1
|
Jin X, Zhang Y, Zhou M, Zhang X, Mei Q, Bai Y, Wei W, Ma F. Experiences With mHealth Use Among Patient-Caregiver Dyads With Chronic Heart Failure: Qualitative Study. J Med Internet Res 2024; 26:e57115. [PMID: 39481106 DOI: 10.2196/57115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 06/27/2024] [Accepted: 10/18/2024] [Indexed: 11/02/2024] Open
Abstract
BACKGROUND Chronic heart failure has become a serious threat to the health of the global population, and self-management is key to treating chronic heart failure. The emergence of mobile health (mHealth) provides new ideas for the self-management of chronic heart failure in which the informal caregiver plays an important role. Current research has mainly studied the experiences with using mHealth among patients with chronic heart failure from the perspective of individual patients, and there is a lack of research from the dichotomous perspective. OBJECTIVE The aim of this study was to explore the experiences with mHealth use among patients with chronic heart failure and their informal caregivers from a dichotomous perspective. METHODS This descriptive phenomenological study from a post-positivist perspective used a dyadic interview method, and face-to-face semistructured interviews were conducted with patients with chronic heart failure and their informal caregivers. Data were collected and managed using NVivo 12 software, and data analysis used thematic analysis to identify and interpret participants' experiences and perspectives. The thematic analysis included familiarizing ourselves with the data, generating initial codes, searching for themes, reviewing themes, defining and naming themes, and producing the report. RESULTS A total of 14 dyads of patients with chronic heart failure and their informal caregivers (13 men and 15 women) participated in this study, including 3 couples and 11 parent-child pairs. We constructed 4 key themes and their subthemes related to the experiences with mHealth use: (1) opposing experiences with mHealth as human interaction or trauma (great experience with mHealth use; trauma), (2) supplement instead of replacement (it is useful but better as a reference; offline is unavoidable sometimes), (3) both agreement and disagreement over who should be the adopter of mHealth (achieving consensus regarding who should adopt mHealth; conflict occurs when considering patients as the adopter of mHealth), (4) for better mHealth (applying mHealth with caution; suggestions for improved mHealth). CONCLUSIONS This study reported that the experiences with mHealth use among patients with chronic heart failure and their informal caregivers were mixed, and it highlighted the human touch of mHealth and the importance of network security. These results featured mHealth as a complement to offline hospitals rather than a replacement. In the context of modern or changing Chinese culture, we encourage patients to use mHealth by themselves and their informal caregivers to provide help when necessary. In addition, we need to use mHealth carefully, and future mHealth designs should focus more on ease of use and be oriented more toward older adults.
Collapse
Affiliation(s)
- Xiaorong Jin
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, Kunming City, China
| | - Yimei Zhang
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, Kunming City, China
| | - Min Zhou
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, Kunming City, China
| | - Xiong Zhang
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, Kunming City, China
| | - Qian Mei
- Coronary Heart Disease Center, Fuwai Yunnan Cardiovascular Hospital, Kunming City, China
| | - Yangjuan Bai
- Cardiology Department, The First Affiliated Hospital of Kunming Medical University, Kunming City, China
| | - Wei Wei
- Digestive Surgery Department, The First Affiliated Hospital of Kunming Medical University, Kunming City, China
| | - Fang Ma
- Department of Nursing, The First Affiliated Hospital of Kunming Medical University, Kunming City, China
| |
Collapse
|
2
|
McGowan LJ, Chater AM, Harper JH, Kilbride C, Victor C, Brierley ML, Bailey DP. Acceptability of a remotely delivered sedentary behaviour intervention to improve sarcopenia and maintain independent living in older adults with frailty: a mixed-methods study. BMC Geriatr 2024; 24:820. [PMID: 39394560 PMCID: PMC11468285 DOI: 10.1186/s12877-024-05385-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Accepted: 09/16/2024] [Indexed: 10/13/2024] Open
Abstract
BACKGROUND Sarcopenia is a leading cause of functional decline, loss of independence, premature mortality, and frailty in older adults. Reducing and breaking up sedentary behaviour is associated with positive sarcopenia and frailty outcomes. This study aimed to explore the acceptability, engagement and experiences of a remotely delivered sedentary behaviour intervention to improve sarcopenia and independent living in older adults with frailty. METHODS This was a mixed-methods study. In-depth qualitative semi-structed interviews were conducted with a subset (N = 15) of participants with frailty (aged 74 ± 6 years) who had participated in the Frail-LESS (LEss Sitting and Sarcopenia in Frail older adults) intervention aimed at reducing sedentary behaviour. The interviews explored acceptability of the intervention overall and its individual components (a psychoeducation workbook, wrist-worn activity tracker, health coaching, online peer support and tailored feedback on sitting, standing and stepping). Process evaluation questionnaires with closed and scaled questions explored intervention engagement, fidelity and experiences. RESULTS Overall acceptability of the intervention was good with most participants perceiving the intervention to have supported them in reducing and/or breaking up their sedentary behaviour. The wrist-worn activity tracker and health coaching appeared to be the most acceptable and useful components, with high levels of engagement. There was attendance at 104 of 150 health coaching sessions offered and 92% of participants reported using the wrist-worn activity tracker. There was a mixed response regarding acceptability of, and engagement with, the psychoeducation workbook, tailored feedback, and online peer support. CONCLUSIONS The Frail-LESS intervention had good levels of acceptability and engagement for some components. The findings of the study can inform modifications to the intervention to optimise acceptability and engagement in a future definitive randomised controlled trial. TRIAL REGISTRATION The trial was registered with ISRCTN (number ISRCTN17158017).
Collapse
Affiliation(s)
- Laura J McGowan
- NIHR Policy Research Unit in Behavioural Science - Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Angel M Chater
- Institute for Sport and Physical Activity Research, University of Bedfordshire, Polhill Avenue, Bedford, MK41 9EA, UK
- Centre for Behaviour Change, University College London, London, WC1E 7HB, UK
| | - Jamie H Harper
- Centre for Physical Activity in Health and Disease, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Uxbridge, UB8 3PH, UK
| | - Cherry Kilbride
- Centre for Physical Activity in Health and Disease, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK
- Division of Physiotherapy and Physician Associates, Department of Health Sciences, Brunel University London, Uxbridge, UB8 3PH, UK
| | - Christina Victor
- Division of Global Public Health, Brunel University London, Uxbridge, UB8 3PH, UK
| | - Marsha L Brierley
- Centre for Physical Activity in Health and Disease, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK
| | - Daniel P Bailey
- Centre for Physical Activity in Health and Disease, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK.
- Division of Sport, Health and Exercise Sciences, Department of Life Sciences, Brunel University London, Uxbridge, UB8 3PH, UK.
| |
Collapse
|
3
|
Straiton N, Moons P, Verstrael A, Liu M, Winter MM. Beyond validation: getting wearable activity trackers into cardiovascular care-a discussion paper. Eur J Cardiovasc Nurs 2024; 23:685-689. [PMID: 38345842 DOI: 10.1093/eurjcn/zvae019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/06/2024] [Accepted: 02/08/2024] [Indexed: 04/24/2024]
Abstract
This paper addresses the challenge of integrating wearable activity trackers (WATs) into cardiovascular disease care. Despite evidence supporting the use of trackers for monitoring and promoting physical activity, implementation challenges persist in clinical settings. The paper emphasizes the lack of systematic, evidence-based implementation approaches for integrating trackers. It underscores the urgent need for stakeholder collaboration between clinicians, patients, implementation scientists, researchers, health and technology partners, and the use of proven implementation science methodologies. This is crucial for bridging the gap and ensuring effective translation of WATs into cardiovascular care, meeting the increasing demand from patients and clinicians.
Collapse
Affiliation(s)
- Nicola Straiton
- Nursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne, Australian Catholic University, Level 5, De Lacy Building, 390 Victoria Street, Darlinghurst, NSW 2010, Australia
| | - Philip Moons
- KU Leuven Department of Public Health and Primary Care, KU Leuven-University of Leuven, Kapucijnenvoer 7 PB7001, 3000 Leuven, Belgium
- Institute of Health and Care Sciences, University of Gothenburg, Arvid Wallgrens backe 1, 413 46 Gothenburg, Sweden
- Department of Paediatrics and Child Health, University of Cape Town, Klipfontein Rd, Rondebosch, 7700 Cape Town, South Africa
| | - Axel Verstrael
- ESC Patient's Platform, European Society of Cardiology, Les Templiers, 2035 route des colles, CS 80179 Biot, 06903 Sophia Antipolis Cedex, France
| | - Mark Liu
- Nursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne, Australian Catholic University, Level 5, De Lacy Building, 390 Victoria Street, Darlinghurst, NSW 2010, Australia
- Faculty of Medicine and Health, University of Sydney, New South Wales 2006, Australia
| | - Michiel M Winter
- Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, University of Amsterdam, Meibergdreef 9, 1105 Amsterdam, The Netherlands
| |
Collapse
|
4
|
Jafleh EA, Alnaqbi FA, Almaeeni HA, Faqeeh S, Alzaabi MA, Al Zaman K. The Role of Wearable Devices in Chronic Disease Monitoring and Patient Care: A Comprehensive Review. Cureus 2024; 16:e68921. [PMID: 39381470 PMCID: PMC11461032 DOI: 10.7759/cureus.68921] [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] [Accepted: 09/08/2024] [Indexed: 10/10/2024] Open
Abstract
Wearable health devices are becoming vital in chronic disease management because they offer real-time monitoring and personalized care. This review explores their effectiveness and challenges across medical fields, including cardiology, respiratory health, neurology, endocrinology, orthopedics, oncology, and mental health. A thorough literature search identified studies focusing on wearable devices' impact on patient outcomes. In cardiology, wearables have proven effective for monitoring hypertension, detecting arrhythmias, and aiding cardiac rehabilitation. In respiratory health, these devices enhance asthma management and continuous monitoring of critical parameters. Neurological applications include seizure detection and Parkinson's disease management, with wearables showing promising results in improving patient outcomes. In endocrinology, wearable technology advances thyroid dysfunction monitoring, fertility tracking, and diabetes management. Orthopedic applications include improved postsurgical recovery and rehabilitation, while wearables help in early complication detection in oncology. Mental health benefits include anxiety detection, post-traumatic stress disorder management, and stress reduction through wearable biofeedback. In conclusion, wearable health devices offer transformative potential for managing chronic illnesses by enhancing real-time monitoring and patient engagement. Despite significant improvements in adherence and outcomes, challenges with data accuracy and privacy persist. However, with ongoing innovation and collaboration, we can all be part of the solution to maximize the benefits of wearable technologies in healthcare.
Collapse
Affiliation(s)
- Eman A Jafleh
- College of Dentistry, University of Sharjah, Sharjah, ARE
| | | | | | - Shooq Faqeeh
- College of Medicine, University of Sharjah, Sharjah, ARE
| | - Moza A Alzaabi
- Internal Medicine, Cleveland Clinic Abu Dhabi, Abu Dhabi, ARE
| | - Khaled Al Zaman
- General Medicine, Cleveland Clinic Abu Dhabi, Abu Dhabi, ARE
| |
Collapse
|
5
|
Huang HH, Chang MH, Chen PT, Lin CL, Sung PS, Chen CH, Fan SY. Exploring factors affecting the acceptance of fall detection technology among older adults and their families: a content analysis. BMC Geriatr 2024; 24:694. [PMID: 39164655 PMCID: PMC11334405 DOI: 10.1186/s12877-024-05262-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 07/30/2024] [Indexed: 08/22/2024] Open
Abstract
BACKGROUND This study conducted in-depth interviews to explore the factors that influence the adoption of fall detection technology among older adults and their families, providing a valuable evaluation framework for healthcare providers in the field of fall detection, with the ultimate goal of assisting older adults immediately and effectively when falls occur. METHODS The method employed a qualitative approach, utilizing semi-structured interviews with 30 older adults and 29 families, focusing on their perspectives and expectations of fall detection technology. Purposive sampling ensured representation from older adults with conditions such as Parkinson's, dementia, and stroke. RESULTS The results reveal key considerations influencing the adoption of fall-detection devices, including health factors, reliance on human care, personal comfort, awareness of market alternatives, attitude towards technology, financial concerns, and expectations for fall detection technology. CONCLUSIONS This study identifies seven key factors influencing the adoption of fall detection technology among older adults and their families. The conclusion highlights the need to address these factors to encourage adoption, advocating for user-centered, safe, and affordable technology. This research provides valuable insights for the development of fall detection technology, aiming to enhance the safety of older adults and reduce the caregiving burden.
Collapse
Affiliation(s)
- Hsin-Hsiung Huang
- Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan, ROC
| | - Ming-Hao Chang
- Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan, ROC
| | - Peng-Ting Chen
- Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan, ROC.
- Medical Device Innovation Center, National Cheng Kung University, No.138, Shengli Rd., North District, Tainan City, 704, Taiwan, ROC.
| | - Chih-Lung Lin
- Department of Electrical Engineering, National Cheng Kung University, Tainan, Taiwan, ROC
| | - Pi-Shan Sung
- Department of Neurology, National Cheng Kung University Hospital, Tainan, Taiwan, ROC
| | - Chien-Hsu Chen
- Department of Industrial Design, National Cheng Kung University, Tainan, Taiwan, ROC
| | - Sheng-Yu Fan
- Institute of Gerontology, National Cheng Kung University, Tainan, Taiwan, ROC
| |
Collapse
|
6
|
Wong AKC, Bayuo J, Su JJ, Chow KKS, Wong SM, Wong BP, Lee AYL, Wong FKY. Exploring the Experiences of Community-Dwelling Older Adults on Using Wearable Monitoring Devices With Regular Support From Community Health Workers, Nurses, and Social Workers: Qualitative Descriptive Study. J Med Internet Res 2024; 26:e49403. [PMID: 39110493 PMCID: PMC11339583 DOI: 10.2196/49403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 01/14/2024] [Accepted: 05/24/2024] [Indexed: 08/24/2024] Open
Abstract
BACKGROUND The use of wearable monitoring devices (WMDs), such as smartwatches, is advancing support and care for community-dwelling older adults across the globe. Despite existing evidence of the importance of WMDs in preventing problems and promoting health, significant concerns remain about the decline in use after a period of time, which warrant an understanding of how older adults experience the devices. OBJECTIVE This study aims to explore and describe the experiences of community-dwelling older adults after receiving our interventional program, which included the use of a smartwatch with support from a community health workers, nurses, and social workers, including the challenges that they experienced while using the device, the perceived benefits, and strategies to promote their sustained use of the device. METHODS We used a qualitative descriptive approach in this study. Older adults who had taken part in an interventional study involving the use of smartwatches and who were receiving regular health and social support were invited to participate in focus group discussions at the end of the trial. Purposive sampling was used to recruit potential participants. Older adults who agreed to participate were assigned to focus groups based on their community. The focus group discussions were facilitated and moderated by 2 members of the research team. All discussions were recorded and transcribed verbatim. We used the constant comparison analytical approach to analyze the focus group data. RESULTS A total of 22 participants assigned to 6 focus groups participated in the study. The experiences of community-dwelling older adults emerged as (1) challenges associated with the use of WMDs, (2) the perceived benefits of using the WMDs, and (3) strategies to promote the use of WMDs. In addition, the findings also demonstrate a hierarchical pattern of health-seeking behaviors by older adults: seeking assistance first from older adult volunteers, then from social workers, and finally from nurses. CONCLUSIONS Ongoing use of the WMDs is potentially possible, but it is important to ensure the availability of technical support, maintain active professional follow-ups by nurses and social workers, and include older adult volunteers to support other older adults in such programs.
Collapse
Affiliation(s)
| | - Jonathan Bayuo
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, China (Hong Kong)
| | - Jing Jing Su
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, China (Hong Kong)
| | | | - Siu Man Wong
- Hong Kong Lutheran Social Service, Kowloon, China (Hong Kong)
| | - Bonnie Po Wong
- Hong Kong Lutheran Social Service, Kowloon, China (Hong Kong)
| | - Athena Yin Lam Lee
- Department of Health, The Government of the Hong Kong Special Administrative Region, Hong Kong Island, China (Hong Kong)
| | | |
Collapse
|
7
|
Sohn A, Turner AM, Speier W, Fonarow GC, Ong MK, Arnold CW. Patients with Heart Failure: Internet Use and Mobile Health Perceptions. Appl Clin Inform 2024; 15:709-716. [PMID: 38382633 PMCID: PMC11357730 DOI: 10.1055/a-2273-5278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 02/20/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Heart failure is a complex clinical syndrome noted on approximately one in eight death certificates in the United States. Vital to reducing complications of heart failure and preventing hospital readmissions is adherence to heart failure self-care routines. Mobile health offers promising opportunities for enhancing self-care behaviors by facilitating tracking and timely reminders. OBJECTIVES We sought to investigate three characteristics of heart failure patients with respect to their heart failure self-care behaviors: (1) internet use to search for heart failure information; (2) familiarity with mobile health apps and devices; and (3) perceptions of using activity trackers or smartwatches to aid in their heart failure self-care. METHODS Forty-nine heart failure patients were asked about their internet and mobile health usage. The structured interview included questions adapted from the Health Information National Trends Survey. RESULTS Over 50% of the patients had utilized the internet to search for heart failure information in the past 12 months, experience using health-related apps, and thoughts that an activity tracker or smartwatch could help them manage heart failure. Qualitative analysis of the interviews revealed six themes: trust in their physicians, alternatives to mobile health apps, lack of need for mobile health devices, financial barriers to activity tracker and smartwatch ownership, benefits of tracking and reminders, and uncertainty of their potential due to lack of knowledge. CONCLUSION Trust in their physicians was a major factor for heart failure patients who reported not searching for health information on the internet. While those who used mobile health technologies found them useful, patients who did not use them were generally unaware of or unknowledgeable about them. Considering patients' preferences for recommendations from their physicians and tendency to search for heart failure information including treatment and management options, patient-provider discussions about mobile health may improve patient knowledge and impact their usage.
Collapse
Affiliation(s)
- Albert Sohn
- Department of Medical Education and Clinical Sciences, Washington State University, Spokane, Washington, United States
- Department of Health Systems and Population Health, University of Washington, Seattle, Washington, United States
- Department of Radiological Sciences, University of California Los Angeles, Los Angeles, California, United States
| | - Anne M. Turner
- Department of Health Systems and Population Health, University of Washington, Seattle, Washington, United States
- Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, Washington, United States
| | - William Speier
- Department of Radiological Sciences, University of California Los Angeles, Los Angeles, California, United States
| | - Gregg C. Fonarow
- Division of Cardiology, Department of Medicine, University of California Los Angeles, Los Angeles, California, United States
| | - Michael K. Ong
- Department of Medicine, University of California Los Angeles, Los Angeles, California, United States
- Department of Health Policy and Management, University of California Los Angeles, Los Angeles, California, United States
- VA Greater Los Angeles Healthcare System, Los Angeles, California, United States
| | - Corey W. Arnold
- Department of Radiological Sciences, University of California Los Angeles, Los Angeles, California, United States
- Department of Electrical and Computer Engineering, University of California, Los Angeles, Los Angeles, California, United States
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, California, United States
- Department of Pathology and Laboratory Medicine, University of California, Los Angeles, Los Angeles, California, United States
| |
Collapse
|
8
|
Takano K, Oba T, Katahira K, Kimura K. Deconstructing Fitbit to Specify the Effective Features in Promoting Physical Activity Among Inactive Adults: Pilot Randomized Controlled Trial. JMIR Mhealth Uhealth 2024; 12:e51216. [PMID: 38996332 PMCID: PMC11282379 DOI: 10.2196/51216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 02/28/2024] [Accepted: 03/22/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND Wearable activity trackers have become key players in mobile health practice as they offer various behavior change techniques (BCTs) to help improve physical activity (PA). Typically, multiple BCTs are implemented simultaneously in a device, making it difficult to identify which BCTs specifically improve PA. OBJECTIVE We investigated the effects of BCTs implemented on a smartwatch, the Fitbit, to determine how each technique promoted PA. METHODS This study was a single-blind, pilot randomized controlled trial, in which 70 adults (n=44, 63% women; mean age 40.5, SD 12.56 years; closed user group) were allocated to 1 of 3 BCT conditions: self-monitoring (feedback on participants' own steps), goal setting (providing daily step goals), and social comparison (displaying daily steps achieved by peers). Each intervention lasted for 4 weeks (fully automated), during which participants wore a Fitbit and responded to day-to-day questionnaires regarding motivation. At pre- and postintervention time points (in-person sessions), levels and readiness for PA as well as different aspects of motivation were assessed. RESULTS Participants showed excellent adherence (mean valid-wear time of Fitbit=26.43/28 days, 94%), and no dropout was recorded. No significant changes were found in self-reported total PA (dz<0.28, P=.40 for the self-monitoring group, P=.58 for the goal setting group, and P=.19 for the social comparison group). Fitbit-assessed step count during the intervention period was slightly higher in the goal setting and social comparison groups than in the self-monitoring group, although the effects did not reach statistical significance (P=.052 and P=.06). However, more than half (27/46, 59%) of the participants in the precontemplation stage reported progress to a higher stage across the 3 conditions. Additionally, significant increases were detected for several aspects of motivation (ie, integrated and external regulation), and significant group differences were identified for the day-to-day changes in external regulation; that is, the self-monitoring group showed a significantly larger increase in the sense of pressure and tension (as part of external regulation) than the goal setting group (P=.04). CONCLUSIONS Fitbit-implemented BCTs promote readiness and motivation for PA, although their effects on PA levels are marginal. The BCT-specific effects were unclear, but preliminary evidence showed that self-monitoring alone may be perceived demanding. Combining self-monitoring with another BCT (or goal setting, at least) may be important for enhancing continuous engagement in PA. TRIAL REGISTRATION Open Science Framework; https://osf.io/87qnb/?view_only=f7b72d48bb5044eca4b8ce729f6b403b.
Collapse
Affiliation(s)
- Keisuke Takano
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Ibaraki, Japan
| | - Takeyuki Oba
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Ibaraki, Japan
| | - Kentaro Katahira
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Ibaraki, Japan
| | - Kenta Kimura
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Ibaraki, Japan
| |
Collapse
|
9
|
French MA, Balasubramanian A, Hansel NN, Penttinen SK, Wise R, Raghavan P, Wegener ST, Roemmich RT, Celnik PA. Impact of automated data flow and reminders on adherence and resource utilization for remotely monitoring physical activity in individuals with stroke or chronic obstructive pulmonary disease. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.04.15.24305852. [PMID: 38699312 PMCID: PMC11064997 DOI: 10.1101/2024.04.15.24305852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
As rehabilitation advances into the era of digital health, remote monitoring of physical activity via wearable devices has the potential to change how we provide care. However, uncertainties about patient adherence and the significant resource requirements needed create challenges to adoption of remote monitoring into clinical care. Here we aim to determine the impact of a novel digital application to overcome these barriers. The Rehabilitation Remote Monitoring Application (RRMA) automatically extracts data about physical activity collected via a Fitbit device, screens the data for adherence, and contacts the participant if adherence is low. We compare adherence and estimate the resources required (i.e., time and financial) to perform remote monitoring of physical activity with and without the RRMA in two patient groups. Seventy-three individuals with stroke or chronic obstructive pulmonary disease completed 28 days of monitoring physical activity with the RRMA, while 62 individuals completed 28 days with the data flow processes being completed manually. Adherence (i.e., the average percentage of the day that the device was worn) was similar between groups (p=0.85). However, the RRMA saved an estimated 123.8 minutes or $50.24 per participant month when compared to manual processes. These results demonstrate that automated technologies like the RRMA can maintain patient adherence to remote monitoring of physical activity while reducing the time and financial resources needed. Applications like the RRMA can facilitate the adoption of remote monitoring in rehabilitation by reducing barriers related to adherence and resource requirements.
Collapse
Affiliation(s)
- Margaret A French
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, Utah, United States of America
| | - Aparna Balasubramanian
- Department of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Nadia N Hansel
- Department of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Sharon K Penttinen
- inHealth Precision Medicine Program, Technology Innovation Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Robert Wise
- inHealth Precision Medicine Program, Technology Innovation Center, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Preeti Raghavan
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Stephen T Wegener
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Ryan T Roemmich
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, Maryland, United States of America
- Center for Movement Studies, Kennedy Krieger Institute, Baltimore, Maryland, United States of America
| | - Pablo A Celnik
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, Maryland, United States of America
| |
Collapse
|
10
|
Del-Valle-Soto C, López-Pimentel JC, Vázquez-Castillo J, Nolazco-Flores JA, Velázquez R, Varela-Aldás J, Visconti P. A Comprehensive Review of Behavior Change Techniques in Wearables and IoT: Implications for Health and Well-Being. SENSORS (BASEL, SWITZERLAND) 2024; 24:2429. [PMID: 38676044 PMCID: PMC11054424 DOI: 10.3390/s24082429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/01/2024] [Accepted: 04/04/2024] [Indexed: 04/28/2024]
Abstract
This research paper delves into the effectiveness and impact of behavior change techniques fostered by information technologies, particularly wearables and Internet of Things (IoT) devices, within the realms of engineering and computer science. By conducting a comprehensive review of the relevant literature sourced from the Scopus database, this study aims to elucidate the mechanisms and strategies employed by these technologies to facilitate behavior change and their potential benefits to individuals and society. Through statistical measurements and related works, our work explores the trends over a span of two decades, from 2000 to 2023, to understand the evolving landscape of behavior change techniques in wearable and IoT technologies. A specific focus is placed on a case study examining the application of behavior change techniques (BCTs) for monitoring vital signs using wearables, underscoring the relevance and urgency of further investigation in this critical intersection of technology and human behavior. The findings shed light on the promising role of wearables and IoT devices for promoting positive behavior modifications and improving individuals' overall well-being and highlighting the need for continued research and development in this area to harness the full potential of technology for societal benefit.
Collapse
Affiliation(s)
- Carolina Del-Valle-Soto
- Facultad de Ingeniería, Universidad Panamericana, Álvaro del Portillo 49, Zapopan 45010, Mexico;
| | | | - Javier Vázquez-Castillo
- Department of Informatics and Networking, Universidad Autónoma del Estado de Quintana Roo, Chetumal 77019, Mexico;
| | | | - Ramiro Velázquez
- Facultad de Ingeniería, Universidad Panamericana, Aguascalientes 20296, Mexico;
| | - José Varela-Aldás
- Centro de Investigaciones de Ciencias Humanas y de la Educación—CICHE, Universidad Indoamérica, Ambato 180103, Ecuador;
| | - Paolo Visconti
- Department of Innovation Engineering, University of Salento, 73100 Lecce, Italy;
| |
Collapse
|
11
|
Moorthy P, Weinert L, Schüttler C, Svensson L, Sedlmayr B, Müller J, Nagel T. Attributes, Methods, and Frameworks Used to Evaluate Wearables and Their Companion mHealth Apps: Scoping Review. JMIR Mhealth Uhealth 2024; 12:e52179. [PMID: 38578671 PMCID: PMC11031706 DOI: 10.2196/52179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 12/15/2023] [Accepted: 02/01/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Wearable devices, mobile technologies, and their combination have been accepted into clinical use to better assess the physical fitness and quality of life of patients and as preventive measures. Usability is pivotal for overcoming constraints and gaining users' acceptance of technology such as wearables and their companion mobile health (mHealth) apps. However, owing to limitations in design and evaluation, interactive wearables and mHealth apps have often been restricted from their full potential. OBJECTIVE This study aims to identify studies that have incorporated wearable devices and determine their frequency of use in conjunction with mHealth apps or their combination. Specifically, this study aims to understand the attributes and evaluation techniques used to evaluate usability in the health care domain for these technologies and their combinations. METHODS We conducted an extensive search across 4 electronic databases, spanning the last 30 years up to December 2021. Studies including the keywords "wearable devices," "mobile apps," "mHealth apps," "physiological data," "usability," "user experience," and "user evaluation" were considered for inclusion. A team of 5 reviewers screened the collected publications and charted the features based on the research questions. Subsequently, we categorized these characteristics following existing usability and wearable taxonomies. We applied a methodological framework for scoping reviews and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist. RESULTS A total of 382 reports were identified from the search strategy, and 68 articles were included. Most of the studies (57/68, 84%) involved the simultaneous use of wearables and connected mobile apps. Wrist-worn commercial consumer devices such as wristbands were the most prevalent, accounting for 66% (45/68) of the wearables identified in our review. Approximately half of the data from the medical domain (32/68, 47%) focused on studies involving participants with chronic illnesses or disorders. Overall, 29 usability attributes were identified, and 5 attributes were frequently used for evaluation: satisfaction (34/68, 50%), ease of use (27/68, 40%), user experience (16/68, 24%), perceived usefulness (18/68, 26%), and effectiveness (15/68, 22%). Only 10% (7/68) of the studies used a user- or human-centered design paradigm for usability evaluation. CONCLUSIONS Our scoping review identified the types and categories of wearable devices and mHealth apps, their frequency of use in studies, and their implementation in the medical context. In addition, we examined the usability evaluation of these technologies: methods, attributes, and frameworks. Within the array of available wearables and mHealth apps, health care providers encounter the challenge of selecting devices and companion apps that are effective, user-friendly, and compatible with user interactions. The current gap in usability and user experience in health care research limits our understanding of the strengths and limitations of wearable technologies and their companion apps. Additional research is necessary to overcome these limitations.
Collapse
Affiliation(s)
- Preetha Moorthy
- Department of Biomedical Informatics, Center for Preventive Medicine and Digital Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Lina Weinert
- Institute of Medical Informatics, Heidelberg University Hospital, Heidelberg, Germany
- Section for Oral Health, Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Christina Schüttler
- Medical Center for Information and Communication Technology, University Hospital Erlangen, Erlangen, Germany
| | - Laura Svensson
- Institute of Medical Informatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Brita Sedlmayr
- Institute for Medical Informatics and Biometry, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Julia Müller
- Institute of Medical Informatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Till Nagel
- Human Data Interaction Lab, Mannheim University of Applied Sciences, Mannheim, Germany
| |
Collapse
|
12
|
Chimatapu SN, Mittelman SD, Habib M, Osuna-Garcia A, Vidmar AP. Wearable Devices Beyond Activity Trackers in Youth With Obesity: Summary of Options. Child Obes 2024; 20:208-218. [PMID: 37023409 PMCID: PMC10979694 DOI: 10.1089/chi.2023.0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Abstract
Background: Current treatment protocols to prevent and treat pediatric obesity focus on prescriptive lifestyle interventions. However, treatment outcomes are modest due to poor adherence and heterogeneity in responses. Wearable technologies offer a unique solution as they provide real-time biofeedback that could improve adherence to and sustainability of lifestyle interventions. To date, all reviews on wearable devices in pediatric obesity cohorts have only explored biofeedback from physical activity trackers. Hence, we conducted a scoping review to (1) catalog other biofeedback wearable devices available in this cohort, (2) document various metrics collected from these devices, and (3) assess safety and adherence to these devices. Methods: This scoping review was conducted adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. Fifteen eligible studies examined the use of biofeedback wearable devices beyond activity trackers in pediatric cohorts, with an emphasis on feasibility of these devices. Results: Included studies varied in sample sizes (15-203) and in ages 6-21 years. Wearable devices are being used to capture various metrics of multicomponent weight loss interventions to provide more insights about glycemic variability, cardiometabolic function, sleep, nutrition, and body fat percentage. High safety and adherence rates were reported among these devices. Conclusions: Available evidence suggests that wearable devices have several applications aside from activity tracking, which could modify health behaviors through real-time biofeedback. Overall, these devices appear to be safe and feasible so as to be employed in various settings in the pediatric age group to prevent and treat obesity.
Collapse
Affiliation(s)
- Sri Nikhita Chimatapu
- Division of Endocrinology, Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Steven D. Mittelman
- Division of Endocrinology, Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Manal Habib
- Division of Endocrinology, Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Antonia Osuna-Garcia
- Department of Health and Life Sciences Librarian, Nursing, Biomedical Library, University of California Los Angeles, Los Angeles, CA, USA
| | - Alaina P. Vidmar
- Center for Endocrinology, Diabetes, and Metabolism, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, USA
| |
Collapse
|
13
|
Bhatia A, Hanna J, Stuart T, Kasper KA, Clausen DM, Gutruf P. Wireless Battery-free and Fully Implantable Organ Interfaces. Chem Rev 2024; 124:2205-2280. [PMID: 38382030 DOI: 10.1021/acs.chemrev.3c00425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
Advances in soft materials, miniaturized electronics, sensors, stimulators, radios, and battery-free power supplies are resulting in a new generation of fully implantable organ interfaces that leverage volumetric reduction and soft mechanics by eliminating electrochemical power storage. This device class offers the ability to provide high-fidelity readouts of physiological processes, enables stimulation, and allows control over organs to realize new therapeutic and diagnostic paradigms. Driven by seamless integration with connected infrastructure, these devices enable personalized digital medicine. Key to advances are carefully designed material, electrophysical, electrochemical, and electromagnetic systems that form implantables with mechanical properties closely matched to the target organ to deliver functionality that supports high-fidelity sensors and stimulators. The elimination of electrochemical power supplies enables control over device operation, anywhere from acute, to lifetimes matching the target subject with physical dimensions that supports imperceptible operation. This review provides a comprehensive overview of the basic building blocks of battery-free organ interfaces and related topics such as implantation, delivery, sterilization, and user acceptance. State of the art examples categorized by organ system and an outlook of interconnection and advanced strategies for computation leveraging the consistent power influx to elevate functionality of this device class over current battery-powered strategies is highlighted.
Collapse
Affiliation(s)
- Aman Bhatia
- Department of Biomedical Engineering, The University of Arizona, Tucson, Arizona 85721, United States
| | - Jessica Hanna
- Department of Biomedical Engineering, The University of Arizona, Tucson, Arizona 85721, United States
| | - Tucker Stuart
- Department of Biomedical Engineering, The University of Arizona, Tucson, Arizona 85721, United States
| | - Kevin Albert Kasper
- Department of Biomedical Engineering, The University of Arizona, Tucson, Arizona 85721, United States
| | - David Marshall Clausen
- Department of Biomedical Engineering, The University of Arizona, Tucson, Arizona 85721, United States
| | - Philipp Gutruf
- Department of Biomedical Engineering, The University of Arizona, Tucson, Arizona 85721, United States
- Department of Electrical and Computer Engineering, The University of Arizona, Tucson, Arizona 85721, United States
- Bio5 Institute, The University of Arizona, Tucson, Arizona 85721, United States
- Neuroscience Graduate Interdisciplinary Program (GIDP), The University of Arizona, Tucson, Arizona 85721, United States
| |
Collapse
|
14
|
Li M, McPhillips MV, Szanton SL, Wenzel J, Li J. Electronic Wearable Device Use for Physical Activity in Older Adults: A Qualitative Study. WORK, AGING AND RETIREMENT 2024; 10:25-37. [PMID: 38196825 PMCID: PMC10772964 DOI: 10.1093/workar/waac023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
Innovative solutions to help older adults increase physical activity are critically important. In this qualitative study, we explored older adults' acceptance, capability, and experiences of using three different types of electronic wearable devices over a period of 4-24 weeks for self-monitoring and promoting physical activity. We conducted 23 semistructured interviews with older adults who participated in three physical activity intervention studies. Two researchers analyzed the data using NVivo version 12, applying a directed content analysis that was partially guided by the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2). Six themes emerged: (1) device learning, (2) hedonic motivation, (3) habit and adherence, (4) facilitating conditions, (5) effort expectancy, and (6) performance expectancy. Although most older adults (95.8%) from this study were first-time users, they reflected positive experiences and generally enjoyed using electronic wearable devices. Participants reported issues related to electronic wearable device functionalities that can be improved to better enhance user experience and motivate increased physical activity. Future research should explore the role of electronic wearable devices in older adults' physical activity with an emphasis on behavioral change over time.
Collapse
Affiliation(s)
- Mengchi Li
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
| | | | - Sarah L Szanton
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
| | - Jennifer Wenzel
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
| | - Junxin Li
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
| |
Collapse
|
15
|
Stara V, Rampioni M, Moșoi AA, Kristaly DM, Moraru SA, Paciaroni L, Paolini S, Raccichini A, Felici E, Cucchieri G, Antognoli L, Millevolte A, Antici M, di Rosa M. The Impact of a Multicomponent Platform Intervention on the Daily Lives of Older Adults. Healthcare (Basel) 2023; 11:3102. [PMID: 38131995 PMCID: PMC10742799 DOI: 10.3390/healthcare11243102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 11/30/2023] [Accepted: 12/01/2023] [Indexed: 12/23/2023] Open
Abstract
Gerontechnology is an interdisciplinary field of research involving gerontology and technology in order to help older adults identify and slow down the effects of age-related physical and cognitive decline. It has enormous potential to allow individuals to remain in their own homes and improve their quality of life. This study aims to assess the impact of a multicomponent platform, consisting of an ambient sensor, wearable devices, and a cloud application, as an intervention in terms of usability and acceptance as primary outcomes and well-being, quality of life, and self-efficacy as secondary outcomes in a sample of 25 older adults aged over 65 after 21 days of non-supervised usage at home. This research involved the use of a mixed-methods approach, in which both qualitative and quantitative data were collected in three different measurements. Overall, the participants shared good engagement with the integrated platform. The system achieved positive results in terms of both usability and acceptance, especially the smartwatch. The state of complete well-being slightly improved over the period, whereas self-efficacy remained stable. This study demonstrates the ability of target users to use technology independently in their home environment: it strengthens the idea that this technology is ready for mainstream use and offers food for thought for developers who create products for the aging population.
Collapse
Affiliation(s)
- Vera Stara
- Model of Care and New Technologies, IRCCS INRCA-National Institute of Health and Science on Aging, Via Santa Margherita 5, 60124 Ancona, Italy; (V.S.); (E.F.); (G.C.); (L.A.)
| | - Margherita Rampioni
- Model of Care and New Technologies, IRCCS INRCA-National Institute of Health and Science on Aging, Via Santa Margherita 5, 60124 Ancona, Italy; (V.S.); (E.F.); (G.C.); (L.A.)
| | - Adrian Alexandru Moșoi
- Department of Psychology, Education and Teacher Training, Transilvania University of Brasov, B-dul Eroilor 29, 500036 Brașov, Romania;
| | - Dominic M. Kristaly
- Department of Automatics and Information Technology, Transilvania University of Brasov, B-dul Eroilor 29, 500036 Brașov, Romania; (D.M.K.); (S.-A.M.)
| | - Sorin-Aurel Moraru
- Department of Automatics and Information Technology, Transilvania University of Brasov, B-dul Eroilor 29, 500036 Brașov, Romania; (D.M.K.); (S.-A.M.)
| | - Lucia Paciaroni
- Neurology Department, IRCCS INRCA-National Institute of Health and Science on Aging, Via della Monta-gnola 81, 60100 Ancona, Italy; (L.P.); (S.P.); (A.R.)
| | - Susy Paolini
- Neurology Department, IRCCS INRCA-National Institute of Health and Science on Aging, Via della Monta-gnola 81, 60100 Ancona, Italy; (L.P.); (S.P.); (A.R.)
| | - Alessandra Raccichini
- Neurology Department, IRCCS INRCA-National Institute of Health and Science on Aging, Via della Monta-gnola 81, 60100 Ancona, Italy; (L.P.); (S.P.); (A.R.)
| | - Elisa Felici
- Model of Care and New Technologies, IRCCS INRCA-National Institute of Health and Science on Aging, Via Santa Margherita 5, 60124 Ancona, Italy; (V.S.); (E.F.); (G.C.); (L.A.)
| | - Giacomo Cucchieri
- Model of Care and New Technologies, IRCCS INRCA-National Institute of Health and Science on Aging, Via Santa Margherita 5, 60124 Ancona, Italy; (V.S.); (E.F.); (G.C.); (L.A.)
| | - Luca Antognoli
- Model of Care and New Technologies, IRCCS INRCA-National Institute of Health and Science on Aging, Via Santa Margherita 5, 60124 Ancona, Italy; (V.S.); (E.F.); (G.C.); (L.A.)
| | | | - Marina Antici
- Laboratorio delle Idee, Via G.B. Miliani 36, 60044 Fabriano, Italy; (A.M.); (M.A.)
| | - Mirko di Rosa
- Unit of Geriatric Pharmacoepidemiology and Biostatistics, IRCCS INRCA-National Institute of Health and Science on Aging, 60124 Ancona, Italy;
| |
Collapse
|
16
|
Choma EA, Hayes S, Lewis BA, Rothman AJ, Wyman JF, Guan W, McMahon SK. Technical Assistance Received by Older Adults to Use Commercially Available Physical Activity Monitors (Ready Steady 3.0 Trial): Ad-Hoc Descriptive Longitudinal Study. JMIR Mhealth Uhealth 2023; 11:e47891. [PMID: 37997772 PMCID: PMC10690145 DOI: 10.2196/47891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 08/11/2023] [Accepted: 09/22/2023] [Indexed: 11/25/2023] Open
Abstract
Background Despite evidence that regular physical activity (PA) among older adults confers numerous health and functional benefits, PA participation rates are low. Using commercially available wearable PA monitors (PAMs) is one way to augment PA promotion efforts. However, while expert recommendations exist for the specific information needed at the beginning of PAM ownership and the general ongoing need for structures that support as-needed technical troubleshooting, information is lacking about the type, frequency, and modes of assistance needed during initial and long-term ownership. Objective This paper describes problems reported and technical assistance received by older adults who used PAMs during the 18 months they participated in a community-based PA trial: Ready Steady 3.0 (RS3). Methods This was an ad-hoc longitudinal analysis of process variables representing technical problems reported and assistance received by 113 RS3 study participants in the 18 months after their orientation to PAMs. Variables included date of contact, problem(s) reported, mode of technical assistance, and whether the equipment was replaced. The descriptive analysis included frequencies and incidence rates of distinct contacts, types of problems, and technical assistance modes. Results On average, participants were aged 77 (SD 5.2) years. Most identified as female (n=87, 77%), reported experience using smartphones (n=92, 81.4%), and used the PAM between 2 and 18 months. Eighty-two participants (72.6%) reported between 1 to 9 problems with using PAMs, resulting in a total of 150 technical assistance contacts with a mean of 1.3 (SD 1.3) contacts. The incidence rate of new, distinct contacts for technical assistance was 99 per 100 persons per year from 2018 to 2021. The most common problems were wearing the PAM (n=43, 28.7%), reading its display (n=23, 15.3%), logging into its app (n=20, 13.3%), charging it (n=18, 12%), and synchronizing it to the app (n=16, 10.7%). The modalities of technical assistance were in person (n=53, 35.3%), by telephone (n=51, 34%), by email (n=25, 16.7%), and by postal mail (n=21, 14%). Conclusions In general, the results of this study show that after receiving orientation to PAMs, problems such as uncomfortable wristbands, difficulty using the PAM or its related app, and obtaining or interpreting relevant personal data were occasionally reported by participants in RS3. Trained staff helped participants troubleshoot and solve these technical problems primarily in person or by phone. Results also underscore the importance of involving older adults in the design, usability testing, and supportive material development processes to prevent technical problems for the initial and ongoing use of PAMs. Clinicians and researchers should further assess technical assistance needed by older adults, accounting for variations in PAM models and wear time, while investigating additional assistance strategies, such as proactive support, short GIF videos, and video calls.
Collapse
Affiliation(s)
- Elizabeth A Choma
- Department of Physical Therapy, Whitworth University, SpokaneWA, United States
| | - Shannon Hayes
- School of Nursing, University of Minnesota, MinneapolisMN, United States
| | - Beth A Lewis
- School of Kinesiology, University of Minnesota, MinneapolisMN, United States
| | - Alexander J Rothman
- Department of Psychology, University of Minnesota, MinneapolisMN, United States
| | - Jean F Wyman
- School of Nursing, University of Minnesota, MinneapolisMN, United States
| | - Weihua Guan
- Division of Biostatistics, School of Public Health, University of Minnesota, MinneapolisMN, United States
| | - Siobhan K McMahon
- School of Nursing, University of Minnesota, MinneapolisMN, United States
| |
Collapse
|
17
|
Straczkiewicz M, Keating NL, Thompson E, Matulonis UA, Campos SM, Wright AA, Onnela JP. Open-Source, Step-Counting Algorithm for Smartphone Data Collected in Clinical and Nonclinical Settings: Algorithm Development and Validation Study. JMIR Cancer 2023; 9:e47646. [PMID: 37966891 PMCID: PMC10687676 DOI: 10.2196/47646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 07/25/2023] [Accepted: 09/25/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Step counts are increasingly used in public health and clinical research to assess well-being, lifestyle, and health status. However, estimating step counts using commercial activity trackers has several limitations, including a lack of reproducibility, generalizability, and scalability. Smartphones are a potentially promising alternative, but their step-counting algorithms require robust validation that accounts for temporal sensor body location, individual gait characteristics, and heterogeneous health states. OBJECTIVE Our goal was to evaluate an open-source, step-counting method for smartphones under various measurement conditions against step counts estimated from data collected simultaneously from different body locations ("cross-body" validation), manually ascertained ground truth ("visually assessed" validation), and step counts from a commercial activity tracker (Fitbit Charge 2) in patients with advanced cancer ("commercial wearable" validation). METHODS We used 8 independent data sets collected in controlled, semicontrolled, and free-living environments with different devices (primarily Android smartphones and wearable accelerometers) carried at typical body locations. A total of 5 data sets (n=103) were used for cross-body validation, 2 data sets (n=107) for visually assessed validation, and 1 data set (n=45) was used for commercial wearable validation. In each scenario, step counts were estimated using a previously published step-counting method for smartphones that uses raw subsecond-level accelerometer data. We calculated the mean bias and limits of agreement (LoA) between step count estimates and validation criteria using Bland-Altman analysis. RESULTS In the cross-body validation data sets, participants performed 751.7 (SD 581.2) steps, and the mean bias was -7.2 (LoA -47.6, 33.3) steps, or -0.5%. In the visually assessed validation data sets, the ground truth step count was 367.4 (SD 359.4) steps, while the mean bias was -0.4 (LoA -75.2, 74.3) steps, or 0.1%. In the commercial wearable validation data set, Fitbit devices indicated mean step counts of 1931.2 (SD 2338.4), while the calculated bias was equal to -67.1 (LoA -603.8, 469.7) steps, or a difference of 3.4%. CONCLUSIONS This study demonstrates that our open-source, step-counting method for smartphone data provides reliable step counts across sensor locations, measurement scenarios, and populations, including healthy adults and patients with cancer.
Collapse
Affiliation(s)
- Marcin Straczkiewicz
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Nancy L Keating
- Department of Health Care Policy, Harvard Medical School, Boston, MA, United States
- Division of General Internal Medicine, Brigham and Women's Hospital, Boston, MA, United States
| | - Embree Thompson
- Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, United States
| | - Ursula A Matulonis
- Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, United States
| | - Susana M Campos
- Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, United States
| | - Alexi A Wright
- Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, United States
| | - Jukka-Pekka Onnela
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| |
Collapse
|
18
|
Waalen J. Mobile Health and Preventive Medicine. Med Clin North Am 2023; 107:1097-1108. [PMID: 37806725 DOI: 10.1016/j.mcna.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Wearable devices providing health-related data (mobile health [mHealth]) have grown in numbers and types of data available over the past 2 decades. Applications in prevention with some of the longest track records are activity trackers to promote fitness (primary prevention), mobile electrocardiogram devices to detect arrhythmias (secondary prevention), and continuous glucose monitoring to improve glycemic control in type 2 diabetes (tertiary prevention). Continued integration of multiple diverse data streams and improved interfaces with individuals (such as artificial intelligence-driven health coaches), and health care teams (as in the hospital-at-home concept), promise to optimize use of mHealth to improve clinical and public health outcomes.
Collapse
Affiliation(s)
- Jill Waalen
- University of California, San Diego/San Diego State University General Preventive Medicine Residency Program & Scripps Research Translational Institute, 3344 North Torrey Pines Court, La Jolla, CA 92037, USA.
| |
Collapse
|
19
|
Oppert ML, Ngo M, Lee GA, Billinghurst M, Banks S, Tolson L. Older adults' experiences of social isolation and loneliness: Can virtual touring increase social connectedness? A pilot study. Geriatr Nurs 2023; 53:270-279. [PMID: 37598431 DOI: 10.1016/j.gerinurse.2023.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 07/31/2023] [Accepted: 08/02/2023] [Indexed: 08/22/2023]
Abstract
The present pilot study explored the research aim of understanding how independent-living older adults experience social isolation and loneliness and whether virtual tour digital technology can increase social connectedness (N = 10). Through triangulation of interviews, experiences, and feedback, this study contributes to the knowledge base on the well-being of our ageing populations and how digital technologies, specifically virtual tourism, can aid in this process. The key findings reveal that the participants in our study were moderately lonely but were open to embracing more digital technology, sharing how it is instrumental in facilitating social connection and life administration. Participating in virtual tour experiences was well accepted as participants expressed enjoyment, nostalgia, and interest in future use. However, its contribution to increasing social connections needs to be clarified and requires further investigation. Several future research and education directions are provided.
Collapse
Affiliation(s)
- Michelle Leanne Oppert
- University of South Australia, Justice and Society, Behaviour-Brain-Body Research Centre, Australia; CROSSING, French Australian Laboratory for Humans-Autonomous Agents Teaming, Adelaide, Australia.
| | - Melissa Ngo
- University of South Australia, Justice and Society, Behaviour-Brain-Body Research Centre, Australia; CROSSING, French Australian Laboratory for Humans-Autonomous Agents Teaming, Adelaide, Australia
| | - Gun A Lee
- University of South Australia, STEM, Australian Research Centre for Interactive and Virtual Environments, Australia
| | - Mark Billinghurst
- University of South Australia, STEM, Australian Research Centre for Interactive and Virtual Environments, Australia; CROSSING, French Australian Laboratory for Humans-Autonomous Agents Teaming, Adelaide, Australia
| | - Siobhan Banks
- University of South Australia, Justice and Society, Behaviour-Brain-Body Research Centre, Australia; CROSSING, French Australian Laboratory for Humans-Autonomous Agents Teaming, Adelaide, Australia
| | | |
Collapse
|
20
|
Trumpf R, Schulte LE, Schroeder H, Larsen RT, Haussermann P, Zijlstra W, Fleiner T. Physical activity monitoring-based interventions in geriatric patients: a scoping review on intervention components and clinical applicability. Eur Rev Aging Phys Act 2023; 20:10. [PMID: 37202731 DOI: 10.1186/s11556-023-00320-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 04/10/2023] [Indexed: 05/20/2023] Open
Abstract
OBJECTIVE To identify and analyze the components applied in interventions using physical activity (PA) monitoring in geriatric patients and determine their feasibility and applicability. METHODS A systematic search in six databases (PubMed, Embase, SPORTDiscus, CINAHL, Web of Science, and GeroLit) was conducted to identify studies reporting interventions that included the application of a PA monitor in adults aged ≥ 60 years with a clinical diagnosis. PA monitor interventions were analyzed regarding their feedback, goal-setting and behavior change technique (BCT) components. To determine the feasibility and applicability of interventions, the participants' adherence to the intervention, their experience as well as adverse events were analyzed. RESULTS Seventeen eligible studies, applying 22 interventions, were identified. Studies included a total of 827 older patients with a median age of 70.2 years. In thirteen interventions (59%), the PA monitor was embedded in a structured behavioral intervention, an indication-specific intervention or usual care. Most frequently applied intervention components were goal setting and self-monitoring (n = 18), real-time PA monitor feedback complemented by feedback from the study team (n = 12), use of further BCTs (n = 18), and regular counseling with the study team (n = 19). Comprehensive information on the participants' intervention adherence and experience were reported for 15 (68%) and 8 (36%) interventions, respectively. CONCLUSION The components included in PA monitoring-based interventions varied considerably especially regarding the extent, frequency, and content of feedback, goal setting and BCTs counseling. Future research should evaluate which components are most effective and clinically applicable to promote physical activity in geriatric patients. To be able to precisely analyze the effects, trials should seek to report details on intervention components, adherence and adverse events, while future reviews may use the findings of this scoping review to conduct analyses with less heterogeneity in study characteristics and intervention strategies.
Collapse
Affiliation(s)
- Rieke Trumpf
- Institute of Movement and Sport Gerontology, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933, Cologne, Germany.
- Department of Geriatric Psychiatry & Psychotherapy, LVR Hospital Cologne, Cologne, Germany.
| | - Laura Elani Schulte
- Institute of Movement and Sport Gerontology, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933, Cologne, Germany
- Department of Geriatric Psychiatry & Psychotherapy, LVR Hospital Cologne, Cologne, Germany
| | - Henning Schroeder
- Department of Geriatric Psychiatry & Psychotherapy, LVR Hospital Cologne, Cologne, Germany
| | - Rasmus Tolstrup Larsen
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Occupational- and Physiotherapy, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Peter Haussermann
- Department of Geriatric Psychiatry & Psychotherapy, LVR Hospital Cologne, Cologne, Germany
| | - Wiebren Zijlstra
- Institute of Movement and Sport Gerontology, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933, Cologne, Germany
| | - Tim Fleiner
- Institute of Movement and Sport Gerontology, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933, Cologne, Germany
- Department of Geriatric Psychiatry & Psychotherapy, LVR Hospital Cologne, Cologne, Germany
- Institute for Geriatric Research, Ulm University Medical Center, Ulm, Germany
| |
Collapse
|
21
|
Javdan M, Ghasemaghaei M, Abouzahra M. Psychological barriers of using wearable devices by seniors: A mixed-methods study. COMPUTERS IN HUMAN BEHAVIOR 2023. [DOI: 10.1016/j.chb.2022.107615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
|
22
|
Straczkiewicz M, Keating NL, Thompson E, Matulonis UA, Campos SM, Wright AA, Onnela JP. Validation of an open-source smartphone step counting algorithm in clinical and non-clinical settings. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.03.28.23287844. [PMID: 37034681 PMCID: PMC10081434 DOI: 10.1101/2023.03.28.23287844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Background Step counts are increasingly used in public health and clinical research to assess wellbeing, lifestyle, and health status. However, estimating step counts using commercial activity trackers has several limitations, including a lack of reproducibility, generalizability, and scalability. Smartphones are a potentially promising alternative, but their step-counting algorithms require robust validation that accounts for temporal sensor body location, individual gait characteristics, and heterogeneous health states. Objective Our goal was to evaluate an open-source step-counting method for smartphones under various measurement conditions against step counts estimated from data collected simultaneously from different body locations ("internal" validation), manually ascertained ground truth ("manual" validation), and step counts from a commercial activity tracker (Fitbit Charge 2) in patients with advanced cancer ("wearable" validation). Methods We used eight independent datasets collected in controlled, semi-controlled, and free-living environments with different devices (primarily Android smartphones and wearable accelerometers) carried at typical body locations. Five datasets (N=103) were used for internal validation, two datasets (N=107) for manual validation, and one dataset (N=45) used for wearable validation. In each scenario, step counts were estimated using a previously published step-counting method for smartphones that uses raw sub-second level accelerometer data. We calculated mean bias and limits of agreement (LoA) between step count estimates and validation criteria using Bland-Altman analysis. Results In the internal validation datasets, participants performed 751.7±581.2 (mean±SD) steps, and the mean bias was -7.2 steps (LoA -47.6, 33.3) or -0.5%. In the manual validation datasets, the ground truth step count was 367.4±359.4 steps while the mean bias was -0.4 steps (LoA -75.2, 74.3) or 0.1 %. In the wearable validation dataset, Fitbit devices indicated mean step counts of 1931.2±2338.4, while the calculated bias was equal to -67.1 steps (LoA -603.8, 469.7) or a difference of 0.3 %. Conclusions This study demonstrates that our open-source step counting method for smartphone data provides reliable step counts across sensor locations, measurement scenarios, and populations, including healthy adults and patients with cancer.
Collapse
Affiliation(s)
| | - Nancy L. Keating
- Department of Health Care Policy, Harvard Medical School, Boston, MA 02115, USA
- Division of General Internal Medicine, Brigham and Women’s Hospital, Boston, MA 02115, USA
| | - Embree Thompson
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA
| | | | - Susana M. Campos
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA
| | - Alexi A. Wright
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02215, USA
| | | |
Collapse
|
23
|
Daley AJ, Griffin RA, Moakes CA, Sanders JP, Skrybant M, Ives N, Maylor B, Greenfield SM, Gokal K, Parretti HM, Biddle SJH, Greaves C, Maddison R, Mutrie N, Esliger DW, Sherar L, Edwardson CL, Yates T, Frew E, Tearne S, Jolly K. Snacktivity™ to promote physical activity and reduce future risk of disease in the population: protocol for a feasibility randomised controlled trial and nested qualitative study. Pilot Feasibility Stud 2023; 9:45. [PMID: 36932423 PMCID: PMC10021043 DOI: 10.1186/s40814-023-01272-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 03/04/2023] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND Many people do not regularly participate in physical activity, which may negatively impact their health. Current physical activity guidelines are focused on promoting weekly accumulation of at least 150 min of moderate to vigorous intensity physical activity (MVPA). Whilst revised guidance now recognises the importance of making small changes to physical activity behaviour, guidance still focuses on adults needing to achieve at least 150 min of MVPA per week. An alternative 'whole day' approach that could motivate the public to be more physically active, is a concept called Snacktivity™. Instead of focusing on achieving 150 min per week of physical activity, for example 30 min of MVPA over 5 days, Snacktivity™ encourages the public to achieve this through small, but frequent, 2-5 min 'snacks' of MVPA throughout the whole day. METHODS The primary aim is to undertake a feasibility trial with nested qualitative interviews to assess the feasibility and acceptability of the Snacktivity™ intervention to inform the design of a subsequent phase III randomised trial. A two-arm randomised controlled feasibility trial aiming to recruit 80 inactive adults will be conducted. Recruitment will be from health and community settings and social media. Participants will be individually randomised (1:1 ratio) to receive either the Snacktivity™ intervention or usual care. The intervention will last 12 weeks with assessment of outcomes completed before and after the intervention in all participants. We are interested in whether the Snacktivity™ trial is appealing to participants (assessed by the recruitment rate) and if the Snacktivity™ intervention and trial methods are acceptable to participants (assessed by Snacktivity™/physical activity adherence and retention rates). The intervention will be delivered by health care providers within health care consultations or by researchers. Participants' experiences of the trial and intervention, and health care providers' views of delivering the intervention within health consultations will be explored. DISCUSSION The development of physical activity interventions that can be delivered at scale are needed. The findings from this study will inform the viability and design of a phase III trial to assess the effectiveness and cost-effectiveness of Snacktivity™ to increase physical activity. TRIAL REGISTRATION ISRCTN: 64851242.
Collapse
Affiliation(s)
- Amanda J Daley
- Centre for Lifestyle Medicine and Behaviour, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
| | - Ryan A Griffin
- Birmingham Clinical Trials Unit, Institute for Applied Health Research, University of Birmingham, Birmingham, UK
| | - Catherine A Moakes
- Birmingham Clinical Trials Unit, Institute for Applied Health Research, University of Birmingham, Birmingham, UK
| | - James P Sanders
- Centre for Lifestyle Medicine and Behaviour, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Magdalena Skrybant
- Institute for Applied Health Research, University of Birmingham, Birmingham, UK
| | - Natalie Ives
- Birmingham Clinical Trials Unit, Institute for Applied Health Research, University of Birmingham, Birmingham, UK
| | - Ben Maylor
- Diabetes Research Centre, College of Life Sciences, University of Leicester and NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Sheila M Greenfield
- Institute for Applied Health Research, University of Birmingham, Birmingham, UK
| | - Kajal Gokal
- Centre for Lifestyle Medicine and Behaviour, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Helen M Parretti
- Norwich Medical School, Faculty of Medicine and Health, University of East Anglia, Norwich, UK
| | - Stuart J H Biddle
- University of Southern Queensland, Springfield, Australia.,Faculty of Sport & Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Colin Greaves
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Ralph Maddison
- Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Australia
| | - Nanette Mutrie
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, UK
| | - Dale W Esliger
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Lauren Sherar
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Charlotte L Edwardson
- Diabetes Research Centre, College of Life Sciences, University of Leicester and NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Tom Yates
- Diabetes Research Centre, College of Life Sciences, University of Leicester and NIHR Leicester Biomedical Research Centre, Leicester, UK
| | - Emma Frew
- Health Economics Unit, Institute for Applied Health Research, University of Birmingham, Birmingham, UK
| | - Sarah Tearne
- Birmingham Clinical Trials Unit, Institute for Applied Health Research, University of Birmingham, Birmingham, UK
| | - Kate Jolly
- Institute for Applied Health Research, University of Birmingham, Birmingham, UK
| |
Collapse
|
24
|
Stuart T, Yin X, Chen SJ, Farley M, McGuire DT, Reddy N, Thien R, DiMatteo S, Fumeaux C, Gutruf P. Context-aware electromagnetic design for continuously wearable biosymbiotic devices. Biosens Bioelectron 2023; 228:115218. [PMID: 36940633 DOI: 10.1016/j.bios.2023.115218] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 02/07/2023] [Accepted: 03/07/2023] [Indexed: 03/16/2023]
Abstract
Imperceptible wireless wearable devices are critical to advance digital medicine with the goal to capture clinical-grade biosignals continuously. Design of these systems is complex because of unique interdependent electromagnetic, mechanic and system level considerations that directly influence performance. Typically, approaches consider body location, related mechanical loads, and desired sensing capabilities, however, design for real world application context is not formulated. Wireless power casting eliminates user interaction and the need to recharge batteries, however, implementation is challenging because the use case influences performance. To facilitate a data-driven approach to design, we demonstrate a method for personalized, context-aware antenna, rectifier and wireless electronics design that considers human behavioral patterns and physiology to optimize electromagnetic and mechanical features for best performance across an average day of the target user group. Implementation of these methods result in devices that enable continuous recording of high-fidelity biosignals over weeks without the need for human interaction.
Collapse
Affiliation(s)
- Tucker Stuart
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, 85721, USA
| | - Xiaoyang Yin
- School of Electrical and Electronic Engineering, The University of Adelaide, Adelaide, SA, 5005, Australia
| | - Shengjian Jammy Chen
- School of Electrical and Electronic Engineering, The University of Adelaide, Adelaide, SA, 5005, Australia; College of Science and Engineering, Flinders University, Tonsley, SA, 5042, Australia
| | - Max Farley
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, 85721, USA
| | - Dylan Thomas McGuire
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, 85721, USA
| | - Nikhil Reddy
- Eller College of Management, University of Arizona, Tucson, AZ, 85721, USA
| | - Ryan Thien
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, 85721, USA
| | - Sam DiMatteo
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, 85721, USA
| | - Christophe Fumeaux
- School of Electrical and Electronic Engineering, The University of Adelaide, Adelaide, SA, 5005, Australia.
| | - Philipp Gutruf
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, 85721, USA; Department of Electrical and Computer Engineering, University of Arizona, Tucson, AZ, 85721, USA; Bio5 Institute, University of Arizona, Tucson, AZ, 85721, USA; Neuroscience GIDP, University of Arizona, Tucson, AZ, 85721, USA.
| |
Collapse
|
25
|
Keats MR, Yu X, Sweeney Magee M, Forbes CC, Grandy SA, Sweeney E, Dummer TJB. Use of Wearable Activity-Monitoring Technologies to Promote Physical Activity in Cancer Survivors: Challenges and Opportunities for Improved Cancer Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4784. [PMID: 36981693 PMCID: PMC10048707 DOI: 10.3390/ijerph20064784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/02/2023] [Accepted: 03/06/2023] [Indexed: 06/18/2023]
Abstract
The aim of this review was to explore the acceptability, opportunities, and challenges associated with wearable activity-monitoring technology to increase physical activity (PA) behavior in cancer survivors. A search of Medline, Embase, CINAHL, and SportDiscus was conducted from 1 January 2011 through 3 October 2022. The search was limited to English language, and peer-reviewed original research. Studies were included if they reported the use of an activity monitor in adults (+18 years) with a history of cancer with the intent to motivate PA behavior. Our search identified 1832 published articles, of which 28 met inclusion/exclusion criteria. Eighteen of these studies included post-treatment cancer survivors, eight were on active cancer treatment, and two were long-term cancer survivor studies. ActiGraph accelerometers were the primary technology used to monitor PA behaviors, with Fitbit as the most commonly utilized self-monitoring wearable technology. Overall, wearable activity monitors were found to be an acceptable and useful tool in improving self-awareness, motivating behavioral change, and increasing PA levels. Self-monitoring wearable activity devices have a positive impact on short-term PA behaviors in cancer survivors, but the increase in PA gradually attenuated through the maintenance phase. Further study is needed to evaluate and increase the sustainability of the use of wearable technologies to support PA in cancer survivors.
Collapse
Affiliation(s)
- Melanie R. Keats
- School of Health and Human Performance, Dalhousie University, Halifax, NS B3H 4R2, Canada
- Division of Medical Oncology, Department of Medicine, Dalhousie University & Nova Scotia Health, Halifax, NS B3H 4R2, Canada
- Beatrice Hunter Cancer Research Institute, Halifax, NS B3H 4R2, Canada
| | - Xing Yu
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Molly Sweeney Magee
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Cynthia C. Forbes
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull HU6 7RX, UK
| | - Scott A. Grandy
- School of Health and Human Performance, Dalhousie University, Halifax, NS B3H 4R2, Canada
- Division of Medical Oncology, Department of Medicine, Dalhousie University & Nova Scotia Health, Halifax, NS B3H 4R2, Canada
- Beatrice Hunter Cancer Research Institute, Halifax, NS B3H 4R2, Canada
- Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Ellen Sweeney
- Beatrice Hunter Cancer Research Institute, Halifax, NS B3H 4R2, Canada
- Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Trevor J. B. Dummer
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| |
Collapse
|
26
|
Zytnick D, Folta SC, Reid KF, Chomitz VR. Better Understanding Wearable Activity Monitor Use and Non-Use Among Older Adults: A Qualitative Study. J Appl Gerontol 2023; 42:447-455. [PMID: 36314597 DOI: 10.1177/07334648221137057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
We used qualitative methods to better understand wearable activity monitor (WAM) use and its relationship with physical activity (PA) among older adults. Four focus groups, stratified by current/past ("ever") WAM users and "never" WAM users, were conducted with 57 participants aged ≥60 years. Data were coded with deductive and inductive approaches. Among ever WAM users, those with low pre-WAM PA levels reported higher PA related to WAM use while those with high pre-WAM PA levels reported they used WAM for tracking and monitoring their activity. Ever WAM users were motivated to increase PA through rewards and social support. Many never WAM users reported that WAM was unnecessary. WAM may be helpful for some older adults to increase their PA, particularly those who are motivated by setting and achieving PA goals. The results could help develop strategies to overcome barriers to WAM adoption and promote WAM use among older adults.
Collapse
Affiliation(s)
- Deena Zytnick
- Department of Public Health and Community Medicine, School of Medicine, 1810Tufts University, Boston, MA, USA
| | - Sara C Folta
- Friedman School of Nutrition Science and Policy, 1810Tufts University, Boston, MA, USA
| | - Kieran F Reid
- Laboratory of Exercise Physiology and Physical Performance, Boston Claude D. Pepper Older Americans Independence Center for Function Promoting Therapies, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Virginia R Chomitz
- Department of Public Health and Community Medicine, School of Medicine, 1810Tufts University, Boston, MA, USA
| |
Collapse
|
27
|
Albuquerque DDS, Goulart FDM, Barros ADSX, Barros WGDS. Envelhecimento, Covid-19 e Saúde Digital: Reflexões sobre o Cenário Brasileiro. REVISTA PSICOLOGIA E SAÚDE 2023. [DOI: 10.20435/pssa.v14i3.1418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
O Brasil está entre os países que apresenta um dos mais expressivos índices de aumento da população idosa no mundo. Diante do cenário atual de pandemia, as discussões sobre a covid-19 parecem retomar e escancarar estigmas sociais associados à velhice. Nesse sentido, o objetivo deste artigo é propor uma discussão sobre o olhar da psicologia do envelhecimento e a pandemia do coronavírus, articulando com os avanços em termos de políticas públicas no contexto brasileiro e perspectivas futuras quanto à promoção de saúde para a população idosa. Para tanto, os tópicos apresentados se complementam de maneira a concluir que a estratégia de saúde digital tem buscado avançar, com o propósito de expandir a oferta e o acesso aos serviços de atenção. Logo, apresenta-se como uma alternativa para promover o envelhecimento ativo e reduzir as barreiras impostas à população idosa brasileira.
Collapse
|
28
|
Chen J, Li T, You H, Wang J, Peng X, Chen B. Behavioral Interpretation of Willingness to Use Wearable Health Devices in Community Residents: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3247. [PMID: 36833943 PMCID: PMC9960868 DOI: 10.3390/ijerph20043247] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/22/2023] [Accepted: 02/06/2023] [Indexed: 05/30/2023]
Abstract
Wearable health devices (WHDs) have become increasingly advantageous in long-term health monitoring and patient management. However, most people have not yet benefited from such innovative technologies, and the willingness to accept WHDs and their influencing factors are still unclear. Based on two behavioral theories: the theory of planned behavior (TPB) and the diffusion of innovation (DOI), this study aims to explore the influencing factors of willingness to use WHDs in community residents from the perspective of both internal and external factors. A convenience sample of 407 community residents were recruited from three randomly selected Community Health Service Centers (CHSCs) in Nanjing, China, and were investigated with a self-developed questionnaires. The mean score of willingness to use WHDs was 17.00 (range 5-25). In the dimensions of TPB, perceived behavioral control (β = 1.979, p < 0.001) was the strongest influencing factor. Subjective norms (β = 1.457, p < 0.001) and attitudes (β = 0.651, p = 0.016) were also positively associated with willingness. In innovation characteristics of DOI, compatibility (β = 0.889, p < 0.001) and observability (β = 0.576, p = 0.003) had positive association with the willingness to wear a WHD. This study supports the applicability of the two behavioral theories to interpret the willingness to use WHDs in Chinese community residents. Compared with the innovative features of WHDs, individual cognitive factors were more critical predictors of willingness to use.
Collapse
Affiliation(s)
- Jiaxin Chen
- School of Nursing, Nanjing Medical University, Nanjing 211166, China
| | - Ting Li
- Geriatric Hospital of Nanjing Medical University, Nanjing 210009, China
| | - Hua You
- School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Jingyu Wang
- School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Xueqing Peng
- Chengdu Center for Disease Control and Prevention, Chengdu 610041, China
| | - Baoyi Chen
- MaiGaoQiao Community Health Service Center, Nanjing 210028, China
| |
Collapse
|
29
|
Toh SFM, Gonzalez PC, Fong KNK. Usability of a wearable device for home-based upper limb telerehabilitation in persons with stroke: A mixed-methods study. Digit Health 2023; 9:20552076231153737. [PMID: 36776407 PMCID: PMC9909064 DOI: 10.1177/20552076231153737] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 01/10/2023] [Indexed: 02/10/2023] Open
Abstract
Background The use of wearable technology offers a promising home-based self-directed option for upper limb training. Although product usability is a crucial aspect of users' acceptance of a wearable device, usability studies in wearable devices are rare, with most studies focusing primarily on clinical validity. Objective This study aimed to explore the usability of a wristwatch device called "Smart reminder" for home-based upper limb telerehabilitation for persons with stroke. Methods Eleven stroke participants used the proposed wristwatch for at least two weeks and underwent a home-based telerehabilitation program. A mixed-methods design was used to explore the usability of the wristwatch. Quantitative data were collected through the System Usability Scale (SUS) questionnaire, and the participants' rate of therapy compliance (gathered from the device) was reported descriptively. In addition, qualitative data were collected through semi-structured interviews with the participants and were analyzed using thematic analysis. Results The results demonstrated that the usability of the proposed wristwatch and telerehabilitation system was rated highly by the participants, with a high SUS mean score of 84.3 (12.3) and high therapy compliance rate (mean = 91%). Qualitatively, all participants reported positive experiences with the wristwatch and indicated keenness to use it again. Participants reported physical improvements and felt motivated to exercise after using the wristwatch. They found the device easy and convenient and appreciated the remote monitoring function. Meanwhile, they highlighted critical considerations for the design of the device and program, including technical support, a wearable design of the device, graded exercise content according to ability, and flexibility in exercise schedules. Finally, they suggested that an interim review with the therapist on their progress might help them continue using the wristwatch. Conclusions This study's results supported the proposed wearable device's usability and showed strong acceptance by the participants for using it as a home-based upper limb telerehabilitation intervention.
Collapse
Affiliation(s)
- Sharon Fong Mei Toh
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR,Department of Rehabilitation, Yishun Community Hospital, National Healthcare Group, Singapore
| | - Pablo Cruz Gonzalez
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR
| | - Kenneth N K Fong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR,Kenneth N. K. Fong, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR.
| |
Collapse
|
30
|
Bösch VD, Warner LM, Nyman SR, Haftenberger J, Clarke K, Inauen J. What do older adults think about when formulating implementation intentions for physical activity? Evidence from a qualitative study. Br J Health Psychol 2023; 28:221-236. [PMID: 36000441 PMCID: PMC10087560 DOI: 10.1111/bjhp.12621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 08/10/2022] [Indexed: 01/10/2023]
Abstract
OBJECTIVES Physical activity is an important health behaviour especially for older adults. Forming implementation intentions is an effective strategy to implement physical activity in daily life for young and middle-aged adults. However, evidence for older adults is inconclusive. This study explored the thoughts of older adults about implementation intentions and potential barriers and facilitators while formulating them. METHODS Three samples of older adults from the United Kingdom (n = 8), Germany (n = 9) and Switzerland (n = 17) were prompted to think aloud while formulating implementation intentions to be more physically active. After the task, semi-structured interviews were conducted. Data were analysed thematically. RESULTS Participants expressed pre-established thoughts about implementation intentions (e.g. they feel too restrictive). During the formulation of implementation intentions, several barriers to creating them were reported (e.g. problems with finding cues due to absence of recurring daily routines), but participants also mentioned that forming implementation intentions acted as a facilitator for physical activity (e.g. cues as useful reminders to be active, task itself triggering self-reflection about physical activity). After the task, participants reflected on circumstances that decrease the likelihood of enacting implementation intentions (e.g. spontaneous alternative activities, weather, health-related barriers, Covid-19-related barriers), which triggered spontaneous coping planning. CONCLUSIONS The results on barriers and facilitators of implementation intentions and physical activity from older adults' perspectives provide starting points for improving instructions for older adults on how to create implementation intentions for physical activity. Future studies are needed to investigate whether the findings extend to implementation intentions for other behaviours.
Collapse
Affiliation(s)
- Valérie Désirée Bösch
- Department of Health Psychology and Behavioral Medicine, University of Bern, Bern, Switzerland
| | - Lisa Marie Warner
- Department of Psychology, MSB Medical School Berlin, Berlin, Germany
| | - Samuel R Nyman
- Bournemouth University Clinical Research Unit, Department of Medical Science & Public Health, Bournemouth University, Bournemouth, UK
| | | | - Kye Clarke
- Department of Psychology, Bournemouth University, Poole, UK
| | - Jennifer Inauen
- Department of Health Psychology and Behavioral Medicine, University of Bern, Bern, Switzerland
| |
Collapse
|
31
|
Mavragani A, Peels DA, Bolman CAW, de Bruijn GJ, Lechner L. Adding Mobile Elements to Online Physical Activity Interventions for Adults Aged Over 50 Years: Prototype Development Study. JMIR Form Res 2023; 7:e42394. [PMID: 36696157 PMCID: PMC9909523 DOI: 10.2196/42394] [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: 09/02/2022] [Revised: 12/14/2022] [Accepted: 12/22/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Only a minority of adults aged over 50 years meet physical activity (PA) guidelines of the World Health Organization (WHO). eHealth interventions are proven effective tools to help this population increase its PA levels in the short term, among which the Active Plus and I Move interventions have been developed by our own research group. To achieve long-term effects, increase intervention use, and decrease dropout rates, 3 emergent but different mobile elements (an activity tracker, an ecological momentary intervention [EMI] program, and a chatbot) were added separately to Active Plus and I Move. In this study, the prototype development and pilot-testing of these interventions is described. OBJECTIVE This study aims to enhance 2 existing PA-stimulating computer-based interventions with 3 mobile elements (an activity tracker, an EMI program, or a chatbot) and test the prototypes on usability and appreciation within a target population of adults aged over 50 years. METHODS A systematic design protocol consisting of development, evaluation, and adaptation procedures was followed with involvement of the target population. Literature searches separated per mobile element and interviews with the target population (N=11) led to 6 prototypes: Active Plus or I Move including (1) an activity tracker, (2) EMI, or (3) a chatbot. These prototypes were tested on usability and appreciation during pilot tests (N=47) and subsequently fine-tuned based on the results. RESULTS The literature searches and interviews provided important recommendations on the preferences of the target population, which enabled us to develop prototypes. The subsequent pilot tests showed that the mobile elements scored moderate to good on usability, with average System Usability Scale (SUS) scores of 52.2-82.2, and moderate to good on enjoyment and satisfaction, with average scores ranging from 5.1 to 8.1 on a scale of 1-10. The activity tracker received the best scores, followed by EMI, followed by the chatbot. Based on the findings, the activity tracker interventions were fine-tuned and technical difficulties regarding EMI and the chatbot were solved, which is expected to further improve usability and appreciation. CONCLUSIONS During this study, 6 prototypes of online PA interventions with added mobile elements were developed and tested for usability and appreciation. Although all prototypes scored moderate to high on usability, enjoyment, and satisfaction, it can be concluded that the integration of an activity tracker with a computer-based PA intervention is the most promising option among the 3 mobile elements tested during this study. The prototype development steps of the systematic design protocol followed can be considered useful and successful for the purposes of this study. The interventions can now be evaluated on a larger scale through a randomized controlled trial. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/31677.
Collapse
Affiliation(s)
| | - Denise A Peels
- Faculty of Psychology, Open Universiteit, Heerlen, Netherlands
| | | | - Gert-Jan de Bruijn
- Department of Communication Science, University of Antwerp, Antwerp, Belgium
| | - Lilian Lechner
- Faculty of Psychology, Open Universiteit, Heerlen, Netherlands
| |
Collapse
|
32
|
Sivakumar B, Lemonde M, Stein M, Mak S, Al-Hesayen A, Arcand J. Patient perspectives on the use of mobile apps to support heart failure management: A qualitative descriptive study. PLoS One 2023; 18:e0285659. [PMID: 37167283 PMCID: PMC10174481 DOI: 10.1371/journal.pone.0285659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 04/27/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND Adherence to diet and medical therapies are key to improving heart failure (HF) outcomes; however, nonadherence is common. While mobile apps may be a promising way to support patients with adherence via education and monitoring, HF patient perspectives regarding the use of apps for HF management in unknown. This data is critical for these tools to be successfully developed, implemented, and adopted to optimize adherence and improve HF outcomes. OBJECTIVE To determine patients' needs, motivations, and challenges on the use of mobile apps to support HF management. METHODS A qualitative descriptive study using focus groups (n = 4,60 minutes) was conducted among HF patients from outpatient HF clinics in Toronto, Canada. The Diffusion of Innovation theory informed a ten-question interview guide. Interview transcripts were independently coded by two researchers and analyzed using content analysis. RESULTS Nineteen HF patients (65 ± 10 yrs, 12 men) identified a total of four key themes related to the use of mobile apps. The theme 'Factors impacting technology use by patients' identified motivations and challenges to app use, including access to credible information, easy and accessible user-interface. Three themes described patients' needs on the use of mobile apps to support HF management: 1) 'Providing patient support through access to information and self-monitoring', apps could provide education on HF-related content (e.g., diet, medication, symptoms); 2) 'Facilitating connection and communication', through information sharing with healthcare providers and connecting with other patients; 3) 'Patient preferences', app features such as reminders for medication, and visuals to show changes in HF symptoms were favoured. CONCLUSIONS HF patients perceive several benefits and challenges to app use for HF self-management. Capitalizing on the benefits and addressing the challenges during the app development process may maximize adoption of such tools in this patient population.
Collapse
Affiliation(s)
- Bridve Sivakumar
- Ontario Tech University, Faculty of Health Science, Oshawa, Canada
| | - Manon Lemonde
- Ontario Tech University, Faculty of Health Science, Oshawa, Canada
| | - Matthew Stein
- Ontario Tech University, Social Research Centre, Oshawa, Canada
| | - Susanna Mak
- Division of Cardiology, Department of Medicine, University of Toronto, Toronto, Canada
- Department of Medicine, Sinai Health, Toronto, Canada
| | | | - JoAnne Arcand
- Ontario Tech University, Faculty of Health Science, Oshawa, Canada
| |
Collapse
|
33
|
Keogh A, Alcock L, Brown P, Buckley E, Brozgol M, Gazit E, Hansen C, Scott K, Schwickert L, Becker C, Hausdorff JM, Maetzler W, Rochester L, Sharrack B, Vogiatzis I, Yarnall A, Mazzà C, Caulfield B. Acceptability of wearable devices for measuring mobility remotely: Observations from the Mobilise-D technical validation study. Digit Health 2023; 9:20552076221150745. [PMID: 36756644 PMCID: PMC9900162 DOI: 10.1177/20552076221150745] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 12/26/2022] [Indexed: 02/05/2023] Open
Abstract
Background This study aimed to explore the acceptability of a wearable device for remotely measuring mobility in the Mobilise-D technical validation study (TVS), and to explore the acceptability of using digital tools to monitor health. Methods Participants (N = 106) in the TVS wore a waist-worn device (McRoberts Dynaport MM + ) for one week. Following this, acceptability of the device was measured using two questionnaires: The Comfort Rating Scale (CRS) and a previously validated questionnaire. A subset of participants (n = 36) also completed semi-structured interviews to further determine device acceptability and to explore their opinions of the use of digital tools to monitor their health. Questionnaire results were analysed descriptively and interviews using a content analysis. Results The device was considered both comfortable (median CRS (IQR; min-max) = 0.0 (0.0; 0-20) on a scale from 0-20 where lower scores signify better comfort) and acceptable (5.0 (0.5; 3.0-5.0) on a scale from 1-5 where higher scores signify better acceptability). Interviews showed it was easy to use, did not interfere with daily activities, and was comfortable. The following themes emerged from participants' as being important to digital technology: altered expectations for themselves, the use of technology, trust, and communication with healthcare professionals. Conclusions Digital tools may bridge existing communication gaps between patients and clinicians and participants are open to this. This work indicates that waist-worn devices are supported, but further work with patient advisors should be undertaken to understand some of the key issues highlighted. This will form part of the ongoing work of the Mobilise-D consortium.
Collapse
Affiliation(s)
- Alison Keogh
- Insight Centre for Data Analytics, O’Brien Science Centre,
University
College Dublin, Dublin, Ireland
- School of Public Health, Physiotherapy and Sports Science,
University
College Dublin, Dublin, Ireland
| | - Lisa Alcock
- Translational and Clinical Research Institute, Faculty of Medical
Sciences, Newcastle
University, Newcastle upon Tyne, UK
| | - Philip Brown
- Physiotherapy
Department, The Newcastle Upon Tyne Hospitals NHS Foundation
Trust, Newcastle Upon Tyne, UK
| | - Ellen Buckley
- INSIGNEO Institute for in silico Medicine,
The University
of Sheffield, Sheffield, UK
- Department of Mechanical Engineering,
The University
of Sheffield, Sheffield, UK
| | - Marina Brozgol
- Center for the Study of Movement, Cognition and Mobility,
Neurological Institute, Tel Aviv Sourasky Medical
Center, Tel Aviv, Israel
| | - Eran Gazit
- Center for the Study of Movement, Cognition and Mobility,
Neurological Institute, Tel Aviv Sourasky Medical
Center, Tel Aviv, Israel
| | - Clint Hansen
- Department of Neurology, University Medical Center Schleswig-Holstein
Campus Kiel, Kiel, Germany
| | - Kirsty Scott
- INSIGNEO Institute for in silico Medicine,
The University
of Sheffield, Sheffield, UK
- Department of Mechanical Engineering,
The University
of Sheffield, Sheffield, UK
| | - Lars Schwickert
- Gesellschaft für Medizinische Forschung,
Robert-Bosch
Foundation GmbH, Stuttgart, Germany
| | - Clemens Becker
- Gesellschaft für Medizinische Forschung,
Robert-Bosch
Foundation GmbH, Stuttgart, Germany
| | - Jeffrey M. Hausdorff
- Center for the Study of Movement, Cognition and Mobility,
Neurological Institute, Tel Aviv Sourasky Medical
Center, Tel Aviv, Israel
- Department of Physical Therapy, Sackler Faculty of Medicine &
Sagol School of Neuroscience, Tel Aviv
University, Tel Aviv, Israel
| | - Walter Maetzler
- Department of Neurology, University Medical Center Schleswig-Holstein
Campus Kiel, Kiel, Germany
| | - Lynn Rochester
- Translational and Clinical Research Institute, Faculty of Medical
Sciences, Newcastle
University, Newcastle upon Tyne, UK
- Physiotherapy
Department, The Newcastle Upon Tyne Hospitals NHS Foundation
Trust, Newcastle Upon Tyne, UK
| | - Basil Sharrack
- Department of Neuroscience and Sheffield NIHR Translational
Neuroscience BRC, Sheffield
Teaching Hospitals NHS Foundation Trust,
Sheffield, UK
| | - Ioannis Vogiatzis
- Department of Sport, Exercise and Rehabilitation,
Northumbria
University Newcastle, Newcastle upon Tyne,
UK
| | - Alison Yarnall
- Translational and Clinical Research Institute, Faculty of Medical
Sciences, Newcastle
University, Newcastle upon Tyne, UK
| | - Claudia Mazzà
- INSIGNEO Institute for in silico Medicine,
The University
of Sheffield, Sheffield, UK
- Department of Mechanical Engineering,
The University
of Sheffield, Sheffield, UK
| | - Brian Caulfield
- Insight Centre for Data Analytics, O’Brien Science Centre,
University
College Dublin, Dublin, Ireland
- School of Public Health, Physiotherapy and Sports Science,
University
College Dublin, Dublin, Ireland
| |
Collapse
|
34
|
Tuominen M, Koski P, Axelin A, Stenholm S, Leskinen T. Acceptable, useful, and ineffective? Recent retirees’ experiences of a 12-month activity tracker-based physical activity intervention. Digit Health 2023. [DOI: 10.1177/20552076221147419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Objective Activity trackers appear cost-effective and acceptable intervention tools for promoting physical activity among older adults, particularly in the short-term. However, long-term studies focused on participants’ experiences continue to be scarce. This study evaluated participants’ experiences of a 12-month activity tracker-driven physical activity intervention. Methods Participants’ experiences were assessed qualitatively using open-ended questionnaire items ( n = 113) and semi-structured interviews conducted after the 12-month intervention ( n = 27). Quantitative items assessed the perceived ease-of-use and usefulness of the activity tracker during the intervention. Qualitative data was analyzed using thematic analysis and Wilcoxon signed-rank tests were used to examine changes in the perceived ease-of-use and usefulness over time. Results The 113 participants completing the 12-month intervention were on average 65.2 ( SD 1.0) years old and 81.4% women with 92.3% providing activity tracker data on at least 2 weeks per each intervention month. In the qualitative analysis, four main themes with 20 subthemes were identified: (a) burdens of participation, (b) affective attitudes of using the activity tracker, (c) perceived effects of using the activity tracker, and (d) no perceived behavioral effects. At 12 months, the participants found activity trackers mainly easy to use (mean 4.6, SD 0.6), reliable (mean 3.6, SD 1.2), motivating (mean 3.9, SD 1.0), and helpful in reducing sitting (mean 3.7, SD 1.0) with no changes observed during the intervention. Conclusions The participants’ experiences were highly varied suggesting that tailored intervention designs are likely to be required for effectively using activity trackers to promote long-term changes in daily activity among older adults.
Collapse
Affiliation(s)
- Miika Tuominen
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Pasi Koski
- Department of Teacher Education, University of Turku, Turku, Finland
| | - Anna Axelin
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Sari Stenholm
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Tuija Leskinen
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| |
Collapse
|
35
|
French MA, Keatley E, Li J, Balasubramanian A, Hansel NN, Wise R, Searson P, Singh A, Raghavan P, Wegener S, Roemmich RT, Celnik P. The feasibility of remotely monitoring physical, cognitive, and psychosocial function in individuals with stroke or chronic obstructive pulmonary disease. Digit Health 2023; 9:20552076231176160. [PMID: 37214659 PMCID: PMC10192672 DOI: 10.1177/20552076231176160] [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: 10/14/2022] [Accepted: 04/28/2023] [Indexed: 05/24/2023] Open
Abstract
Objective Clinical implementation of remote monitoring of human function requires an understanding of its feasibility. We evaluated adherence and the resources required to monitor physical, cognitive, and psychosocial function in individuals with either chronic obstructive pulmonary disease or stroke during a three-month period. Methods Seventy-three individuals agreed to wear a Fitbit to monitor physical function and to complete monthly online assessments of cognitive and psychosocial function. During a three-month period, we measured adherence to monitoring (1) physical function using average daily wear time, and (2) cognition and psychosocial function using the percentage of assessments completed. We measured the resources needed to promote adherence as (1) the number of participants requiring at least one reminder to synchronize their Fitbit, and (2) the number of reminders needed for each completed cognitive and psychosocial assessment. Results After accounting for withdrawals, the average daily wear time was 77.5 ± 19.9% of the day and did not differ significantly between months 1, 2, and 3 (p = 0.30). To achieve this level of adherence, 64.9% of participants required at least one reminder to synchronize their device. Participants completed 61.0% of the cognitive and psychosocial assessments; the portion of assessments completed each month didnot significantly differ (p = 0.44). Participants required 1.13 ± 0.57 reminders for each completed assessment. Results did not differ by disease diagnosis. Conclusions Remote monitoring of human function in individuals with either chronic obstructive pulmonary disease or stroke is feasible as demonstrated by high adherence. However, the number of reminders required indicates that careful consideration must be given to the resources available to obtain high adherence.
Collapse
Affiliation(s)
- Margaret A French
- Department of Physical Medicine and
Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD,
USA
| | - Eva Keatley
- Department of Physical Medicine and
Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD,
USA
| | - Junyao Li
- Department of Physical Medicine and
Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD,
USA
| | - Aparna Balasubramanian
- Division of Pulmonary and Critical Care
Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Nadia N Hansel
- Division of Pulmonary and Critical Care
Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Robert Wise
- Division of Pulmonary and Critical Care
Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Peter Searson
- Department of Physical Medicine and
Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD,
USA
- Department of Materials Science and
Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Anil Singh
- Department of Pulmonary and Critical
Care Medicine, Allegheny Health Network, Pittsburg, PA, USA
| | - Preeti Raghavan
- Department of Physical Medicine and
Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD,
USA
| | - Stephen Wegener
- Department of Physical Medicine and
Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD,
USA
| | - Ryan T Roemmich
- Department of Physical Medicine and
Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD,
USA
- Kennedy Krieger Institute, Center for Movement Studies, Baltimore, MD, USA
| | - Pablo Celnik
- Department of Physical Medicine and
Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD,
USA
| |
Collapse
|
36
|
Chung J, Brakey HR, Reeder B, Myers O, Demiris G. Community-dwelling older adults' acceptance of smartwatches for health and location tracking. Int J Older People Nurs 2023; 18:e12490. [PMID: 35818900 PMCID: PMC10078487 DOI: 10.1111/opn.12490] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 06/23/2022] [Accepted: 06/27/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND Despite rapid growth in the popularity of smartwatches, evidence lacks regarding older adults' acceptance of smartwatches. Since most wearable sensors are not designed specifically for older adults, there is a need to examine wearability and usability challenges of wearable sensing devices faced by older adults to facilitate the use of objective measurements of health and mobility. OBJECTIVES We aimed to examine older adults' perceptions of GPS-enabled smartwatches and to identify potential barriers and facilitators of smartwatch and sensor data use. METHODS As part of a larger feasibility study, we conducted a mixed-methods study that included a descriptive content analysis of interviews and a brief usability survey with 30 participants aged 60 years and older after they had used a smartwatch for 3 days. RESULTS Most participants perceived wearable activity trackers including smartwatches and sensor-based data as useful for tracking health, finding activity patterns and promoting healthy behaviours. Privacy was of little concern, leading to willingness to share activity and location data with others. Participants identified barriers to usability as clumsy design, lack of aesthetic appeal, and difficulty reading the display and using the GPS tracking function. In contrast, identified facilitators of adoption included a big display, high-tech look, self-awareness and possible behaviour change. CONCLUSIONS Smartwatches have the potential of personalised detection of health deterioration and disability prevention, based on analysis of older adults' activities in free-living environments. The usefulness of this technology for older adults can be significantly increased by addressing usability issues and providing instructions on challenging features. IMPLICATIONS FOR PRACTICE To support sustained self-monitoring behaviours through wearable sensor devices in older adults, it is critical to examine how they perceive those devices and identify factors affecting technology acceptance that can maximise adoption.
Collapse
Affiliation(s)
- Jane Chung
- Virginia Commonwealth University School of Nursing, Richmond, Virginia, USA
| | - Heidi Rishel Brakey
- Clinical and Translational Science Center, University of New Mexico, Albuquerque, New Mexico, USA
| | - Blaine Reeder
- University of Missouri School of Nursing, Columbia, Missouri, USA.,University of Missouri Institute for Data Science & Informatics, Columbia, Missouri, USA
| | - Orrin Myers
- Department of Family and Community Medicine, School of Medicine, University of New Mexico, Albuquerque, New Mexico, USA
| | - George Demiris
- University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| |
Collapse
|
37
|
Hvalič-Touzery S, Šetinc M, Dolničar V. Benefits of a Wearable Activity Tracker with Safety Features for Older Adults: An Intervention Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15723. [PMID: 36497796 PMCID: PMC9737307 DOI: 10.3390/ijerph192315723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/18/2022] [Accepted: 11/23/2022] [Indexed: 06/17/2023]
Abstract
Accidental falls and physical inactivity are important age-related issues for which smart technologies have demonstrated potential utility. This research aimed to explore the benefits of combining wearable activity monitors and telecare for older adults. A four-month interventional study was conducted between June 2021 and February 2022 in Slovenia. A purposive sample of 22 dyads of older adults aged 60 years and over and their relatives or family members used a wearable GoLiveClip device. The Pillar Integration Process was used to analyze the quantitative and qualitative data. Seven pillars emerged: (1) the use of smart technologies as a motivator for physical activity; (2) factors related to smart technology use affecting physical activity levels; (3) increased usefulness of smart technologies for users who completed the study; (4) activity monitoring as the most useful functionality of the solution; (5) the influence of technical problems on usefulness; (6) the influence of age and previous experience with smart technologies on usefulness; and (7) moderate psychological effects of smart technology use. Activity trackers were found to effectively promote physical activity in older adults, and safety features were shown to be an important part of the solution, regardless of health status or physical activity level.
Collapse
|
38
|
Sivakumar B, Lemonde M, Stein M, Goldstein S, Mak S, Arcand J. Evaluating Health Care Provider Perspectives on the Use of Mobile Apps to Support Patients With Heart Failure Management: Qualitative Descriptive Study. JMIR Cardio 2022; 6:e40546. [PMID: 36287588 PMCID: PMC9647459 DOI: 10.2196/40546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 09/29/2022] [Accepted: 09/29/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Nonadherence to diet and medical therapies in heart failure (HF) contributes to poor HF outcomes. Mobile apps may be a promising way to improve adherence because they increase knowledge and behavior change via education and monitoring. Well-designed apps with input from health care providers (HCPs) can lead to successful adoption of such apps in practice. However, little is known about HCPs' perspectives on the use of mobile apps to support HF management. OBJECTIVE The aim of this study is to determine HCPs' perspectives (needs, motivations, and challenges) on the use of mobile apps to support patients with HF management. METHODS A qualitative descriptive study using one-on-one semistructured interviews, informed by the diffusion of innovation theory, was conducted among HF HCPs, including cardiologists, nurses, and nurse practitioners. Transcripts were independently coded by 2 researchers and analyzed using content analysis. RESULTS The 21 HCPs (cardiologists: n=8, 38%; nurses: n=6, 29%; and nurse practitioners: n=7, 33%) identified challenges and opportunities for app adoption across 5 themes: participant-perceived factors that affect app adoption-these include patient age, technology savviness, technology access, and ease of use; improved delivery of care-apps can support remote care; collect, share, and assess health information; identify adverse events; prevent hospitalizations; and limit clinic visits; facilitating patient engagement in care-apps can provide feedback and reinforcement, facilitate connection and communication between patients and their HCPs, support monitoring, and track self-care; providing patient support through education-apps can provide HF-related information (ie, diet and medications); and participant views on app features for their patients-HCPs felt that useful apps would have reminders and alarms and participative elements (gamification, food scanner, and quizzes). CONCLUSIONS HCPs had positive views on the use of mobile apps to support patients with HF management. These findings can inform effective development and implementation strategies of HF management apps in clinical practice.
Collapse
Affiliation(s)
- Bridve Sivakumar
- Faculty of Health Science, Ontario Tech University, Oshawa, ON, Canada
| | - Manon Lemonde
- Faculty of Health Science, Ontario Tech University, Oshawa, ON, Canada
| | - Matthew Stein
- Social Research Centre, Ontario Tech University, Oshawa, ON, Canada
| | - Sarah Goldstein
- School of Nutrition, Faculty of Community Services, Toronto Metropolitan University, Toronto, ON, Canada
| | - Susanna Mak
- Division of Cardiology, Department of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Medicine, Sinai Health, Toronto, ON, Canada
| | - JoAnne Arcand
- Faculty of Health Science, Ontario Tech University, Oshawa, ON, Canada
| |
Collapse
|
39
|
Mavragani A, Meshesha LZ, E Blevins C, Battle CL, Lindsay C, Marsh E, Feltus S, Buman M, Agu E, Stein M. A Smartphone Physical Activity App for Patients in Alcohol Treatment: Single-Arm Feasibility Trial. JMIR Form Res 2022; 6:e35926. [PMID: 36260381 PMCID: PMC9631169 DOI: 10.2196/35926] [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: 12/23/2021] [Revised: 06/20/2022] [Accepted: 06/21/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Alcohol use disorder (AUD) is a significant public health concern worldwide. Alcohol consumption is a leading cause of death in the United States and has a significant negative impact on individuals and society. Relapse following treatment is common, and adjunct intervention approaches to improve alcohol outcomes during early recovery continue to be critical. Interventions focused on increasing physical activity (PA) may improve AUD treatment outcomes. Given the ubiquity of smartphones and activity trackers, integrating this technology into a mobile app may be a feasible, acceptable, and scalable approach for increasing PA in individuals with AUD. OBJECTIVE This study aims to test the Fit&Sober app developed for patients with AUD. The goals of the app were to facilitate self-monitoring of PA engagement and daily mood and alcohol cravings, increase awareness of immediate benefits of PA on mood and cravings, encourage setting and adjusting PA goals, provide resources and increase knowledge for increasing PA, and serve as a resource for alcohol relapse prevention strategies. METHODS To preliminarily test the Fit&Sober app, we conducted an open pilot trial of patients with AUD in early recovery (N=22; 13/22, 59% women; mean age 43.6, SD 11.6 years). At the time of hospital admission, participants drank 72% of the days in the last 3 months, averaging 9 drinks per drinking day. The extent to which the Fit&Sober app was feasible and acceptable among patients with AUD during early recovery was examined. Changes in alcohol consumption, PA, anxiety, depression, alcohol craving, and quality of life were also examined after 12 weeks of app use. RESULTS Participants reported high levels of satisfaction with the Fit&Sober app. App metadata suggested that participants were still using the app approximately 2.5 days per week by the end of the intervention. Pre-post analyses revealed small-to-moderate effects on increase in PA, from a mean of 5784 (SD 2511) steps per day at baseline to 7236 (SD 3130) steps per day at 12 weeks (Cohen d=0.35). Moderate-to-large effects were observed for increases in percentage of abstinent days (Cohen d=2.17) and quality of life (Cohen d=0.58) as well as decreases in anxiety (Cohen d=-0.71) and depression symptoms (Cohen d=-0.58). CONCLUSIONS The Fit&Sober app is an acceptable and feasible approach for increasing PA in patients with AUD during early recovery. A future randomized controlled trial is necessary to determine the efficacy of the Fit&Sober app for long-term maintenance of PA, ancillary mental health, and alcohol outcomes. If the efficacy of the Fit&Sober app could be established, patients with AUD would have a valuable adjunct to traditional alcohol treatment that can be delivered in any setting and at any time, thereby improving the overall health and well-being of this population. TRIAL REGISTRATION ClinicalTrials.gov NCT02958280; https://www.clinicaltrials.gov/ct2/show/NCT02958280.
Collapse
Affiliation(s)
| | - Lidia Z Meshesha
- Department of Psychology, University of Central Florida, Orlando, FL, United States
| | - Claire E Blevins
- Butler Hospital, Providence, RI, United States.,Alpert Medical School of Brown University, Providence, RI, United States
| | - Cynthia L Battle
- Butler Hospital, Providence, RI, United States.,Alpert Medical School of Brown University, Providence, RI, United States
| | | | - Eliza Marsh
- Butler Hospital, Providence, RI, United States
| | - Sage Feltus
- Butler Hospital, Providence, RI, United States
| | - Matthew Buman
- Arizona State University, Tempe, AZ, United States.,Worcester Polytechnic Institute, Worcester, MA, United States
| | - Emmanuel Agu
- Worcester Polytechnic Institute, Worcester, MA, United States
| | | |
Collapse
|
40
|
Dobbie LJ, Tahrani A, Alam U, James J, Wilding J, Cuthbertson DJ. Exercise in Obesity-the Role of Technology in Health Services: Can This Approach Work? Curr Obes Rep 2022; 11:93-106. [PMID: 34791611 PMCID: PMC8597870 DOI: 10.1007/s13679-021-00461-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/02/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW Physical activity (PA) is an important strategy to prevent and treat obesity. Electronic health (eHealth) interventions, such as wearable activity monitors and smartphone apps, may promote adherence to regular PA and successful weight loss. This review highlights the evidence for eHealth interventions in promoting PA and reducing weight. RECENT FINDINGS Wearables can increase PA and are associated with moderate weight loss in middle/older-aged individuals, with less convincing effects long-term (> 1 year) and in younger people. Data for interventions such as mobile phone applications, SMS, and exergaming are less robust. Investigations of all eHealth interventions are often limited by complex, multi-modality study designs, involving concomitant dietary modification, making the independent contribution of each eHealth intervention on body weight challenging to assess. eHealth interventions may promote PA, thereby contributing to weight loss/weight maintenance; however, further evaluation is required for this approach to be adopted into routine clinical practice.
Collapse
Affiliation(s)
- Laurence J. Dobbie
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
- University Hospital Aintree, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Abd Tahrani
- Institute of Metabolism and Systems, School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UK
- Department of Diabetes and Endocrinology, Birmingham Heartlands Hospital, Birmingham, UK
| | - Uazman Alam
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
- University Hospital Aintree, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Jennifer James
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
- University Hospital Aintree, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - John Wilding
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
- University Hospital Aintree, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Daniel J. Cuthbertson
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
- University Hospital Aintree, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| |
Collapse
|
41
|
Prusynski RA, Kelly VE, Fogelberg DJ, Pradhan S. The association between sleep deficits and sedentary behavior in people with mild Parkinson disease. Disabil Rehabil 2022; 44:5585-5591. [PMID: 34218729 PMCID: PMC10659136 DOI: 10.1080/09638288.2021.1940320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 05/06/2021] [Accepted: 06/04/2021] [Indexed: 10/20/2022]
Abstract
Purpose: Sleep deficits are a common nonmotor symptom of Parkinson disease (PD). People with mild PD also achieve less physical activity (PA) than healthy older adults (HOA), but the relationship between sleep and PA in PD is unclear. This study examined associations between sleep and PA in participants with PD and HOA.Materials and Methods: Secondary analysis of a prospective observational study. Participants wore a commercially available activity monitor for two weeks. Wilcoxon Rank-Sum tests compared nighttime sleep, wakenings after sleep onset, number of wakenings, naps, step count, and PA intensity between PD and HOA groups. Age-adjusted regression models calculated associations between nighttime sleep and PA.Results: Per day, participants with PD slept 75 fewer minutes (p < 0.01), took 5,792 fewer steps (p < 0.001), achieved less PA at all intensities, and had 32% more sedentary time (p < 0.001) compared to HOA. Thirty minutes more sleep was associated with 26 fewer sedentary minutes for HOA (p = 0.01) and 25 fewer sedentary minutes for the PD group (p < 0.001).Conclusions: Sleep and PA are reduced in mild PD compared to HOA. Both groups demonstrated similar associations between reduced sleep and increased sedentary behavior. Results may encourage providers to screen for sleep deficits when promoting PA.IMPLICATIONS FOR REHABILITATIONThe use of a wrist-worn commercial activity and sleep monitor was well tolerated by both healthy older adults and people with mild Parkinson Disease in this study.People with mild Parkinson Disease slept less and were less active than a group of healthy older adults.Less sleep was associated with more sedentary behavior in both groups.The relationship between poor sleep and sedentary behavior in mild Parkinson Disease suggests that rehabilitation interventions may be optimized by targeting both physical activity and sleep deficits.
Collapse
Affiliation(s)
- Rachel A Prusynski
- Department of Rehabilitation Medicine, University of Washington, Washington, Seattle, WA, USA
| | - Valerie E Kelly
- Department of Rehabilitation Medicine, University of Washington, Washington, Seattle, WA, USA
| | - Donald J Fogelberg
- Department of Rehabilitation Medicine, University of Washington, Washington, Seattle, WA, USA
| | - Sujata Pradhan
- Department of Rehabilitation Medicine, University of Washington, Washington, Seattle, WA, USA
| |
Collapse
|
42
|
Rodríguez I, Cajamarca G, Herskovic V. When does self-report of pain occur?: A study of older adults. PeerJ 2022; 10:e13716. [PMID: 35873914 PMCID: PMC9306549 DOI: 10.7717/peerj.13716] [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: 02/10/2022] [Accepted: 06/21/2022] [Indexed: 01/17/2023] Open
Abstract
Technologies for self-care can drive participatory health and promote independence of older adults. One self-care activity is regularly measuring and registering personal health indicators (self-reporting). Older adults may benefit from this practice, as they are more likely to have chronic health issues and have specific self-monitoring needs. However, self-reporting technologies are usually not designed specifically for them. Pain is usually measured using patient reports compiled during medical appointments, although this process may be affected by memory bias and under reporting of fluctuating pain. To address these issues, we introduced a simple tangible interface to self-report pain levels and conducted a three-hour evaluation with 24 older adults. The goal of this study was to identify whether specific activities, activity levels or pain levels trigger older adults to self-report their pain level, besides to understand how older adults would use such a device. Within the limited time frame of the experiment, the majority of our participants chose to report pain when they felt it most, not reporting lower levels of pain. No evidence was found to suggest a relationship between the reporting of pain and the activity (or activity level). Several design insights intended to improve the design of technologies are provided.
Collapse
Affiliation(s)
- Iyubanit Rodríguez
- Department of Engineering, Universidad de Costa Rica, Alajuela, Alajuela, Costa Rica
| | - Gabriela Cajamarca
- Department of Computer Science, Pontificia Universidad Católica de Chile, Santiago, Región Metropolitana, Chile
| | - Valeria Herskovic
- Department of Computer Science, Pontificia Universidad Católica de Chile, Santiago, Región Metropolitana, Chile
| |
Collapse
|
43
|
Vasquez BA, Betriana F, Nemenzo E, Inabangan AK, Tanioka R, Garcia L, Juntasopeepun P, Tanioka T, Locsin RC. Effects of Healthcare Technologies on the Promotion of Physical Activities in Older Persons: A Systematic Review. Inform Health Soc Care 2022; 48:196-210. [PMID: 35699246 DOI: 10.1080/17538157.2022.2086874] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2022]
Abstract
This study aimed to explore the effects of health technologies on the promotion of health through physical activities of older persons. Following PRISMA guidelines, a systematic review of relevant articles published prior to 2020 was conducted from selected indices such as COCHRANE, PubMed, Science Direct, Proquest, including the use of hand search procedure. Twenty-seven articles were analyzed with significant findings influential to older people nursing: types of health technologies used for promoting physical activity; effects of technology use in promoting physical activity of older person care; and aspects that need to be considered in technology use among older persons. Characteristics of technologies were accuracy, usefulness, reliability, comfort, safety, and relevancy. Most technologies promoting physical activities for older people were wearable technologies that use artificial intelligence. Altogether, these technologies influenced overall healthcare behaviors of older persons. With healthcare technology efficiencies, proficiencies, and dependencies, technology-based healthcare have served older people well. Most technologies for older people care, such as wearables, reliably produce characteristics enhancing dependency and accuracy of bio-behavioral information influencing physical activities of older persons. Health technologies foster the values of physical activities among older persons thereby promoting healthy living.
Collapse
Affiliation(s)
- Brian A Vasquez
- Majmaah University, College of Applied Medical Sciences, Majmaah, Kingdom of Saudi Arabia
| | - Feni Betriana
- Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Endrex Nemenzo
- College of Nursing, Cebu Normal University, Cebu City, Philippines.,Minghsin University of Science and Technology, Hsinchu, Taiwan
| | | | - Ryuichi Tanioka
- Department of Rehabilitation, Hiroshima Cosmopolitan University, Hiroshima, Japan
| | - Laurence Garcia
- College of Nursing and Health Sciences, Cebu Normal University, Cebu City, Philippines
| | | | - Tetsuya Tanioka
- Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Rozzano C Locsin
- Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand.,Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan.,Florida Atlantic University, Boca Raton, Florida, USA
| |
Collapse
|
44
|
Rochmawati E, Kamilah F, Iskandar AC. Acceptance of e-health technology among older people: A qualitative study. Nurs Health Sci 2022; 24:437-446. [PMID: 35297152 DOI: 10.1111/nhs.12939] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 02/17/2022] [Accepted: 03/12/2022] [Indexed: 01/04/2023]
Abstract
E-health technology has been widely implemented in healthcare systems and has many benefits. However, available studies that focus on the acceptance and adoption of e-health technology, particularly among older people in primary care centers, are still limited. A qualitative approach was adopted in this study to explore the acceptability and adoption of health technology among older people who use primary health care. Semistructured interviews were conducted with 11 older people to gain in-depth insight into their perspectives on health technology. An inductive thematic analysis was conducted to gain insight from older people. Three main themes emerged: (1) "demand of care" refers a situation where participants realized that they had a health problem, sought ways to solve the health problem, and expected to be cared and monitored; (2) "resistance and openness" represent technology acceptance by older people; and (3) "preference for home health monitoring": We found older people preferred home health monitoring in terms of comfort and ease of use. The study has provided important new knowledge in relation to acceptance and preference for health technology that currently exists, particularly among older people in Indonesia.
Collapse
Affiliation(s)
- Erna Rochmawati
- School of Master in Nursing, Universitas of Muhammadiyah Yogyakarta, Bantul, Indonesia
| | - Farhah Kamilah
- School of Master in Nursing, Universitas of Muhammadiyah Yogyakarta, Bantul, Indonesia
| | - Ayuk Cucuk Iskandar
- School of Master in Nursing, Universitas of Muhammadiyah Yogyakarta, Bantul, Indonesia
| |
Collapse
|
45
|
Stuart T, Hanna J, Gutruf P. Wearable devices for continuous monitoring of biosignals: Challenges and opportunities. APL Bioeng 2022; 6:021502. [PMID: 35464617 PMCID: PMC9010050 DOI: 10.1063/5.0086935] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 03/29/2022] [Indexed: 12/17/2022] Open
Abstract
The ability for wearable devices to collect high-fidelity biosignals continuously over weeks and months at a time has become an increasingly sought-after characteristic to provide advanced diagnostic and therapeutic capabilities. Wearable devices for this purpose face a multitude of challenges such as formfactors with long-term user acceptance and power supplies that enable continuous operation without requiring extensive user interaction. This review summarizes design considerations associated with these attributes and summarizes recent advances toward continuous operation with high-fidelity biosignal recording abilities. The review also provides insight into systematic barriers for these device archetypes and outlines most promising technological approaches to expand capabilities. We conclude with a summary of current developments of hardware and approaches for embedded artificial intelligence in this wearable device class, which is pivotal for next generation autonomous diagnostic, therapeutic, and assistive health tools.
Collapse
Affiliation(s)
- Tucker Stuart
- Department of Biomedical Engineering, University of Arizona, Tucson, Arizona 85721, USA
| | - Jessica Hanna
- Department of Biomedical Engineering, University of Arizona, Tucson, Arizona 85721, USA
| | - Philipp Gutruf
- Department of Biomedical Engineering, University of Arizona, Tucson, Arizona 85721, USA
- Department of Electrical and Computer Engineering, University of Arizona, Tucson, Arizona 85721, USA
- Bio5 Institute, University of Arizona, Tucson, Arizona 85721, USA
- Neuroscience GIDP, University of Arizona, Tucson, Arizona 85721, USA
| |
Collapse
|
46
|
Chen P, Shen Y, Li Z, Sun X, Feng XL, Fisher EB. What Factors Predict the Adoption of Type 2 Diabetes Patients to Wearable Activity Trackers-Application of Diffusion of Innovation Theory. Front Public Health 2022; 9:773293. [PMID: 35047473 PMCID: PMC8761937 DOI: 10.3389/fpubh.2021.773293] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 11/12/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Globally, diabetes has brought an enormous burden to public health resources, and the situation of disease burden caused by diabetes in China is especially severe. China is currently facing the dual threat of aging and diabetes, and wearable activity trackers could promote elderly diabetic patients' physical activity levels and help them to manage blood glucose control. Therefore, examining the influencing factors of elderly patients' adoption intention is critical as wearing adoption determines actual wearing behaviors. Objective: This study aims to explore the predicting factors of Chinese elderly type 2 diabetic patients' adoption intention to wearable activity trackers and their actual wearing behavior, using diffusion of innovation theory as the theoretical framework. We hope to provide insights into future interventions using wearable activity trackers as tools to improve the outcome of patients. Methods: Wearable activity trackers were freely distributed to type 2 diabetic patients in Beijing, China. A questionnaire survey was conducted to examine predicting factors of adoption intention after a week's try-on. Actual wearing behavior for 3-month was obtained from the exclusive cloud. Data were analyzed with structural equation modeling. Results: A total of 725 patients completed the questionnaire. Patients had a mean age of 60.3 ± 7.6 years old and the educational level was generally lower. The results indicated that observability was the primary influencing factor of patients' adoption intention (β = 0.775, P < 0.001). Relative advantage (β = 0.182, P = 0.014) and perceived social image (β = 0.080, P = 0.039) also had a positive influence while perceived risk (β = -0.148, P < 0.001) exerted a negative influence. In addition, results showed that the more intention led to the better actual wearing behavior (β = 0.127, P = 0.003). Observability (β = 0.103, P = 0.005), perceived ease (β = 0.085, P = 0.004), and relative advantage (β = 0.041, P = 0.009) also indirectly influenced the wearing behavior. Conclusion: The intentions of Chinese elderly type 2 diabetic patients to wearable activity trackers directly influenced the actual wearing behavior. In addition, their adoption intention to wearable activity trackers was mainly influenced by observability, perceived ease to use, relative advantage, perceived risk, and social image.
Collapse
Affiliation(s)
- Ping Chen
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Ying Shen
- Global Health Office, Beijing Center for Disease Prevention and Control, Beijing, China
| | - Zeming Li
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Xinying Sun
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Xing Lin Feng
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
| | - Edwin B Fisher
- Department of Health Behavior Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| |
Collapse
|
47
|
Robertson MC, Swartz MC, Christopherson U, Bentley JR, Basen-Engquist KM, Thompson D, Volpi E, Lyons EJ. A Photography-based, Social Media Walking Intervention Targeting Autonomous Motivations for Physical Activity: Semistructured Interviews With Older Women. JMIR Serious Games 2022; 10:e35511. [PMID: 35436205 PMCID: PMC9052025 DOI: 10.2196/35511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 02/03/2022] [Accepted: 02/17/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Older adult women are at risk for negative health outcomes that engaging in sustained physical activity can help prevent. However, promoting long-term maintenance of physical activity in this population has proven to be a challenge. Increasing autonomous motivations (ie, intrinsic, integrated, and identified regulations) for physical activity may facilitate enduring behavior change. Digitally delivered games for health that take a celebratory technology approach, that is, using technology to create new ways to experience valued behaviors and express valued beliefs, may be a useful way to target autonomous motivations for physical activity. Formative research with the target population is needed to design compelling intervention content. OBJECTIVE The objective of this study is to investigate older adult women's reactions to and thoughts about a photography-based, social media walking game targeting autonomous motivations for physical activity. METHODS During an individual semistructured interview, a moderator solicited feedback from 20 older adult women (age range 65-74 years) as part of formative research to develop a social media game featuring weekly walking challenges. The challenges were designed to target autonomous motivations for physical activity. Interviews were audio-recorded and transcribed verbatim. Two reviewers conducted thematic content analysis on interview transcripts. RESULTS We identified 3 overarching themes in qualitative data analysis. These reflected the playful experiences, value, and acceptability associated with the intervention challenges. Generally, participants understood what the challenges were asking them to do, proffered appropriate example responses, and indicated that the challenges would be enjoyable. Participants reported that the intervention content afforded many and varied playful experiences (eg, competition, discovery, exploration, expression, fellowship, humor, nurture, sensation). Further, participants indicated that the intervention increased their motivation for physical activity, occasioned meaningful shifts in perspective, increased their knowledge of various topics of interest, provided an opportunity to create valued connection with others, and provided health-related benefits. Participants suggested the intervention emphasize local history, nature, and cultural events. CONCLUSIONS The photography-based, social media walking game with relatively simple game mechanics was well received and judged to be apt to bring about a wide variety of emotive experiences. A clear, geographically specific identity emerged as a key driver of interest for intervention content. Taking a celebratory technology approach holds promise for targeting autonomous motivations for physical activity in older adult women.
Collapse
Affiliation(s)
- Michael C Robertson
- Department of Nutrition, Metabolism & Rehabilitation Sciences, School of Health Professions, University of Texas Medical Branch at Galveston, Galveston, TX, United States
| | - Maria Chang Swartz
- Department of Pediatrics-Research, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Ursela Christopherson
- Department of Nutrition, Metabolism & Rehabilitation Sciences, School of Health Professions, University of Texas Medical Branch at Galveston, Galveston, TX, United States
| | - Jason R Bentley
- Department of Nutrition, Metabolism & Rehabilitation Sciences, School of Health Professions, University of Texas Medical Branch at Galveston, Galveston, TX, United States
- Department of Clinical Health and Applied Sciences, University of Houston - Clear Lake, Houston, TX, United States
| | - Karen M Basen-Engquist
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Debbe Thompson
- US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, United States
| | - Elena Volpi
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, United States
| | - Elizabeth J Lyons
- Department of Nutrition, Metabolism & Rehabilitation Sciences, School of Health Professions, University of Texas Medical Branch at Galveston, Galveston, TX, United States
| |
Collapse
|
48
|
mHealth-Supported Interventions With Potential to Address Sedentary Behavior in Older Adults: A Scoping Review. J Aging Phys Act 2022; 30:1085-1100. [PMID: 35354668 DOI: 10.1123/japa.2021-0338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 01/31/2022] [Accepted: 02/21/2022] [Indexed: 11/18/2022]
Abstract
Sedentary behavior (SB) is an independent risk for negative health outcomes in older adults. Mobile health (mHealth) technology has potential to address SB in this population. This scoping review aimed to describe, synthesize, and identify gaps in literature on mHealth-supported interventions with potential to reduce sedentariness in older people. Following an iterative search of five major databases, 13 studies were included in the final review. Only three papers described SB-related factors as the primary target of intervention. mHealth-Driven components were frequently paired with nonmobile approaches and aided self-regulation of physical activity as opposed to SB. Most SB-related outcomes were not statistically significant or were inconclusive. This scoping review revealed a paucity of research applying mHealth-supported approaches to directly overcome sedentariness in older people. Protocol studies included in the review provide evidence that efforts to address this research gap continue to be made, but the need for additional high-quality research remains.
Collapse
|
49
|
Zhang Z, Giordani B, Margulis A, Chen W. Efficacy and acceptability of using wearable activity trackers in older adults living in retirement communities: a mixed method study. BMC Geriatr 2022; 22:231. [PMID: 35313819 PMCID: PMC8935620 DOI: 10.1186/s12877-022-02931-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 03/07/2022] [Indexed: 01/01/2023] Open
Abstract
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/day (p < 0.001). The Acceptance questionnaire revealed that the wearable activity tracker was acceptable, useful, and easy to use. Participants found that wearable activity trackers helped improve self-awareness and motivation of PA but reported a few concerns regarding the comfort of wearing the activity trackers and the ease of reading visual feedback. CONCLUSIONS Wearable activity trackers lead to a small but significant increase of PA and are perceived as acceptable and useful in older adults. Given the rapidly growing older population, wearable activity trackers are promising tools that could be used in large-scale interventions to improve PA and health in older adults. TRIAL REGISTRATION Registered on Clinicaltrials.gov # NCT05233813 (Registered on 10/02/2022).
Collapse
Affiliation(s)
- Zhanjia Zhang
- Department of Physical Education, Peking University, Beijing, 100871, China.,School of Kinesiology, University of Michigan, 1402 Washington Heights, 3145 OBL, Ann Arbor, MI, 48109, USA
| | - Bruno Giordani
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Alayna Margulis
- School of Kinesiology, University of Michigan, 1402 Washington Heights, 3145 OBL, Ann Arbor, MI, 48109, USA
| | - Weiyun Chen
- School of Kinesiology, University of Michigan, 1402 Washington Heights, 3145 OBL, Ann Arbor, MI, 48109, USA.
| |
Collapse
|
50
|
Creaser AV, Hall J, Costa S, Bingham DD, Clemes SA. Exploring Families' Acceptance of Wearable Activity Trackers: A Mixed-Methods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063472. [PMID: 35329166 PMCID: PMC8950917 DOI: 10.3390/ijerph19063472] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/02/2022] [Accepted: 03/12/2022] [Indexed: 12/30/2022]
Abstract
Background: The family environment plays a crucial role in child physical activity (PA). Wearable activity trackers (wearables) show potential for increasing children’s PA; however, few studies have explored families’ acceptance of wearables. This study investigated the acceptability of using wearables in a family setting, aligning experiences with components of the Technology Acceptance Model and Theoretical Domains Framework. Methods: Twenty-four families, with children aged 5–9 years, took part in a 5-week study, where all members were provided with a Fitbit Alta HR for 4 weeks. Acceptability was measured using weekly surveys and pre-post-questionnaires. Nineteen families participated in a focus group. Quantitative and qualitative data were integrated using the Pillar Integration Process technique. Results: Pillars reflected (1) external variables impacting wearable use and PA and (2) wearable use, (3) ease of use, (4) usefulness for increasing PA and other health outcomes, (5) attitudes, and (6) intention to use a wearable, including future intervention suggestions. Conclusions: Families found the Fitbit easy to use and acceptable, but use varied, and perceived impact on PA were mixed, with external variables contributing towards this. This study provides insights into how wearables may be integrated into family-based PA interventions and highlights barriers and facilitators of family wearable use.
Collapse
Affiliation(s)
- Amy V. Creaser
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK; (A.V.C.); (S.C.)
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford BD9 6RJ, UK; (J.H.); (D.D.B.)
| | - Jennifer Hall
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford BD9 6RJ, UK; (J.H.); (D.D.B.)
| | - Silvia Costa
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK; (A.V.C.); (S.C.)
| | - Daniel D. Bingham
- Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford BD9 6RJ, UK; (J.H.); (D.D.B.)
| | - Stacy A. Clemes
- School of Sport, Exercise, and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK; (A.V.C.); (S.C.)
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust, University of Leicester, Leicester LE5 4PW, UK
- Correspondence:
| |
Collapse
|