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Zhang W, Xiong K, Zhu C, Evans R, Zhou L, Podrini C. Promoting child and adolescent health through wearable technology: A systematic review. Digit Health 2024; 10:20552076241260507. [PMID: 38868368 PMCID: PMC11168039 DOI: 10.1177/20552076241260507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 05/23/2024] [Indexed: 06/14/2024] Open
Abstract
Background Wearable technology is used in healthcare to monitor the health of individuals. This study presents an updated systematic literature review of the use of wearable technology in promoting child and adolescent health, accompanied by recommendations for future research. Methods This review focuses on studies involving children and adolescents aged between 2 and 18 years, regardless of their health condition or disabilities. Studies that were published from 2016 to 2024, and which met the inclusion criteria, were extracted from four academic databases (i.e. PubMed, Cochrane, Embase, and Web of Science) using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) protocol. Data on intervention purposes, interventions deployed, intervention duration, measurements, and the main outcomes of the studies were collected. Results A total of 53 studies involving 14,852 participants were reviewed. They focused on various aspects, including the ownership and use of wearable devices (n = 3), the feasibility (n = 22), effectiveness (n = 4), and adherence (n = 2) of intervention strategies, or a combination of multiple aspects (n = 22). Among the interventions deployed, Fitbit was the most frequently used, featuring in 26 studies, followed by ActiGraph (n = 11). In intervention studies, the majority of studies focused on pre-morbidity prevention (n = 26) and the treatment of illnesses (n = 20), with limited attention given to postoperative monitoring (n = 4). Conclusions The use of wearable technology by children and adolescents has proven to be both feasible and effective for health promotion. This systematic review summarizes existing research by exploring the use of wearable technology in promoting health across diverse youth populations, including healthy and unhealthy individuals. It examines health promotion at various stages of the disease continuum, including pre-disease prevention, in-disease treatment, and postoperative monitoring. Additionally, the review provides directions for future research.
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Affiliation(s)
- Wei Zhang
- School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan, China
| | - Keying Xiong
- School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan, China
| | - Chengyan Zhu
- School of Political Science and Public Administration, Wuhan University, Wuhan, China
| | - Richard Evans
- College of Digital Transformation, Faculty of Computer Science, Dalhousie University, Halifax, Canada
| | - Lijuan Zhou
- School of Public Administration and Law, Hunan Agricultural University, Changsha, China
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Saliba M, Drapeau N, Skime M, Hu X, Accardi CJ, Athreya AP, Kolacz J, Shekunov J, Jones DP, Croarkin PE, Romanowicz M. PISTACHIo (PreemptIon of diSrupTive behAvior in CHIldren): real-time monitoring of sleep and behavior of children 3-7 years old receiving parent-child interaction therapy augment with artificial intelligence - the study protocol, pilot study. Pilot Feasibility Stud 2023; 9:23. [PMID: 36759915 PMCID: PMC9909978 DOI: 10.1186/s40814-023-01254-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 01/28/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Emotional behavior problems (EBP) are the most common and persistent mental health issues in early childhood. Early intervention programs are crucial in helping children with EBP. Parent-child interaction therapy (PCIT) is an evidence-based therapy designed to address personal difficulties of parent-child dyads as well as reduce externalizing behaviors. In clinical practice, parents consistently struggle to provide accurate characterizations of EBP symptoms (number, timing of tantrums, precipitating events) even from the week before in their young children. The main aim of the study is to evaluate feasibility of the use of smartwatches in children aged 3-7 years with EBP. METHODS This randomized double-blind controlled study aims to recruit a total of 100 participants, consisting of 50 children aged 3-7 years with an EBP measure rated above the clinically significant range (T-score ≥ 60) (Eyberg Child Behavior Inventory-ECBI; Eyberg & Pincus, 1999) and their parents who are at least 18 years old. Participants are randomly assigned to the artificial intelligence-PCIT group (AI-PCIT) or the PCIT-sham biometric group. Outcome parameters include weekly ECBI and Pediatric Sleep Questionnaire (PSQ) as well as Child Behavior Checklist (CBCL) obtained weeks 1, 6, and 12 of the study. Two smartphone applications (Garmin connect and mEMA) and a wearable Garmin smartwatch are used collect the data to monitor step count, sleep, heart rate, and activity intensity. In the AI-PCIT group, the mEMA application will allow for the ecological momentary assessment (EMA) and will send behavioral alerts to the parent. DISCUSSION Real-time predictive technologies to engage patients rely on daily commitment on behalf of the participant and recurrent frequent smartphone notifications. Ecological momentary assessment (EMA) provides a way to digitally phenotype in-the-moment behavior and functioning of the parent-child dyad. One of the study's goals is to determine if AI-PCIT outcomes are superior in comparison with standard PCIT. Overall, we believe that the PISTACHIo study will also be able to determine tolerability of smartwatches in children aged 3-7 with EBP and could participate in a fundamental shift from the traditional way of assessing and treating EBP to a more individualized treatment plan based on real-time information about the child's behavior. TRIAL REGISTRATION The ongoing clinical trial study protocol conforms to the international Consolidated Standards of Reporting Trials (CONSORT) guidelines and is registered in clinicaltrials.gov (ID: NCT05077722), an international clinical trial registry.
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Affiliation(s)
- Maria Saliba
- grid.66875.3a0000 0004 0459 167XDepartment of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905 USA
| | - Noelle Drapeau
- grid.66875.3a0000 0004 0459 167XDepartment of Pediatrics, Mayo Clinic, Rochester, MN 55905 USA
| | - Michelle Skime
- grid.66875.3a0000 0004 0459 167XDepartment of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905 USA
| | - Xin Hu
- grid.189967.80000 0001 0941 6502Clinical Biomarkers Laboratory, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, Emory University, Atlanta, GA 30322 USA
| | - Carolyn Jonas Accardi
- grid.189967.80000 0001 0941 6502Clinical Biomarkers Laboratory, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, Emory University, Atlanta, GA 30322 USA
| | - Arjun P. Athreya
- grid.66875.3a0000 0004 0459 167XDepartment of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905 USA ,grid.66875.3a0000 0004 0459 167XDepartment of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN 55905 USA
| | - Jacek Kolacz
- grid.412332.50000 0001 1545 0811Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH 43210 USA
| | - Julia Shekunov
- grid.66875.3a0000 0004 0459 167XDepartment of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905 USA
| | - Dean P. Jones
- grid.189967.80000 0001 0941 6502Clinical Biomarkers Laboratory, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, Emory University, Atlanta, GA 30322 USA
| | - Paul E. Croarkin
- grid.66875.3a0000 0004 0459 167XDepartment of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905 USA
| | - Magdalena Romanowicz
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, 55905, USA.
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Doumen M, De Cock D, Van Lierde C, Betrains A, Pazmino S, Bertrand D, Westhovens R, Verschueren P. Engagement and attrition with eHealth tools for remote monitoring in chronic arthritis: a systematic review and meta-analysis. RMD Open 2022; 8:rmdopen-2022-002625. [PMID: 36302561 PMCID: PMC9621170 DOI: 10.1136/rmdopen-2022-002625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 09/30/2022] [Indexed: 11/06/2022] Open
Abstract
Objectives Although eHealth tools are potentially useful for remote disease monitoring, barriers include concerns of low engagement and high attrition. We aimed to summarise evidence on patients’ engagement and attrition with eHealth tools for remotely monitoring disease activity/impact in chronic arthritis. Methods A systematic literature search was conducted for original articles and abstracts published before September 2022. Eligible studies reported quantitative measures of patients’ engagement with eHealth instruments used for remote monitoring in chronic arthritis. Engagement rates were pooled using random effects meta-analysis. Results Of 8246 references, 45 studies were included: 23 using smartphone applications, 13 evaluating wearable activity trackers, 7 using personal digital assistants, 6 including web-based platforms and 2 using short message service. Wearable-based studies mostly reported engagement as the proportion of days the tracker was worn (70% pooled across 6 studies). For other eHealth tools, engagement was mostly reported as completion rates for remote patient-reported outcomes (PROs). The pooled completion rate was 80%, although between-study heterogeneity was high (I2 93%) with significant differences between eHealth tools and frequency of PRO-collection. Engagement significantly decreased with longer study duration, but attrition varied across studies (0%–89%). Several predictors of higher engagement were reported. Data on the influence of PRO-reporting frequency were conflicting. Conclusion Generally high patient engagement was reported with eHealth tools for remote monitoring in chronic arthritis. However, we found considerable between-study heterogeneity and a relative lack of real-world data. Future studies should use standardised measures of engagement, preferably assessed in a daily practice setting. Trial registeration number The protocol was registered on PROSPERO (CRD42021267936).
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Affiliation(s)
- Michaël Doumen
- Department of Development and Regeneration, Skeletal Biology and Engineering Research Centre, Katholieke Universiteit Leuven, Leuven, Belgium,Rheumatology, KU Leuven University Hospitals, Leuven, Belgium
| | - Diederik De Cock
- Department of Public Health, Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Caroline Van Lierde
- Department of Development and Regeneration, Skeletal Biology and Engineering Research Centre, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Albrecht Betrains
- General Internal Medicine, KU Leuven University Hospitals, Leuven, Belgium
| | - Sofia Pazmino
- Department of Development and Regeneration, Skeletal Biology and Engineering Research Centre, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Delphine Bertrand
- Department of Development and Regeneration, Skeletal Biology and Engineering Research Centre, Katholieke Universiteit Leuven, Leuven, Belgium
| | - René Westhovens
- Department of Development and Regeneration, Skeletal Biology and Engineering Research Centre, Katholieke Universiteit Leuven, Leuven, Belgium,Rheumatology, KU Leuven University Hospitals, Leuven, Belgium
| | - Patrick Verschueren
- Department of Development and Regeneration, Skeletal Biology and Engineering Research Centre, Katholieke Universiteit Leuven, Leuven, Belgium,Rheumatology, KU Leuven University Hospitals, Leuven, Belgium
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Iversen MD, Andre M, von Heideken J. Physical Activity Interventions in Children with Juvenile Idiopathic Arthritis: A Systematic Review of Randomized Controlled Trials. Pediatric Health Med Ther 2022; 13:115-143. [PMID: 35444485 PMCID: PMC9015041 DOI: 10.2147/phmt.s282611] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 03/25/2022] [Indexed: 11/27/2022] Open
Abstract
Introduction Children with juvenile arthritis (JA) experience pain, stiffness, fatigue, and decreased motion leading to difficulties with daily activities and low physical activity (PA). PA is critical to improve health and function and mitigate JA-associated symptoms. This study evaluated the evidence for PA interventions in children with JA. Materials and Methods A systematic review of randomized controlled trials (RCTs) of PA interventions in children with JA was conducted. Ovid (Medline), Cochrane Library, EMBASE, and CINAHL databases were searched for papers published in English between 1/1/1946 and 9/1/2021. Studies which concurrently assessed medical interventions were excluded. Participant and intervention characteristics and outcomes were extracted. Study internal validity and intervention attributes were assessed. Results A total of 555 studies were identified, with 13 studies from 10 countries included. Data from 672 children diagnosed with juvenile idiopathic arthritis (JIA) (range of mean ages, 8.7 to 16.1 years) were analyzed. Fifty-two percent of intervention arms incorporated strengthening exercise alone or combined with other exercise, with 61.9% performed 3x/week. About 43.5% of sessions lasted >45 to ≤60 minutes and 65.2% of programs were ≥12 to <28 weeks. PA interventions improved function and symptoms without adverse events. Intervention details were missing especially regarding PA intensity, reasons for dropouts, and adherence. Only two studies incorporated strategies to promote adherence. Discussion RCTs of PA interventions in JA only include JIA. Available RCTs used mixed modes of interventions. Reporting of PA interventions lacks sufficient detail to discern the dose-response relationship. Strategies to motivate engagement in PA and to support families to promote PA are lacking, as are studies of long-term outcomes. Conclusion There are limited RCTs of PA interventions in JIA. Adherence was better with low intensity programs. PA interventions for JIA yield positive health benefits but better reporting of PA intervention details is needed to generate more high-quality evidence and inform clinical practice. Prospero Registration Maura Iversen, Johan von Heideken, Marie Andre. Physical Activity in Children with Rheumatic Diseases: a systematic review. PROSPERO 2021 CRD42021274634 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021274634.
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Affiliation(s)
- Maura D Iversen
- College of Health Professions, Sacred Heart University, Fairfield, CT, USA
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
- Section of Clinical Sciences, Division of Immunology, Rheumatology & Immunity, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Correspondence: Maura D Iversen, College of Health Professions, Sacred Heart University, 5151 Park Avenue, Fairfield, CT, 06825, USA, Tel +1 203 396-8024, Fax +1 203-396-8025, Email
| | - Marie Andre
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Johan von Heideken
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
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5
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Butler S, Sculley D, Santos D, Fellas A, Gironès X, Singh-Grewal D, Coda A. Effectiveness of eHealth and mHealth Interventions Supporting Children and Young People Living With Juvenile Idiopathic Arthritis: Systematic Review and Meta-analysis. J Med Internet Res 2022; 24:e30457. [PMID: 35107431 PMCID: PMC8851322 DOI: 10.2196/30457] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 09/10/2021] [Accepted: 11/08/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Juvenile idiopathic arthritis (JIA) management aims to promote remission through timely, individualized, well-coordinated interdisciplinary care using a range of pharmacological, physical, psychological, and educational interventions. However, achieving this goal is workforce-intensive. Harnessing the burgeoning eHealth and mobile health (mHealth) interventions could be a resource-efficient way of supplementing JIA management. OBJECTIVE This systematic review aims to identify the eHealth and mHealth interventions that have been proven to be effective in supporting health outcomes for children and young people (aged 1-18 years) living with JIA. METHODS We systematically searched 15 databases (2018-2021). Studies were eligible if they considered children and young people (aged 1-18 years) diagnosed with JIA, an eHealth or mHealth intervention, any comparator, and health outcomes related to the used interventions. Independently, 2 reviewers screened the studies for inclusion and appraised the study quality using the Downs and Black (modified) checklist. Study outcomes were summarized using a narrative, descriptive method and, where possible, combined for a meta-analysis using a random-effects model. RESULTS Of the 301 studies identified in the search strategy, 15 (5%) fair-to-good-quality studies met the inclusion criteria, which identified 10 interventions for JIA (age 4-18.6 years). Of these 10 interventions, 5 (50%) supported symptom monitoring by capturing real-time data using health applications, electronic diaries, or web-based portals to monitor pain or health-related quality of life (HRQoL). Within individual studies, a preference was demonstrated for real-time pain monitoring over recall pain assessments because of a peak-end effect, improved time efficiency (P=.002), and meeting children's and young people's HRQoL needs (P<.001) during pediatric rheumatology consultations. Furthermore, 20% (2/10) of interventions supported physical activity promotion using a web-based program or a wearable activity tracker. The web-based program exhibited a moderate effect, which increased endurance time, physical activity levels, and moderate to vigorous physical activity (standardized mean difference [SMD] 0.60, SD 0.02-1.18; I2=79%; P=.04). The final 30% (3/10) of interventions supported self-management development through web-based programs, or apps, facilitating a small effect, reducing pain intensity (SMD -0.14, 95% CI -0.43 to 0.15; I2=53%; P=.33), and increasing disease knowledge and self-efficacy (SMD 0.30, 95% CI 0.03-0.56; I2=74%; P=.03). These results were not statistically significant. No effect was seen regarding pain interference, HRQoL, anxiety, depression, pain coping, disease activity, functional ability, or treatment adherence. CONCLUSIONS Evidence that supports the inclusion of eHealth and mHealth interventions in JIA management is increasing. However, this evidence needs to be considered cautiously because of the small sample size, wide CIs, and moderate to high statistical heterogeneity. More rigorous research is needed on the longitudinal effects of real-time monitoring, web-based pediatric rheumatologist-children and young people interactions, the comparison among different self-management programs, and the use of wearable technologies as an objective measurement for monitoring physical activity before any recommendations that inform current practice can be given.
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Affiliation(s)
- Sonia Butler
- School of Bioscience and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Ourimbah, Australia
| | - Dean Sculley
- School of Bioscience and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Ourimbah, Australia
| | - Derek Santos
- School of Health Sciences, Queen Margaret University, Edinburgh, United Kingdom
| | - Antoni Fellas
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Xavier Gironès
- University of Vic-Central University of Catalonia, Manresa, Spain
| | - Davinder Singh-Grewal
- Department of Rheumatology, Sydney Children's Hospitals Network, Randwick and Westmead, Sydney, Australia.,Department of Rheumatology, John Hunter Children's Hospital, Newcastle, Australia.,School of Women's and Children's Health, University of New South Wales, Sydney, Australia.,Discipline of Child and Adolescent Health, University of Sydney, Sydney, Australia
| | - Andrea Coda
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia.,Priority Research Centre Health Behaviour, Hunter Medical Research Institute, Newcastle, Australia
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Abstract
Cardiovascular disease risk is evident during childhood for patients with juvenile systemic lupus erythematosus, juvenile dermatomyositis, and juvenile idiopathic arthritis. The American Heart Association defines cardiovascular health as a positive health construct reflecting the sum of protective factors against cardiovascular disease. Disease-related factors such as chronic inflammation and endothelial dysfunction increase cardiovascular disease risk directly and through bidirectional relationships with poor cardiovascular health factors. Pharmacologic and nonpharmacologic interventions to improve cardiovascular health and long-term cardiovascular outcomes in children with rheumatic disease are needed.
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Kamps AWA, Clevering AF, Nieuwdorp BW, de Weger WW, van Lente L. Asthma control is not associated with physical activity level in children with asthma during regular follow-up. J Asthma 2021; 59:1933-1939. [PMID: 34644214 DOI: 10.1080/02770903.2021.1993248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Engagement in physical activity (PA) is one of the important aims of long-term asthma treatment. The objective of this study is to evaluate whether improvement of asthma control is associated with enhanced PA during regular follow-up in children with asthma. METHODS Children, 6-18 years, with asthma were eligible for inclusion when their asthma was uncontrolled at a regular follow-up visit. Participants completed a seven-day recall questionnaire to assess engagement in different physical activities (Physical Activity Questionnaires for Children) at baseline and at the time asthma control was achieved according to predefined criteria. They were also instructed to wear an accelerometer (ActigraphTM GT1M) for seven consecutive days at these timepoints. RESULTS Thirty children (21 boys), aged 10.5 (2.9) years, with uncontrolled asthma were included. After a median (IQR) follow up time of 163 (94-253) days PA was assessed again. Accelerometer obtained moderate vigorous PA (median (IQR) 56 (43-66) versus 53 (35-63) minutes) as well as self-reported PA (median (IQR) PAQ score 7.4 (5.9-10.1) versus 7.2 (6.5-11.0)) were not significantly different at the time of uncontrolled and controlled asthma. Moderate vigorous PA increased in 46.2%, was comparable in 23.1%, and decreased in 30.7% of patients, respectively. Self-reported PA increased in 19.0%, was comparable in 52.4%, and decreased in 28.6% of patients, respectively. CONCLUSIONS Based on the results of this study we conclude that asthma control is not associated with self-reported and accelerometer obtained level of physical activity during regular follow-up in children with asthma.
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Affiliation(s)
- A W A Kamps
- Department of Pediatrics, Martini Hospital, Groningen, The Netherlands
| | - A F Clevering
- Department of Pediatrics, Martini Hospital, Groningen, The Netherlands
| | - B W Nieuwdorp
- Department of Pediatrics, Martini Hospital, Groningen, The Netherlands
| | - W W de Weger
- Department of Pediatrics, Martini Hospital, Groningen, The Netherlands
| | - L van Lente
- Department of Clinical Epidemiology, Martini Academy, Martini Hospital, Groningen, The Netherlands
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Creaser AV, Clemes SA, Costa S, Hall J, Ridgers ND, Barber SE, Bingham DD. The Acceptability, Feasibility, and Effectiveness of Wearable Activity Trackers for Increasing Physical Activity in Children and Adolescents: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126211. [PMID: 34201248 PMCID: PMC8228417 DOI: 10.3390/ijerph18126211] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 06/03/2021] [Accepted: 06/06/2021] [Indexed: 02/08/2023]
Abstract
Wearable activity trackers (wearables) embed numerous behaviour change techniques (BCTs) that have previously been shown to increase adult physical activity (PA). With few children and adolescents achieving PA guidelines, it is crucial to explore ways to increase their PA. This systematic review examined the acceptability, feasibility, and effectiveness of wearables and their potential mechanisms of action for increasing PA in 5 to 19-year-olds. A systematic search of six databases was conducted, including data from the start date of each database to December 2019 (PROSPERO registration: CRD42020164506). Thirty-three studies were included. Most studies (70%) included only adolescents (10 to 19 years). There was some-but largely mixed-evidence that wearables increase steps and moderate-to-vigorous-intensity PA and reduce sedentary behaviour. There were no apparent differences in effectiveness based on the number of BCTs used and between studies using a wearable alone or as part of a multi-component intervention. Qualitative findings suggested wearables increased motivation to be physically active via self-monitoring, goal setting, feedback, and competition. However, children and adolescents reported technical difficulties and a novelty effect when using wearables, which may impact wearables' long-term use. More rigorous and long-term studies investigating the acceptability, feasibility, and effectiveness of wearables in 5 to 19-year-olds are warranted.
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Affiliation(s)
- Amy V. Creaser
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK; (S.A.C.); (S.C.)
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford BD9 6RJ, UK; (J.H.); (S.E.B.); (D.D.B.)
- Correspondence:
| | - Stacy A. Clemes
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK; (S.A.C.); (S.C.)
- Leicester Biomedical Research Centre, National Institute for Health Research (NIHR), University Hospitals of Leicester NHS Trust and University of Leicester, Leicester LE5 4PW, UK
| | - Silvia Costa
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK; (S.A.C.); (S.C.)
| | - Jennifer Hall
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford BD9 6RJ, UK; (J.H.); (S.E.B.); (D.D.B.)
| | - Nicola D. Ridgers
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong 3125, Australia;
| | - Sally E. Barber
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford BD9 6RJ, UK; (J.H.); (S.E.B.); (D.D.B.)
| | - Daniel D. Bingham
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford BD9 6RJ, UK; (J.H.); (S.E.B.); (D.D.B.)
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Ridgers ND, Timperio A, Ball K, Lai SK, Brown H, Macfarlane S, Salmon J. Effect of commercial wearables and digital behaviour change resources on the physical activity of adolescents attending schools in socio-economically disadvantaged areas: the RAW-PA cluster-randomised controlled trial. Int J Behav Nutr Phys Act 2021; 18:52. [PMID: 33845853 PMCID: PMC8042874 DOI: 10.1186/s12966-021-01110-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 03/11/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND There has been increasing interest in using wearable activity trackers to promote physical activity in youth. This study examined the short- and longer-term effects of a wearable activity tracker combined with digital behaviour change resources on the physical activity of adolescents attending schools in socio-economically disadvantaged areas. METHODS The Raising Awareness of Physical Activity (RAW-PA) Study was a 12-week, multicomponent intervention that combined a Fitbit Flex (and accompanying app), and online digital behaviour change resources and weekly challenges delivered via Facebook. RAW-PA was evaluated using a cluster-randomised controlled trial with 275 adolescents (50.2% female; 13.7 ± 0.4 years) from 18 Melbourne secondary schools (intervention n = 9; wait-list control group n = 9). The primary outcome was moderate- to vigorous-intensity physical activity (MVPA), measured using hip-worn ActiGraph accelerometers. The secondary outcome was self-reported physical activity. Data were collected at baseline, 12-weeks (immediately post-intervention), and 6-months post-intervention (follow-up). Multilevel models were used to determine the effects of the intervention on daily MVPA over time, adjusting for covariates. RESULTS No significant differences were observed between intervention and wait-list control adolescents' device-assessed MVPA immediately post-intervention. At 6-months post-intervention, adolescents in the intervention group engaged in 5 min (95% CI: - 9.1 to - 1.0) less MVPA per day than those in the wait-list control group. Males in the intervention group engaged in 11 min (95% CI: - 17.6 to - 4.5) less MVPA than males in the wait-list control group at 6-months post-intervention. No significant differences were observed for females at either time point. For self-reported physical activity, no significant effects were found at 12-weeks and 6-months post-intervention. CONCLUSIONS Combining a wearable activity tracker with digital behaviour change resources and weekly challenges did not increase inactive adolescents' accelerometer-derived and self-reported physical activity levels immediately post-intervention. This contrasts previous research that has suggested wearable activity tracker may increase youth physical activity levels in the short-term. Lower engagement in MVPA 6-months post-intervention was observed for males but not for females, though it is unclear why this finding was observed. The results suggest wearable activity trackers, in combination with supporting materials, may not be effective for increasing physical activity levels in adolescents. TRIAL REGISTRATION ACTRN12616000899448 . Australian and New Zealand Clinical Trials Registry. Registered 7 July 2016.
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Affiliation(s)
- Nicola D Ridgers
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
| | - Anna Timperio
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Kylie Ball
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Samuel K Lai
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Helen Brown
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Susie Macfarlane
- Learning Futures, Deakin University, Burwood, Victoria, Australia
| | - Jo Salmon
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
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Brigden A, Shaw A, Anderson E, Crawley E. Chronic fatigue syndrome/myalgic encephalomyelitis in children aged 5 to 11 years: A qualitative study. Clin Child Psychol Psychiatry 2021; 26:18-32. [PMID: 33092395 PMCID: PMC7802053 DOI: 10.1177/1359104520964528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Treatments for paediatric chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) have not been designed or evaluated for younger children (5-11-years). The development of a complex intervention for this population requires an in-depth understanding of the perspectives and psychosocial context of children and families. Children with CFS/ME (5-11-years) and their families were recruited from a specialist CFS/ME service, and interviewed using semi-structured topic guides. Data were analysed thematically. Twenty-two participants were interviewed; eight parents, two children (aged nine and ten) and six parent-child dyads (aged 5-11-years). Theme 1: CFS/ME in younger children is complex and disabling. Theme 2: Children aged eight and over (in comparison to those under eight) were more able to describe their illness, engage in clinical consultation, understand diagnosis and self-manage. Theme 3: Parents of children under eight took full responsibility for their child's treatment. As children got older, this increasingly became a joint effort between the parent and child. Parents felt unsupported in their caring role. Clinicians should consider different treatment approaches for children under eight, focusing on: parent-only clinical sessions, training parents to deliver treatment, and increasing support for parents. Children over eight may benefit from tools to help them understand diagnosis, treatment and aids for self-management.
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Affiliation(s)
- Amberly Brigden
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Alison Shaw
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Emma Anderson
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Esther Crawley
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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Duck AA, Hall KC, Klamm M, Temple M, Robinson JC. Physical activity and fitness: The feasibility and preliminary effectiveness of wearable activity tracker technology incorporating altruistic motivation in youth. J SPEC PEDIATR NURS 2021; 26:e12313. [PMID: 32970924 DOI: 10.1111/jspn.12313] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/04/2020] [Accepted: 09/08/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE The purpose of this study was to examine the feasibility and preliminary effectiveness of using wearable activity tracker technology, integrated with altruistic motivation in children to increase physical activity (PA), fitness, and prosocial behavior. DESIGN AND METHODS A quasiexperimental design was employed in two 4th grade classrooms in a rural southern state. The intervention was a wearable PA tracker and a web-based curriculum with activities to earn power points redeemable to provide life-saving food to undernourished kids internationally. Seventeen children in the intervention group participated in the 10-week PA program and 18 children were in the wait listed control group. Three measures were assessed in both groups at baseline and postintervention: (a) PA measured with accelerometers, (b) fitness levels measured with shuttle run, and (c) prosocial behavior measured with Strengths and Difficulties questionnaire. RESULTS Of the 35 children enrolled, the majority were nine years old (n = 28), black (n = 31) and female (n = 23). An overall enrollment rate of 88%, attrition rate of 9%, and an accelerometer noncompliance rate of 25% was determined to assess feasibility. There was no statistical significance between the control and intervention group outcome variables. The average minutes of PA in the control group decreased 8 min from baseline to postintervention (p = .05). In the intervention group, PA decreased by 10 min from baseline to postintervention (p = .12). In both the control and intervention groups, prosocial behavior scores decreased (p = .09 control; p = .62 intervention). The fitness scores, VO2 max, did not significantly change (intervention p = .21; control p = .35). PRACTICE IMPLICATIONS Developing effective interventions that foster PA and dissuade sedentary behaviors are essential to enhancing PA and fitness levels. The recruitment, retention, and accelerometer wear adherence suggest this setting, with this population is feasible. The intervention is deliverable, however, the potential of wearable activity trackers and the effect of prosocial behavior that benefits others in increasing PA and improving cardiorespiratory fitness, should be further researched by building on the successful elements of this study.
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Affiliation(s)
- Angela A Duck
- University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Katherine C Hall
- University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Melissa Klamm
- University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Melissa Temple
- Southwest Mississippi Community College, Summit, Mississippi, USA
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Butler S, Sculley D, Santos DS, Fellas A, Gironès X, Singh-Grewal D, Coda A. Usability of eHealth and Mobile Health Interventions by Young People Living With Juvenile Idiopathic Arthritis: Systematic Review. JMIR Pediatr Parent 2020; 3:e15833. [PMID: 33258786 PMCID: PMC7738264 DOI: 10.2196/15833] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Revised: 01/27/2020] [Accepted: 10/03/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Considering the changing landscape of internet use and rising ownership of digital technology by young people, new methods could be considered to improve the current model of juvenile idiopathic arthritis (JIA) management. OBJECTIVE This systematic review aims to evaluate the usability of eHealth and mobile health (mHealth) interventions currently available for young people living with JIA. METHODS The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were used to oversee this review. We systematically searched 15 databases for 252 potential studies; 2 authors independently screened all quantitative studies reporting the use of eHealth and mHealth interventions for young people (aged 1-18 years) diagnosed with JIA. Studies were excluded if they did not report outcome measures or were reviews, commentaries, or qualitative studies. Study methodological quality was scored using the Down and Black (modified) checklist. A narrative descriptive methodology was used to quantify the data because of heterogeneity across the studies. RESULTS A total of 11 studies were included in this review, reporting 7 eHealth and mHealth interventions for young people (aged 4-18 years) living with JIA, targeting health issues such as pain, health-related quality of life, physical activity, and chronic disease self-management. The usability of the interventions was facilitated through training and ongoing support. The engagement was promoted by a combination of persuasive influences, and barriers preventing adherence were removed through personal reminders and flexible program schedules to cater to JIA and non-JIA illnesses or other commonly seen activities in childhood. The feedback obtained was that most young people and their parents liked the interventions. CONCLUSIONS The results of this review need to be considered cautiously because of the lack of rigorous testing and heterogeneity, which limits the detailed descriptions of data synthesis. Further research is needed to consider gender differences, associated costs, and the effectiveness of the interventions on health outcomes to better support young people living with JIA.
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Affiliation(s)
- Sonia Butler
- School of Bioscience and Pharmacy, University of Newcastle, Ourimbah, New South Wales, Australia
| | - Dean Sculley
- School of Bioscience and Pharmacy, University of Newcastle, Ourimbah, New South Wales, Australia
| | - Derek Santos Santos
- School of Health Sciences, Queen Margaret University, Edinburgh, United Kingdom
| | - Antoni Fellas
- School of Health Sciences, University of Newcastle, Callaghan, New South Wales, Australia
| | - Xavier Gironès
- Director of Research and Innovation, University of Vic-Central University of Catalonia, Manresa (Barcelona), Spain
| | - Davinder Singh-Grewal
- Department of Rheumatology, Sydney Children's Hospitals Network, Randwick and Westmead, Sydney, New South Wales, Australia
- Department of Rheumatology, John Hunter Children's Hospital, Newcastle, Australia
- Discipline of Child and Adolescent Health, University of Sydney, Sydney, Australia
- School of Women's and Children's Health, University of New South Wales, Sydney, Australia
| | - Andrea Coda
- School of Health Sciences, University of Newcastle, Callaghan, New South Wales, Australia
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Elmagboul N, Coburn BW, Foster J, Mudano A, Melnick J, Bergman D, Yang S, Chen L, Filby C, Mikuls TR, Curtis JR, Saag K. Physical activity measured using wearable activity tracking devices associated with gout flares. Arthritis Res Ther 2020; 22:181. [PMID: 32746893 PMCID: PMC7398057 DOI: 10.1186/s13075-020-02272-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 07/20/2020] [Indexed: 02/09/2023] Open
Abstract
Objective To determine the feasibility and validity of using wearable activity trackers to test associations between gout flares with physical activity and sleep. Methods Participants with physician-diagnosed gout, hyperuricemia (≥ 6.8 mg/dl), current smartphone use, and ≥ 2 self-reported flares in the previous 6 months were enrolled. Physical activity, heart rate, and sleep data were obtained from wearable activity trackers (Fitbit Charge HR2). Daily compliance was defined by the availability of sufficiently complete activity data at least 80% of the day. Associations of weekly gout flares with sleep and activity were measured by comparing flare-related values to average sleep and steps per day. We used mixed linear models to account for repeated observations. Results Forty-four participants enrolled; 33 met the criteria for minimal wear time and flare reporting, with activity tracker data available for 60.5% of all total study days. Mean ± SD age was 48.8 ± 14.9 years; 85% were men; 15% were black; 88% were on allopurinol or febuxostat, and 30% reported ≥ 6 flares in the prior 6 months. Activity trackers captured 204 (38%) person-weeks with flares and 340 (62%) person-weeks without flares. Mean ± SD daily step count was significantly lower (p < 0.0001) during weeks with gout flares (5900 ± 4071) than during non-flare periods (6972 ± 5214); sleep however did not differ. Conclusion The pattern of wear in this study illustrates reasonable feasibility of using such devices in future arthritis research. The use of these devices to passively measure changes in physical activity patterns may provide an estimate of gout flare occurrence and duration. Trial registration NCT, NCT02855437. Registered 4 August 2016
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Affiliation(s)
- Nada Elmagboul
- University of Alabama at Birmingham, 1720 2nd Avenue South, Birmingham, AL, 35294, USA
| | - Brian W Coburn
- University of Nebraska Medical Center and VA Nebraska-Western Iowa Health Care System, Omaha, NE, USA
| | - Jeffrey Foster
- University of Alabama at Birmingham, 1720 2nd Avenue South, Birmingham, AL, 35294, USA
| | - Amy Mudano
- University of Alabama at Birmingham, 1720 2nd Avenue South, Birmingham, AL, 35294, USA
| | - Joshua Melnick
- University of Alabama at Birmingham, 1720 2nd Avenue South, Birmingham, AL, 35294, USA
| | - Debra Bergman
- University of Nebraska Medical Center and VA Nebraska-Western Iowa Health Care System, Omaha, NE, USA
| | - Shuo Yang
- University of Alabama at Birmingham, 1720 2nd Avenue South, Birmingham, AL, 35294, USA
| | - Lang Chen
- University of Alabama at Birmingham, 1720 2nd Avenue South, Birmingham, AL, 35294, USA
| | - Cooper Filby
- University of Alabama at Birmingham, 1720 2nd Avenue South, Birmingham, AL, 35294, USA
| | - Ted R Mikuls
- University of Nebraska Medical Center and VA Nebraska-Western Iowa Health Care System, Omaha, NE, USA
| | - Jeffrey R Curtis
- University of Alabama at Birmingham, 1720 2nd Avenue South, Birmingham, AL, 35294, USA
| | - Kenneth Saag
- University of Alabama at Birmingham, 1720 2nd Avenue South, Birmingham, AL, 35294, USA.
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Vaughn J, Gollarahalli S, Shaw RJ, Docherty S, Yang Q, Malhotra C, Summers-Goeckerman E, Shah N. Mobile Health Technology for Pediatric Symptom Monitoring: A Feasibility Study. Nurs Res 2020; 69:142-148. [PMID: 31972852 DOI: 10.1097/nnr.0000000000000403] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Pediatric blood and marrow transplant (PBMT) patients experience significant symptom distress. Mobile health (mHealth) technologies can be leveraged to improve understanding of the patient's symptom experience by providing continuous, real-time, in situ, patient-generated symptom data. This rich data stream can subsequently enhance symptom management strategies. However, limited research has been conducted in this area. OBJECTIVES This pilot study seeks to (a) explore the feasibility of integrating mHealth technologies to monitor symptom data for PBMT patients and (b) evaluate the study design, measures, and procedures. METHODS An exploratory longitudinal design was employed to assess the feasibility of monitoring 10 PBMT patients' symptoms using data from two mHealth technologies: (a) a smartphone mHealth application (app) to collect symptom data and (b) a wearable tracking device (Apple watch) to collect physiological data. Feasibility was measured as usability and acceptability. Monthly patient interviews and an end-of-study feasibility survey were employed and analyzed to further understand reasons for sustained interest in and attrition from the study. RESULTS Overall usability of the wearable was 51%, and app was 56%. Children reported devices were easy to use and acceptable. The study demonstrated acceptability with an enrollment rate of 83% and an attrition rate of 30%, with 70% of the children remaining in the study for at least 40 days. DISCUSSION This pilot study is among the first to explore the feasibility of using mobile technologies to longitudinally obtain patient-generated symptom data to enhance understanding of the PBMT symptom experience. In addition, it will improve our understanding of how these data present, interact, and cluster together throughout the posttransplant period.
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Affiliation(s)
- Jacqueline Vaughn
- Jacqueline Vaughn, BSN, RN, CHSE, is PhD Candidate, Duke University School of Nursing, Durham, North Carolina. Ryan J. Shaw, PhD, RN, is Associate Professor, Duke University School of Nursing, Durham, North Carolina. Sharron Docherty, PhD PNP-BC, FAAN, is Associate Professor, Duke University School of Nursing, Durham, North Carolina. Qing Yang, PhD, is Assistant Professor, Duke University School of Nursing, Durham, North Carolina. Sid Gollarahalli, BA, is Clinical Research Specialist, Duke Health, Durham, North Carolina. Chandni Malhotra, BS, is Undergraduate Research Assistant, Department of Statistics, North Carolina State University, Raleigh. Erika Summers-Goeckerman, MSN, RN, CPNP-AC, is Pediatric Blood and Marrow Transplant Nurse Practitioner, Hematology-Oncology, Duke Health, Durham, North Carolina. Nirmish Shah, MD, is Assistant Professor of Medicine, Hematology-Oncology, Duke Health, Durham, North Carolina
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Cajita MI, Kline CE, Burke LE, Bigini EG, Imes CC. Feasible but Not Yet Efficacious: A Scoping Review of Wearable Activity Monitors in Interventions Targeting Physical Activity, Sedentary Behavior, and Sleep. CURR EPIDEMIOL REP 2020; 7:25-38. [PMID: 33365227 DOI: 10.1007/s40471-020-00229-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Purpose of Review The present review aimed to explore the range and characteristics of interventions that utilize WAM and descriptively summarize the efficacy of these interventions. Recent Findings A total of 65 articles (61 studies) were included in this review. Most of the WAM-based interventions (n=58) were designed to improve physical activity (PA). Interventions targeting sedentary behavior (SB) were much less common (n=12), and even less frequent were WAM-based sleep interventions (n=3). Most studies tested the feasibility of WAM-based interventions; hence, efficacy of these interventions in improving PA, SB, and/or sleep could not be conclusively determined. Nonetheless, WAM-based interventions showed considerable potential in increasing PA and decreasing SB. Summary WAM-based PA interventions exhibited preliminary efficacy in increasing PA. Although not as many interventions were focused on SB, current interventions also showed potential in decreasing sedentary time. Meanwhile, more evidence is needed to determine the utility of WAM in improving sleep. Major challenges with including WAM as part of interventions are reduced engagement in using the devices over time and the rapid changes in technology resulting in devices becoming obsolete soon after completion of an efficacy trial.
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Affiliation(s)
- Maan Isabella Cajita
- University of Illinois at Chicago, College of Nursing, 845 S. Damen Ave., Chicago, IL, USA
| | - Christopher E Kline
- University of Pittsburgh, Department of Health and Physical Activity, Pittsburgh, PA, USA
| | - Lora E Burke
- University of Pittsburgh, School of Nursing, Pittsburgh, PA, USA
| | - Evelyn G Bigini
- University of Pittsburgh, School of Nursing, Pittsburgh, PA, USA
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Scheid JL, West SL. Opportunities of Wearable Technology to Increase Physical Activity in Individuals with Chronic Disease: An Editorial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16173124. [PMID: 31466226 PMCID: PMC6747396 DOI: 10.3390/ijerph16173124] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 08/24/2019] [Accepted: 08/26/2019] [Indexed: 02/08/2023]
Abstract
In this editorial, we will discuss one promising tool to encourage physical activity participation in individuals with chronic disease: The use of wearable technology.
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Affiliation(s)
- Jennifer L Scheid
- Department of Health Promotion, Daemen College, 4380 Main St, Amherst, New York, NY 14226, USA.
| | - Sarah L West
- Department of Biology & Trent/Fleming School of Nursing, Trent University, Peterborough, Ontario, ON K9J0G2, Canada
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