffrey H Tison
- Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Kirstin Aschbacher
- Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Jeffrey E Olgin
- Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Gregory M Marcus
- Division of Cardiology, Department of Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Mark J Pletcher
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, United States
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Laranjo L, Quiroz JC, Tong HL, Arevalo Bazalar M, Coiera E. A Mobile Social Networking App for Weight Management and Physical Activity Promotion: Results From an Experimental Mixed Methods Study. J Med Internet Res 2020; 22:e19991. [PMID: 33289670 PMCID: PMC7755540 DOI: 10.2196/19991] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 08/06/2020] [Accepted: 11/11/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Smartphone apps, fitness trackers, and online social networks have shown promise in weight management and physical activity interventions. However, there are knowledge gaps in identifying the most effective and engaging interventions and intervention features preferred by their users. OBJECTIVE This 6-month pilot study on a social networking mobile app connected to wireless weight and activity tracking devices has 2 main aims: to evaluate changes in BMI, weight, and physical activity levels in users from different BMI categories and to assess user perspectives on the intervention, particularly on social comparison and automated self-monitoring and feedback features. METHODS This was a mixed methods study involving a one-arm, pre-post quasi-experimental pilot with postintervention interviews and focus groups. Healthy young adults used a social networking mobile app intervention integrated with wireless tracking devices (a weight scale and a physical activity tracker) for 6 months. Quantitative results were analyzed separately for 2 groups-underweight-normal and overweight-obese BMI-using t tests and Wilcoxon sum rank, Wilcoxon signed rank, and chi-square tests. Weekly BMI change in participants was explored using linear mixed effects analysis. Interviews and focus groups were analyzed inductively using thematic analysis. RESULTS In total, 55 participants were recruited (mean age of 23.6, SD 4.6 years; 28 women) and 45 returned for the final session (n=45, 82% retention rate). There were no differences in BMI from baseline to postintervention (6 months) and between the 2 BMI groups. However, at 4 weeks, participants' BMI decreased by 0.34 kg/m2 (P<.001), with a loss of 0.86 kg/m2 in the overweight-obese group (P=.01). Participants in the overweight-obese group used the app significantly less compared with individuals in the underweight-normal BMI group, as they mentioned negative feelings and demotivation from social comparison, particularly from upward comparison with fitter people. Participants in the underweight-normal BMI group were avid users of the app's self-monitoring and feedback (P=.02) and social (P=.04) features compared with those in the overweight-obese group, and they significantly increased their daily step count over the 6-month study duration by an average of 2292 steps (95% CI 898-3370; P<.001). Most participants mentioned a desire for a more personalized intervention. CONCLUSIONS This study shows the effects of different interventions on participants from higher and lower BMI groups and different perspectives regarding the intervention, particularly with respect to its social features. Participants in the overweight-obese group did not sustain a short-term decrease in their BMI and mentioned negative emotions from app use, while participants in the underweight-normal BMI group used the app more frequently and significantly increased their daily step count. These differences highlight the importance of intervention personalization. Future research should explore the role of personalized features to help overcome personal barriers and better match individual preferences and needs.
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Affiliation(s)
- Liliana Laranjo
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia.,Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Juan C Quiroz
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia.,Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
| | - Huong Ly Tong
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | | | - Enrico Coiera
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
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Abstract
We study seven fitness trackers and their associated smartphone apps from a wide variety of manufacturers, and record who they are talking to. Our results suggest that some of them communicate with unexpected third parties, including social networks, advertisement websites, weather services, and various external APIs. This implies that such unanticipated third-parties may glean personal information of users.
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Affiliation(s)
- Andrei Kazlouski
- Computer Science Department, University of Crete, Greece.,Institute of Computer Science, Foundation for Research and Technology, Greece
| | - Thomas Marchioro
- Computer Science Department, University of Crete, Greece.,Institute of Computer Science, Foundation for Research and Technology, Greece
| | - Harry Manifavas
- Computer Science Department, University of Crete, Greece.,Institute of Computer Science, Foundation for Research and Technology, Greece
| | - Evangelos Markatos
- Computer Science Department, University of Crete, Greece.,Institute of Computer Science, Foundation for Research and Technology, Greece
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