Effects of an Activity Tracker and App Intervention to Increase Physical Activity in Whole Families—The Step It Up Family Feasibility Study

(1) Background: Interventions using activity trackers and smartphone apps have demonstrated their ability to increase physical activity in children and adults. However, they have not been tested in whole families. Further, few family-centered interventions have actively involved both parents and assessed physical activity effects separately for children, mothers and fathers. Objective: To examine the feasibility and short-term effects of an activity tracker and app intervention to increase physical activity in the whole family (children, mothers and fathers). (2) Methods: This was a single-arm feasibility study with pre-post intervention measures. Between 2017–2018, 40 families (58 children aged 6–10 years, 39 mothers, 33 fathers) participated in the 6-week Step it Up Family program in Queensland, Australia. Using commercial activity trackers combined with apps (Garmin Vivofit Jr for children, Vivofit 3 for adults; Garmin Australasia Pty Ltd., Sydney, Australia), the intervention included individual and family-level goal-setting, self-monitoring, performance feedback, family step challenges, family social support and modelling, weekly motivational text messages and an introductory session. Parent surveys were used to assess physical activity effects measured as pre-post intervention changes in moderate-to-vigorous physical activity (MVPA) in children, mothers and fathers. Objective Garmin activity tracker data was recorded to assess physical activity levels (steps, active minutes) during the intervention. (3) Results: Thirty-eight families completed the post intervention survey (95% retention). At post intervention, MVPA had increased in children by 58 min/day (boys: 54 min/day, girls: 62 min/day; all p < 0.001). In mothers, MVPA increased by 27 min/day (p < 0.001) and in fathers, it increased by 31 min/day (p < 0.001). The percentage of children meeting Australia’s physical activity guidelines for children (≥60 MVPA min/day) increased from 34% to 89% (p < 0.001). The percentage of mothers and fathers meeting Australia’s physical activity guidelines for adults (≥150 MVPA min/week) increased from 8% to 57% (p < 0.001) in mothers and from 21% to 68% (p < 0.001) in fathers. The percentage of families with ‘at least one child and both parents’ meeting the physical activity guidelines increased from 0% to 41% (p < 0.001). Objective activity tracker data recorded during the intervention showed that the mean (SD) number of active minutes per day in children was 82.1 (17.1). Further, the mean (SD) steps per day was 9590.7 (2425.3) in children, 7397.5 (1954.2) in mothers and 8161.7 (3370.3) in fathers. (4) Conclusions: Acknowledging the uncontrolled study design, the large pre-post changes in MVPA and rather high step counts recorded during the intervention suggest that an activity tracker and app intervention can increase physical activity in whole families. The Step it Up Family program warrants further efficacy testing in a larger, randomized controlled trial.

Download Full-text

Efficacy of an activity tracker-and app intervention to increase physical activity in the entire family: Pilot single-arm intervention study (Preprint)

10.2196/preprints.17410 ◽

2019 ◽

Author(s):

Stephanie Schoeppe ◽

Jo Salmon ◽

Susan L. Williams ◽

Deborah Power ◽

Stephanie Alley ◽

...

Keyword(s):

Physical Activity ◽

Intervention Study ◽

Post Intervention ◽

Entire Family ◽

Physical Activity Guidelines ◽

Mothers And Fathers ◽

Activity Tracker ◽

Activity Trackers ◽

Family Program ◽

Intervention Efficacy

BACKGROUND Interventions using activity trackers and smartphone apps have demonstrated their ability to increase physical activity in children and adults. However, they have not been tested in entire families. Further, few family-centred interventions have actively involved both parents, and assessed intervention efficacy separately for children, mothers and fathers. OBJECTIVE This study aimed to examine the short-term efficacy of an activity tracker and app intervention to increase physical activity in the entire family (children, mothers and fathers). METHODS This was a pilot single-arm intervention study with pre-post measures. Between 2017-2018, 40 families (58 children aged 6-10 years, 39 mothers, 33 fathers) participated in the 6-week Step it Up Family program in Queensland, Australia. Using commercial activity trackers combined with apps (Garmin Vivofit Jr for children, Vivofit 3 for adults), the intervention included individual and family-level goal-setting, self-monitoring, performance feedback, family step challenges, family social support and modelling, weekly motivational text messages, and an introductory session delivered face-to-face or via telephone. Parent surveys were used to assess intervention efficacy measured as pre-post intervention changes in moderate-to-vigorous physical activity (MVPA) in children, mothers and fathers. RESULTS Thirty-eight families completed the post intervention survey (95% retention). At post intervention, MVPA had increased in children by 58 min/day (boys: 54 min/day, girls: 62 min/day; all P < .001). In mothers, MVPA increased by 27 min/day (P < .001), and in fathers, it increased by 31 min/day (P < .001). Furthermore, the percentage of children meeting Australia’s physical activity guidelines for children (≥60 MVPA min/day) increased from 34% to 89% (P < .001). The percentage of mothers and fathers meeting Australia’s physical activity guidelines for adults (≥150 MVPA min/week) increased from 8% to 57% (P < .001) in mothers, and from 21% to 68% (P < .001) in fathers. CONCLUSIONS Findings suggest that an activity tracker and app intervention is an efficacious approach to increasing physical activity in entire families to meet national physical activity guidelines. The Step it Up Family program warrants further testing in a larger, randomised controlled trial to determine its long-term impact. CLINICALTRIAL No trial registration as this is not an RCT. It is a pilot single-arm intervention study

Download Full-text

Group Outdoor Health Walks Using Activity Trackers: Measurement and Implementation Insight from a Mixed Methods Feasibility Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17072515 ◽

2020 ◽

Vol 17 (7) ◽

pp. 2515 ◽

Cited By ~ 1

Author(s):

Katherine N. Irvine ◽

Melissa R. Marselle ◽

Alan Melrose ◽

Sara L. Warber

Keyword(s):

Physical Activity ◽

Mixed Methods ◽

Feasibility Study ◽

Large Scale ◽

Holistic Health ◽

Physical Activity Guidelines ◽

Health And Wellbeing ◽

Activity Trackers ◽

Outdoor Walking ◽

Programme Delivery

Outdoor walking groups are nature-based interventions (NBIs) that promote health and wellbeing by modifying individual behaviour. The challenges of such NBIs include the motivation of inactive adults to participate and measurement issues. This feasibility study investigates a 12-week group outdoor health walk (GOHW) incorporating activity trackers and use of a holistic health and wellbeing measure, the Self-sasessment of Change (SAC) scale. A mixed methods design explored participant recruitment and retention, programme delivery, and measures of physical activity and health and wellbeing. Walker data included: pre-post questionnaires, daily step counts, and interviews. Programme delivery information included: weekly checklists, staff reflections, stakeholder meeting minutes, and a report. Thirteen adults (age 63–81, 76% female) joined and completed the activity tracker GOHW. Activity trackers motivated walkers to join and be more active but complicated programme delivery. Activity trackers allowed the quantification of physical activity and the SAC health and wellbeing measure was easy to use. By week 12, all participants met national physical activity guidelines. Clinically relevant changes on the SAC scale included: sleeping well, experiencing vibrant senses, and feeling energised, focused, joyful, calm and whole. Results illustrate the feasibility of using activity trackers to motivate engagement in and provide a measure of physical activity from GOHWs. The SAC scale offers a promising measure for nature–health research. A conceptual model is provided for the development of future large-scale studies of NBIs, such as group outdoor health walks.

Download Full-text

Neural Network–Based Algorithm for Adjusting Activity Targets to Sustain Exercise Engagement Among People Using Activity Trackers: Retrospective Observation and Algorithm Development Study

JMIR mhealth and uhealth ◽

10.2196/18142 ◽

2020 ◽

Vol 8 (9) ◽

pp. e18142

Author(s):

Ramin Mohammadi ◽

Mursal Atif ◽

Amanda Jayne Centi ◽

Stephen Agboola ◽

Kamal Jethwani ◽

...

Keyword(s):

Neural Network ◽

Physical Activity ◽

Machine Learning ◽

Learning Model ◽

Step Count ◽

Daily Step ◽

Activity Tracker ◽

Activity Trackers ◽

Machine Learning Model ◽

Daily Step Count

Background It is well established that lack of physical activity is detrimental to the overall health of an individual. Modern-day activity trackers enable individuals to monitor their daily activities to meet and maintain targets. This is expected to promote activity encouraging behavior, but the benefits of activity trackers attenuate over time due to waning adherence. One of the key approaches to improving adherence to goals is to motivate individuals to improve on their historic performance metrics. Objective The aim of this work was to build a machine learning model to predict an achievable weekly activity target by considering (1) patterns in the user’s activity tracker data in the previous week and (2) behavior and environment characteristics. By setting realistic goals, ones that are neither too easy nor too difficult to achieve, activity tracker users can be encouraged to continue to meet these goals, and at the same time, to find utility in their activity tracker. Methods We built a neural network model that prescribes a weekly activity target for an individual that can be realistically achieved. The inputs to the model were user-specific personal, social, and environmental factors, daily step count from the previous 7 days, and an entropy measure that characterized the pattern of daily step count. Data for training and evaluating the machine learning model were collected over a duration of 9 weeks. Results Of 30 individuals who were enrolled, data from 20 participants were used. The model predicted target daily count with a mean absolute error of 1545 (95% CI 1383-1706) steps for an 8-week period. Conclusions Artificial intelligence applied to physical activity data combined with behavioral data can be used to set personalized goals in accordance with the individual’s level of activity and thereby improve adherence to a fitness tracker; this could be used to increase engagement with activity trackers. A follow-up prospective study is ongoing to determine the performance of the engagement algorithm.

Download Full-text

Public Posting as a Strategy to Increase Walking

Californian Journal of Health Promotion ◽

10.32398/cjhp.v2i4.897 ◽

2004 ◽

Vol 2 (4) ◽

pp. 65-71

Author(s):

Rayleen Earney ◽

Timothy J. Bungum

Keyword(s):

Physical Activity ◽

Intervention Period ◽

Post Intervention ◽

Activity Data ◽

Walking Behavior ◽

Physical Activity Guidelines ◽

Innovative Strategies ◽

The Public ◽

Public Posting ◽

Recommended Physical Activity

Because most American adults do not meet recommended physical activity guidelines, the need for new and innovative strategies is apparent. The current study employed public posting in an attempt to increase walking behavior in a worksite setting. Pedometer generated data was publicly posted in a prominent location in the worksite. In our study that utilized a pre-experimental design, we found that walking steps were statistically higher during the intervention and in a post intervention period as compared to the baseline data. We conclude that the public posting of physical activity data has the potential to increase walking behavior.

Download Full-text

Effect of interventions using physical activity trackers on physical activity in people aged 60 years and over: a systematic review and meta-analysis

British Journal of Sports Medicine ◽

10.1136/bjsports-2018-100324 ◽

2019 ◽

Vol 54 (20) ◽

pp. 1188-1194 ◽

Cited By ~ 5

Author(s):

Juliana S Oliveira ◽

Cathie Sherrington ◽

Elizabeth R Y Zheng ◽

Marcia Rodrigues Franco ◽

Anne Tiedemann

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Physical Activity ◽

Systematic Review ◽

Older People ◽

Activity Levels ◽

Activity Tracker ◽

Activity Trackers ◽

The Impact

BackgroundOlder people are at high risk of physical inactivity. Activity trackers can facilitate physical activity. We aimed to investigate the effect of interventions using activity trackers on physical activity, mobility, quality of life and mental health among people aged 60+ years.MethodsFor this systematic review, we searched eight databases, including MEDLINE, Embase and CENTRAL from inception to April 2018. Randomised controlled trials of interventions that used activity trackers to promote physical activity among people aged 60+ years were included in the analyses. The study protocol was registered with PROSPERO, number CRD42017065250.ResultsWe identified 23 eligible trials. Interventions using activity trackers had a moderate effect on physical activity (23 studies; standardised mean difference (SMD)=0.55; 95% CI 0.40 to 0.70; I2=86%) and increased steps/day by 1558 (95% CI 1099 to 2018 steps/day; I2=92%) compared with usual care, no intervention and wait-list control. Longer duration activity tracker-based interventions were more effective than short duration interventions (18 studies, SMD=0.70; 95% CI 0.47 to 0.93 vs 5 studies, SMD=0.14; 95% CI −0.26 to 0.54, p for comparison=0.02). Interventions that used activity trackers improved mobility (three studies; SMD=0.61; 95% CI 0.31 to 0.90; I2=10%), but not quality of life (nine studies; SMD=0.09; 95% CI −0.07 to 0.25; I2=45%). Only one trial included mental health outcomes and it reported similar effects of the activity tracker intervention compared with control.ConclusionsInterventions using activity trackers improve physical activity levels and mobility among older people compared with control. However, the impact of activity tracker interventions on quality of life, and mental health is unknown.

Download Full-text

P59 Monitoring the recovery time of children after elective tonsillectomies using commercial activity trackers, an prospective feasibility study

Archives of Disease in Childhood ◽

10.1136/archdischild-2019-esdppp.97 ◽

2019 ◽

Vol 104 (6) ◽

pp. e41.2-e42

Author(s):

PIP Lambrechtse ◽

VC Ziesenitz ◽

A Atkinson ◽

EJ Bos ◽

T Welzel ◽

...

Keyword(s):

Physical Activity ◽

Feasibility Study ◽

Recovery Time ◽

List Type ◽

Age Group ◽

Validity And Reliability ◽

Open Label ◽

Activity Data ◽

Activity Trackers ◽

Wearable Activity Trackers

IntroductionWearable activity trackers are increasingly incorporated into daily life and are advancing in their technology in means of accuracy, validity and acceptability,1-6 however there is deficient knowledge on using these devices in a paediatric setting. The objective of this pilot study was to assess the feasibility of physical activity tracking in children7 before and after a standardized surgical intervention and to assess the recovery time after surgery.MethodsThis was a single centre, open-label, prospective feasibility study. We aimed at recruiting 24 children and adolescents 4–16 years of age undergoing elective tonsillectomy. The preoperative period was 10 days before surgery and the postoperative period was 28 days. Activity data were gathered with activity trackers.8 Reference activity was defined as the individual mean of daily steps preoperatively. Recovery time was defined as the number of days that the patient needed to reach reference activity postoperatively. The population was stratified according to age (4–7, 8–16 years).ResultsTwelve male and twelve female patients participated (mean age 6yr, mean BMI percentile 44.7). The age group 4–7 years had a mean recovery time of 11.2 days (SD 5.0) compared to 8.3 days (SD 1.7) in the age group 8–16. The difference was 2.9 days. The tracker datasets were 58% complete. The rate of technical failures of the trackers was 29.2% for the total study period.ConclusionsActivity trackers are a potential tool viable to assess recovery time after surgery in children. Recovery time after tonsillectomy seems to be age-dependent with older children recovering faster. For future studies, we recommend using trackers as a part of assessing physical activity as a parameter of general wellbeing of child during or after an intervention. Using wearable activity trackers is a more modern and appropriate method to assess physical activity,9-14 especially in a paediatric population.ReferencesBrooke SM, An HS, Kang SK, Noble JM, Berg KE, Lee JM. Concurrent validity of wearable activity trackers under free-living conditions. J Strength Cond Res 2017;31(4).Fokkema T, Kooiman TJM, Krijnen WP, Van Der Schans CP, De Groot M. Reliability and validity of ten consumer activity trackers depend on walking speed. Med Sci Sports Exerc. 2017;49(4).Evenson KR, Goto MM, Furberg RD. Systematic review of the validity and reliability of consumer-wearable activity trackers. Vol. 12, International Journal of Behavioral Nutrition and Physical Activity 2015.Huang Y, Xu J, Yu B, Shull PB. Validity of FitBit, Jawbone UP, Nike+ and other wearable devices for level and stair walking. Gait Posture 2016;Hein IM, Troost PW, De Vries MC, Knibbe CAJ, Van Goudoever JB, Lindauer RJL. Why do children decide not to participate in clinical research: A quantitative and qualitative study. Pediatr Res 2015;Van Berge Henegouwen MTH, Van Driel HF, Kasteleijn-Nolst Trenité DGA. A patient diary as a tool to improve medicine compliance. Pharm World Sci 1999;21(1):21–4.Stone AA. Patient non-compliance with paper diaries. BMJ 2002;Disclosure(s)Nothing to disclose

Download Full-text

Determinants for Sustained Use of an Activity Tracker: Observational Study (Preprint)

10.2196/preprints.7311 ◽

2017 ◽

Author(s):

Sander Hermsen ◽

Jonas Moons ◽

Peter Kerkhof ◽

Carina Wiekens ◽

Martijn De Groot

Keyword(s):

Physical Activity ◽

Random Forest ◽

User Experience ◽

First Year ◽

Relative Importance ◽

Related Factors ◽

Activity Tracker ◽

Activity Trackers ◽

Natural Development ◽

Sustained Use

BACKGROUND A lack of physical activity is considered to cause 6% of deaths globally. Feedback from wearables such as activity trackers has the potential to encourage daily physical activity. To date, little research is available on the natural development of adherence to activity trackers or on potential factors that predict which users manage to keep using their activity tracker during the first year (and thereby increasing the chance of healthy behavior change) and which users discontinue using their trackers after a short time. OBJECTIVE The aim of this study was to identify the determinants for sustained use in the first year after purchase. Specifically, we look at the relative importance of demographic and socioeconomic, psychological, health-related, goal-related, technological, user experience–related, and social predictors of feedback device use. Furthermore, this study tests the effect of these predictors on physical activity. METHODS A total of 711 participants from four urban areas in France received an activity tracker (Fitbit Zip) and gave permission to use their logged data. Participants filled out three Web-based questionnaires: at start, after 98 days, and after 232 days to measure the aforementioned determinants. Furthermore, for each participant, we collected activity data tracked by their Fitbit tracker for 320 days. We determined the relative importance of all included predictors by using Random Forest, a machine learning analysis technique. RESULTS The data showed a slow exponential decay in Fitbit use, with 73.9% (526/711) of participants still tracking after 100 days and 16.0% (114/711) of participants tracking after 320 days. On average, participants used the tracker for 129 days. Most important reasons to quit tracking were technical issues such as empty batteries and broken trackers or lost trackers (21.5% of all Q3 respondents, 130/601). Random Forest analysis of predictors revealed that the most influential determinants were age, user experience–related factors, mobile phone type, household type, perceived effect of the Fitbit tracker, and goal-related factors. We explore the role of those predictors that show meaningful differences in the number of days the tracker was worn. CONCLUSIONS This study offers an overview of the natural development of the use of an activity tracker, as well as the relative importance of a range of determinants from literature. Decay is exponential but slower than may be expected from existing literature. Many factors have a small contribution to sustained use. The most important determinants are technical condition, age, user experience, and goal-related factors. This finding suggests that activity tracking is potentially beneficial for a broad range of target groups, but more attention should be paid to technical and user experience–related aspects of activity trackers.

Download Full-text

Men on the Move–Nashville: Feasibility and Acceptability of a Technology-Enhanced Physical Activity Pilot Intervention for Overweight and Obese Middle and Older Age African American Men

American Journal of Men s Health ◽

10.1177/1557988316644174 ◽

2016 ◽

Vol 12 (4) ◽

pp. 798-811 ◽

Cited By ~ 7

Author(s):

Donnatesa A. L. Dean ◽

Derek M. Griffith ◽

Sydika A. McKissic ◽

Emily K. Cornish ◽

Vicki Johnson-Lawrence

Keyword(s):

Physical Activity ◽

African American ◽

Small Group ◽

Physical Activity Intervention ◽

African American Men ◽

Text Messages ◽

Fat Percentage ◽

Physically Active ◽

Activity Trackers ◽

Group Sessions

Men on the Move–Nashville was a quasi-experimental, 10-week pilot physical activity intervention. A total of 40 overweight or obese African American men ages 30 to 70 (mean age = 47) enrolled in the intervention. Participants attended 8 weekly, 90-minute small group sessions with a certified personal trainer. Each session consisted of discussions aimed to educate and motivate men to be more physically active, and an exercise component aimed to increase endurance, strength, and flexibility. Throughout each week, men used wearable activity trackers to promote self-monitoring and received informational and motivational SMS text messages. Of the 40 enrolled men, 85% completed the intervention, and 80% attended four or more small group sessions. Additionally, 70% of participants successfully used the activity tracker, but only 30% of men utilized their gym memberships. Participants benefited from both the small group discussions and activities through increasing social connection and guidance from their trainer and group members. These African American men reported being motivated to engage in physical activity through each of these technologies. Men reported that the activity trackers provided an important extension to their social network of physically active people. The intervention resulted in significant increases in men’s self-reported levels of light, moderate, vigorous, and sports-related physical activities, and high-density lipoprotein cholesterol levels, and significant decreases in weight and body fat percentage with small, moderate and large effects shown. Including technology and didactic components in small group-based interventions holds promise in motivating African American men to increase their physical activity.

Download Full-text

Engaging Older Adults With Parkinson’s Disease in Physical Activity Using Technology: A Feasibility Study

Gerontology and Geriatric Medicine ◽

10.1177/2333721419842671 ◽

2019 ◽

Vol 5 ◽

pp. 233372141984267 ◽

Cited By ~ 2

Author(s):

Melinda Hermanns ◽

Barbara K. Haas ◽

Jerome Lisk

Keyword(s):

Physical Activity ◽

Older Adults ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Feasibility Study ◽

Support Group ◽

Self Efficacy ◽

Online Support ◽

Online Support Group ◽

Activity Tracker

Parkinson’s disease (PD), a progressive neurodegenerative disorder, presents unique and daily challenges. Living with PD may limit one’s physical activity and negatively affect quality of life (QOL). No studies were identified that utilized online technology to promote health in this population. The purposes of this study were to (a) assess the feasibility of an intervention that requires wearing a physical activity tracker and participating in an online support group, and (b) examine the effect of this intervention on the self-efficacy for physical activity and QOL of older adults with PD. A 12-week longitudinal pretest/posttest design was used to assess physical activity, engagement in an online support group, self-efficacy, and QOL. A postintervention questionnaire was used to capture the participants’ ( n = 5) experience using the physical activity tracker and an electronic tablet to engage in an online support group. The sample size of this feasibility study precluded robust quantitative analysis of QOL or self-efficacy. Findings from the open-ended questionnaire suggest technology was challenging for most participants, yet it did provide social support. Teaching effective interventions to promote self-management for increasing physical activity, and consequently improving QOL, is recommended. While technology can assist, older persons with PD may experience technological challenges.

Download Full-text

Wearable Activity Trackers in the Management of Rheumatic Diseases: Where Are We in 2020?

Sensors ◽

10.3390/s20174797 ◽

2020 ◽

Vol 20 (17) ◽

pp. 4797

Author(s):

Thomas Davergne ◽

Antsa Rakotozafiarison ◽

Hervé Servy ◽

Laure Gossec

Keyword(s):

Physical Activity ◽

Time Management ◽

Automatic Monitoring ◽

Great Accuracy ◽

Self Monitoring ◽

Activity Tracker ◽

External Monitoring ◽

Activity Trackers ◽

Steps Per Day ◽

Wearable Activity Trackers

In healthcare, physical activity can be monitored in two ways: self-monitoring by the patient himself or external monitoring by health professionals. Regarding self-monitoring, wearable activity trackers allow automated passive data collection that educate and motivate patients. Wearing an activity tracker can improve walking time by around 1500 steps per day. However, there are concerns about measurement accuracy (e.g., lack of a common validation protocol or measurement discrepancies between different devices). For external monitoring, many innovative electronic tools are currently used in rheumatology to help support physician time management, to reduce the burden on clinic time, and to prioritize patients who may need further attention. In inflammatory arthritis, such as rheumatoid arthritis, regular monitoring of patients to detect disease flares improves outcomes. In a pilot study applying machine learning to activity tracker steps, we showed that physical activity was strongly linked to disease flares and that patterns of physical activity could be used to predict flares with great accuracy, with a sensitivity and specificity above 95%. Thus, automatic monitoring of steps may lead to improved disease control through potential early identification of disease flares. However, activity trackers have some limitations when applied to rheumatic patients, such as tracker adherence, lack of clarity on long-term effectiveness, or the potential multiplicity of trackers.

Download Full-text