Factors associated with long-term wearable physical activity monitor user engagement

Factors associated with long-term use of digital devices in the electronic Framingham Heart Study

Long-term use of digital devices is critical for successful clinical or research use, but digital health studies are challenged by a rapid drop-off in participation. A nested e-cohort (eFHS) is embedded in the Framingham Heart Study and uses three system components: a new smartphone app, a digital blood pressure (BP) cuff, and a smartwatch. This study aims to identify factors associated with the use of individual eFHS system components over 1-year. Among 1948 eFHS enrollees, we examine participants who returned surveys within 90 days (n = 1918), and those who chose to use the smartwatch (n = 1243) and BP cuff (n = 1115). For each component, we investigate the same set of candidate predictors for usage and use generalized linear mixed models to select predictors (P < 0.1, P value from Z test statistic), adjusting for age, sex, and time (app use: 3-month period, device use: weekly). A multivariable model with the predictors selected from initial testing is used to identify factors associated with use of components (P < 0.05, P value from Z test statistic) adjusting for age, sex, and time. In multivariable models, older age is associated with higher use of all system components. Female sex and higher education levels are associated with higher completion of app-based surveys whereas higher scores for depressive symptoms, and lower than excellent self-rated health are associated with lower use of the smartwatch over the 12-month follow-up. Our findings show that sociodemographic and health related factors are significantly associated with long-term use of digital devices. Future research is needed to test interventional strategies focusing on these factors to evaluate improvement in long-term engagement.

Experiences of activity monitoring and perceptions of digital support among working individuals with hip and knee osteoarthritis - a focus group study

Background

Mobile health (mHealth), wearable activity trackers (WATs) and other digital solutions could support physical activity (PA) in individuals with hip and knee osteoarthritis (OA), but little is described regarding experiences and perceptions of digital support and the use of WAT to self-monitor PA. Thus, the aim of this study was to explore the experiences of using a WAT to monitor PA and the general perceptions of mHealth and digital support in OA care among individuals of working age with hip and knee OA.

Methods

We conducted a focus group study where individuals with hip and knee OA (n = 18) were recruited from the intervention group in a cluster-randomized controlled trial (C-RCT). The intervention in the C-RCT comprised of 12-weeks use of a WAT with a mobile application to monitor PA in addition to participating in a supported OA self-management program. In this study, three focus group discussions were conducted. The discussions were transcribed and qualitative content analysis with an inductive approach was applied.

Results

The analysis resulted in two main categories: A WAT may aid in optimization of PA, but is not a panacea with subcategories WATs facilitate PA; Increased awareness of one’s limitations and WATs are not always encouraging, and the second main category was Digital support is an appreciated part of OA care with subcategories Individualized, early and continuous support; PT is essential but needs to be modernized and Easy, comprehensive, and reliable digital support.

Conclusion

WATs may facilitate PA but also aid individuals with OA to find the optimal level of activity to avoid increased pain. Digital support in OA care was appreciated, particularly as a part of traditional care with physical visits. The participants expressed that the digital support should be easy, comprehensive, early, and continuous.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-14065-0.

The structure and information spread capability of the network formed by integrated fitness apps

Purpose

In this article we aim to understand how the network formed by fitness tracking devices and associated apps as a subset of the broader health-related Internet of things is capable of spreading information.

Design/methodology/approach

The authors used a combination of a content analysis, network analysis, community detection and simulation. A sample of 922 health-related apps (including manufacturers' apps and developers) were collected through snowball sampling after an initial content analysis from a Google search for fitness tracking devices.

Findings

The network of fitness apps is disassortative with high-degree nodes connecting to low-degree nodes, follow a power-law degree distribution and present with low community structure. Information spreads faster through the network than an artificial small-world network and fastest when nodes with high degree centrality are the seeds.

Practical implications

This capability to spread information holds implications for both intended and unintended data sharing.

Originality/value

The analysis confirms and supports evidence of widespread mobility of data between fitness and health apps that were initially reported in earlier work and in addition provides evidence for the dynamic diffusion capability of the network based on its structure. The structure of the network enables the duality of the purpose of data sharing.

Clinical characteristics and disease burden in prurigo nodularis

BACKGROUND

Prurigo nodularis (PN) is a chronic inflammatory skin disease characterized by intense pruritus, but information on patient experience and impact on quality of life (QoL) remains understudied.

AIM

To characterize disease characteristics and QoL in a global sample of patients with PN.

METHODS

An anonymous survey was distributed via patient support groups for PN.

RESULTS

In total, 231 members responded to the survey. The majority of respondents reported itch localized both to nodules and to intervening skin (67.0%). Associated symptoms included prickling, pain, stinging and burning. The extensor lower legs (69% right, 67.3% left) and flexor forearms (66.1% right, 62% left) were the most common sites of itch. Participants reported frequent healthcare utilization, with 36.3% visiting a doctor ≥ 10 times in the past year. Physician-diagnosed anxiety (45.4%), depression (16.4%) and the atopic triad (18.7%) were commonly reported. Patients with PN had mean scores of 16.4, 11.6 and 16.8 on the Dermatology Life Quality Index, Pittsburgh Sleep Quality Index and 5-Dimensions Itch, respectively.

CONCLUSIONS

Severe pruritus with accompanying pain, stinging and burning is characteristic of PN, with the majority of patients experiencing itch in both nodular and interlesional skin. Patients further report decreased QoL scores and impaired sleep. Patient experiences should guide future management of PN.