Behavior Change Techniques Present in Wearable Activity Trackers: A Critical Analysis (original) (raw)
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JMIR mHealth and uHealth
Background: Wearable activity trackers offer the opportunity to increase physical activity through continuous monitoring. Viewing tracker use as a beneficial health behavior, we explored the factors that facilitate and hinder long-term activity tracker use, applying the transtheoretical model of behavior change with the focus on the maintenance stage and relapse. Objective: The aim of this study was to investigate older adults' perceptions and uses of activity trackers at different points of use: from nonuse and short-term use to long-term use and abandoned use to determine the factors to maintain tracker use and prevent users from discontinuing tracker usage. Methods: Data for the research come from 10 focus groups. Of them, 4 focus groups included participants who had never used activity trackers (n=17). These focus groups included an activity tracker trial. The other 6 focus groups (without the activity tracker trial) were conducted with short-term (n=9), long-term (n=11), and former tracker users (n=11; 2 focus groups per user type). Results: The results revealed that older adults in different tracker use stages liked and wished for different tracker features, with long-term users (users in the maintenance stage) being the most diverse and sophisticated users of the technology. Long-term users had developed a habit of tracker use whereas other participants made an effort to employ various encouragement strategies to ensure behavior maintenance. Social support through collaboration was the primary motivator for long-term users to maintain activity tracker use. Short-term and former users focused on competition, and nonusers engaged in vicarious tracker use experiences. Former users, or those who relapsed by abandoning their trackers, indicated that activity tracker use was fueled by curiosity in quantifying daily physical activity rather than the desire to increase physical activity. Long-term users saw a greater range of pros in activity tracker use whereas others focused on the cons of this behavior. Conclusions: The results suggest that activity trackers may be an effective technology to encourage physical activity among older adults, especially those who have never tried it. However, initial positive response to tracker use does not guarantee tracker use maintenance. Maintenance depends on recognizing the long-term benefits of tracker use, social support, and internal motivation. Nonadoption and relapse may occur because of technology's limitations and gaining awareness of one's physical activity without changing the physical activity level itself.
2020
Traditional physical activity tracking tools, such as self-report questionnaires, are inherently subjective and vulnerable to bias. Physical activity tracking technology, such as activity tracking wristbands, is becoming more reliable and readily available. As such, researchers are employing these objective measurement tools in both observational- and intervention-based studies. There remains a gap in the literature on how to properly select activity tracking wristbands for research, specifically for the older adult population. This paper outlines considerations for choosing the most appropriate wrist-worn wearable device for use in research with older adults. Device features, outcome measures, population, and methodological considerations are explored.
Behavior Change Techniques Incorporated in Fitness Trackers: Content Analysis
JMIR mHealth and uHealth
Background: The use of fitness trackers as tools of self-management to promote physical activity is increasing. However, the content of fitness trackers remains unexplored. Objective: The aim of this study was to use the Behavior Change Technique Taxonomy v1 (BCTTv1) to examine if swim-proof fitness trackers below Aus 150incorporatebehaviorchangetechniques(BCTs)thatrelatetoself−managementstrategiestoincreasephysicalactivityandreducesedentarybehaviorandtodetermineifcontentofthefitnesstrackerscorrespondtophysicalactivityguidelines.Methods:Atotalof2ratersusedtheBCTTv1tocode6fitnesstrackersthatmettheinclusioncriteria.Theinclusioncriteriaweretheabilitytotrackactivity,beswimproof,becompatiblewithAndroidandAppleoperatingsystems,andcostbelowAus150 incorporate behavior change techniques (BCTs) that relate to self-management strategies to increase physical activity and reduce sedentary behavior and to determine if content of the fitness trackers correspond to physical activity guidelines. Methods: A total of 2 raters used the BCTTv1 to code 6 fitness trackers that met the inclusion criteria. The inclusion criteria were the ability to track activity, be swim proof, be compatible with Android and Apple operating systems, and cost below Aus 150incorporatebehaviorchangetechniques(BCTs)thatrelatetoself−managementstrategiestoincreasephysicalactivityandreducesedentarybehaviorandtodetermineifcontentofthefitnesstrackerscorrespondtophysicalactivityguidelines.Methods:Atotalof2ratersusedtheBCTTv1tocode6fitnesstrackersthatmettheinclusioncriteria.Theinclusioncriteriaweretheabilitytotrackactivity,beswimproof,becompatiblewithAndroidandAppleoperatingsystems,andcostbelowAus150. Results: All fitness trackers contained BCTs known to promote physical activity, with the most frequently used BCTs overlapping with self-management strategies, including goal setting, self-monitoring, and feedback on behavior. Fitbit Flex 2 (Fitbit Inc) contained the most BCTs at 20. Huawei Band 2 Pro (Huawei Technologies) and Misfit Shine 2 (Fossil Group) contained the least BCTs at 11. Conclusions: Fitness trackers contain evidence-based BCTs that overlap with self-management strategies, which have been shown to increase physical activity and reduce sedentary behavior. Fitness trackers offer the prospect for physical activity interventions that are cost-effective and easily accessed by a wide population.
BMC Geriatrics, 2022
Background Wearable activity trackers hold the potential for enhancing health and fitness, but the use of wearable activity trackers has remained largely unexplored in older adults. The purpose of the current study was to examine the effectiveness and acceptability of wearable activity trackers for promoting physical activity (PA) in older adults living in retirement communities. Methods Forty older adult participants (mean age = 85.4 years) used a wearable activity tracker (Fitbit InspireHR) for 12 weeks. Participants were provided with personalized activity goals and weekly feedback of PA during the 12 weeks. The main outcomes were daily step counts collected at baseline and the end of the intervention, and participants’ experiences of using the wearable activity tracker assessed after the 12-week intervention through an 8-item questionnaire and individual interviews. Results Participants used the activity tracker on 97.5% of measured days and had an average increase of 900 steps/...
Proceedings of the Annual Hawaii International Conference on System Sciences, 2021
This study proposes that wearable activity trackers (WATs), such as Fitbit, Apple Watch, can be viewed as assistive technologies to promote older adults' health and independent living. Qualitative interview data with 20 older adults (65 and older) who had used WATs for six months or longer were analyzed within the framework of the Match Person and Technology (MPT) model. We found that personal and psychosocial factors, environmental factors, and technology-related factors contributed to the participants' long-term engagement with WATs. Determination and self-discipline, support from one's family members and friends, and goal setting and feedback of goal accomplishment were among the most mentioned facilitators of using WATs for more than six months. We discussed the design implications of these findings.
Objective: To understand the validity and reliability of consumer-grade activity trackers (consumer wearables) in older, community-dwelling adults. Methods: A systematic review of studies involving adults aged over 65 years who underwent physical activity monitoring with consumer wearables. A total of 7 observational studies qualified, identified from electronic databases: MEDLINE, EMBASE, Cochrane Library and others (2014–2018). Validity was interpreted using correlation coefficients (CC) and percentage error for agreement between reference devices or gold-standard validation methods Reliability was compared using mean differences or ranges (under-or overestimation) of step count and activity time. Results: Total sample size was 290 adults, mean age of 70.2 ± 4.8 years and females constituting 46.7 ± 26.1%. The studies evaluated eight different consumer wearables used by community-dwelling adults with a range of co-morbidities. Daily step count for all consumer wearables correlated highly with validation criterion, especially the ActiGraph device: intraclass correlation coefficients (ICC) were 0.94 for Fitbit One, 0.94 for Zip, 0.86 for Charge HR and 0.96 for Misfit Shine. Slower walking pace and impaired ambulation reduced the levels of agreement. Daily step count captured by Fitbit Zip was on average 7117 (± 5,880.6), which was overestimated by five of the eight consumer wearables compared with reference devices (range 167.6–2,690.3 steps/day). Measurement of activity duration was accurate compared with reference devices, yet less so than step count. Conclusion: In older, community-dwelling adults, consumer wearables accurately measure step count and activity duration, as confirmed by reference devices and validation methods Further research is required to understand how co-morbidities, gait and activity levels interact with monitoring in free-living environments.
American Journal of Health Promotion, 2019
Abstract Objective: To examine whether a fitness tracker (FT) intervention changes physical activity (PA) behavior compared to a control condition or compared to an alternative intervention. Data Source: Searches between January 01, 2010, and January 01, 2019, were conducted in PubMed, CINAHL, Cochrane CENTRAL, EMBASE, and PsycINFO. Inclusion/Exclusion Criteria: Randomized clinical trials of adults using an FT to change PA behavior were included. Nonclinical trials, studies that included the delivery of structured exercise, and/or studies that only used the FT to assess PA were excluded. Data Extraction: Extracted features included characteristics of the study population, intervention components, PA outcomes, and results. Data Synthesis: Papers were pooled in a statistical meta-analysis using a fixed effects model. Where statistical pooling was not possible, standardized mean difference (SMD) and 95% confidence intervals (CI) were calculated. Findings were presented in a narrative form and tables. Results: Of 2076 articles found, 21 were included in the review. A small yet significant positive effect (SMD = 0.25, 95% CI = 0.17-0.32; P < .01; I2 = 56.9%; P = .03) was found in step count for interventions compared to control. A small yet significant negative effect (SMD = −0.11, 95% CI = −0.20 to −0.02; P = .02; I2 = 58.2%; P = 0.03) was found in moderate-to-vigorous PA for interventions compared to an alternative intervention. Conclusion: Trackers may enhance PA interventions, as a general positive effect is found in step count compared to a control. However, there is no evidence of a positive effect when interventions are compared to an alternative intervention. It is unknown whether results are due to other intervention components and/or clinical heterogeneity.
Background: Lack of physical activity (PA) is a risk factor for death and non-communicable disease. Despite this, more than one fourth of adults worldwide do not follow PA guidelines. As part of a feasibility study to test a complex intervention for increasing PA, we included a consumer-based activity tracker (AT) as a tool to measure PA outcomes and to track heart rate during exercise sessions. The aim of the present study was to identify factors that increase wear time when using a consumer-based AT for monitoring of participants in clinical research. Methods: Sixteen participants aged 55-74 years, with obesity, sedentary lifestyle, and elevated cardiovascular risk were recruited to a 12-month feasibility study. Participants wore a Polar M430 AT to collect continuous PA data during a six-month intervention followed by six months of follow-up. We performed quantitative wear time analysis, tested the validity of the AT, and completed two rounds of qualitative interviews to investiga...
Acceptability of wristband activity trackers among community dwelling older adults
Geriatric nursing (New York, N.Y.), 2015
Wristband activity trackers have become widely used among young adults. However, few studies have explored their use for monitoring and improving health outcomes among older adults. The purpose of this study was to evaluate the feasibility and utility of activity tracker use among older adults for monitoring activity, improving self-efficacy, and health outcomes. A 12-week pilot study was conducted to evaluate the feasibility and utility of mobile wristband activity trackers. The sample (N = 34) was 65% women 73.5 ± 9.4 years of age who had a high school diploma or GED (38%) and reported an income ≤$35,000 (58%). Participants completing the study (95%) experienced a decrease in waist circumference (p > 0.009), however no change in self-efficacy. Participants found activity trackers easy to use which contributed to minimal study withdrawals. It was concluded that activity trackers could be useful for monitoring and promoting physical activity and improving older adults' health.