It is Feasible for 3 to 5‐Year‐Old Children to Use Smartwatch Activity Trackers: A Systematic Review

Dog-walkers are more likely to achieve moderate-intensity physical activity. Linking the use of activity trackers with dog-walking may be beneficial both in terms of improving the targeted behavior and increasing the likelihood of sustained use. This manuscript aims to describe the protocol of a pilot study which intends to examine the effects of simultaneous use of activity trackers by humans and their dogs on the physical activity level of humans and dogs. This study uses nonprobability sampling of dog owners of age 25–65 (N = 80) and involves four parallel groups in an observational randomized controlled trial with a 2 × 2 factorial design, based on use of dog or human activity trackers for eight weeks. Each group consists of dog-human duos, in which both, either or none are wearing an activity tracker for eight weeks. At baseline and end, all human subjects wear ActiGraph accelerometers that quantify physical activity for one week. Commercial activity trackers are used for tracking human and dog activity remotely. Additional measures for humans are body composition and self-reported physical activity. Dog owners also report dog’s weight and physical activity using a questionnaire. A factorial analysis of covariance (ANCOVA) is used to compare physical activity across the four groups from baseline to week-10.

ObjectiveActivity trackers are designed to support individuals in monitoring and increasing their physical activity. The use of activity trackers among individuals diagnosed with depression and anxiety has not yet been examined. This pilot study investigates how this target group engages with an activity tracker during a 10-week health intervention aimed to increase their physical activity level and improve their physical and mental health.MethodsTwo groups of 11 young adults (aged 18–29 years) diagnosed with depression or anxiety participated in the digital health intervention. The study used mixed methods to investigate the research question. Quantitative health data were used to assess the intervention’s influence on the participants’ health and qualitative data provided insights into the participants’ digital health experience.ResultsThe study demonstrated an ambiguous influence from the use of an activity tracker with positive physical and mental health results, but a fading and even negative digital health engagement and counterproductive competition.ConclusionsThe ambiguous results identify a need for (1) developing strategies for health professionals to provide supervised use of activity trackers and support the target groups’ abilities to convert health information about physical activity into positive health strategies, and (2) designing alternatives for health promoting IT targeted users who face challenges and need motivation beyond self-tracking and competition.

The aim of this study was to assess physical activity and sedentary behavior, as well as the usage behavior, usability, acceptance, and motivational impact of an applied activity tracker among nursing home residents. Physical activity and usage behavior were measured among 22 residents (68 to 102 years) by use of a commercial activity tracker worn during waking hours for 77 days on average. Usability, acceptance, and motivational impact of the tracker were examined using an adapted questionnaire. Participants walked, on average, 1007 ± 806 steps per day and spent, on average, more than 9 h (77.2% of their waking time) sedentary. The average steps/day increased significantly within the first five weeks of wearing the activity tracker. The acceptance rate was high (94.4%). The tracker was used for 65.4% of the individual study period, and usage behavior did not significantly change during the first five wearing weeks. Participants with a usage time of ≥50% walked significantly more steps per day than those with a lower usage. Overall, we were able to reveal that the residents were highly inactive and sedentary. The results support the feasibility of a long-term application of activity trackers to assess or even increase physical activity behavior.

BackgroundDuring transition to retirement there is often a rearrangement of daily life which might provide a key opportunity for interventions to promote a non-sedentary and active lifestyle. To be able...

BackgroundDespite a range of efforts to increase physical activity participation in Australia, inactivity levels in older adults have remained high over recent decades, contributing to increased rates of chronic health conditions. Lifestyle interventions, including telephone counseling (TC), improve physical activity participation and associated health outcomes over the short term; however, ongoing feedback and support is required to maintain these changes. Newer technologies such as wearable activity trackers (ATs) may offer an alternative method for providing ongoing support.ObjectiveThis study aims to investigate whether newer technologies such as wearable ATs assist in providing ongoing support to maintain physical activity levels and health outcomes.MethodsOlder adults aged >60 years who had just completed a 12-week face-to-face individualized community exercise program in Tasmania, Australia, participated in the study. They were randomized to receive AT, TC, or usual care (UC). All groups received a home exercise program and an optional referral to a community-based exercise program. The AT group also received an AT and text message feedback from an accredited exercise physiologist (AEP). The TC group received phone calls from an AEP throughout the 12-month intervention. The primary outcome was daily steps measured by an ActivPAL (TM) accelerometer at baseline and at 3, 6, and 12 months. Secondary outcome measures included body composition, blood pressure, 10-time sit-to-stand (TTSTS) test, timed up and go test, and cardiorespiratory fitness. This trial was approved by the Tasmanian Health and Medical Human Research Ethics Committee (H0014713).ResultsA total of 117 participants were randomized to the study (AT, n=37; TC, n=38; UC, n=42). At baseline, the participants (75/117, 64.1% female; mean age 72.4 years, SD 6.4) completed an average of 6136 steps (SD 2985) per day. Although there were no significant differences between groups, the TC and AT groups maintained daily step counts (mean difference [MD] −79 steps, 95% CI −823 to 663 steps; P=.81; and MD −588 steps, 95% CI −1359 to 182 steps; P=.09), and UC showed a reduction in daily steps (MD 981 steps, 95% CI −1668 to −294 steps; P=.003) during the 12-month period. Diastolic blood pressure was significantly higher after AT than after UC (MD 5.62 mm Hg, 95% CI 1.30 to 9.94 mm Hg; P=.01), and TTSTS was significantly slower on TC compared with UC (MD 2.36 seconds, 95% CI −0.14 to 4.87 seconds; P=.03).ConclusionsThe use of an AT with AEP support or TC is effective at maintaining daily step count in older adults over a 12-month period, suggesting that wearable ATs are as effective as TC. Further research to investigate which option is more cost-effective would be beneficial.Trial RegistrationAustralian New Zealand Clinical Trial Registry ACTRN12615001104549; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=369118

Background Digital health interventions targeting behavior change are promising in adults and adolescents; however, less attention has been given to younger children. The proliferation of wearables, such as smartwatches and activity trackers, that support the collection of and reflection on personal health data highlights an opportunity to consider novel approaches to supporting health in young children (aged 5-11 y).Objective This review aims to investigate how smartwatches and activity trackers have been used across child health interventions (for children aged 5-11 y) for different health areas, specifically to identify the population characteristics of those being targeted, describe the characteristics of the devices being used, and report the feasibility and acceptability of these devices for health-related applications with children.MethodsWe searched 10 databases (CINAHL, Embase, ACM Digital Library, IEEE Xplore, Cochrane Library, PsycINFO, Web of Science, PubMed, Scopus, and MEDLINE) to identify relevant literature in March 2023. The inclusion criteria for studies were as follows: (1) peer-reviewed, empirical studies; (2) published in English; (3) involved a child aged 5 to 11 years using a smartwatch for health-related purposes. Two researchers independently screened articles to assess eligibility. One researcher extracted data relating to the 3 aims and synthesized the results using narrative and thematic synthesis.Results The database searches identified 3312 articles, of which 15 (0.45%) were included in this review. Three (20%) articles referred to the same intervention. In 77% (10/13) of the studies, the devices were used to target improvements in physical activity. Other applications included using smartwatches to deliver interventions for emotional regulation and asthma management. In total, 9 commercial devices were identified, many of which delivered minimal data feedback on the smartwatch or activity tracker, instead relying on a partner app running on a linked parental smartphone with greater functionality. Of the 13 studies, 8 (62%) used devices designed for adults rather than children. User feedback was positive overall, demonstrating the acceptability and feasibility of using these devices with children. However, the studies often lacked a child-focused approach, with 3 (23%) studies gathering user feedback only from parents.Conclusions Interventions involving smartwatches and activity trackers for children aged 5 to 11 years remain limited, primarily focusing on enhancing physical activity, with few studies investigating other health applications. These devices often provide limited data feedback and functionality to support children’s independent engagement with the data, relying on paired smartphone apps managed by caregivers, who control access and facilitate children’s interaction with the data. Future research should adopt child-centered methods in the design and evaluation of these technologies, integrating children’s perspectives alongside their caregivers, to ensure that they are not only feasible and acceptable but also meaningful and effective for young children.Trial RegistrationPROSPERO CRD42022373813, https://tinyurl.com/4kxu8zss

Despite the increased use of activity trackers, little is known about how they can be used in healthcare settings. This study aimed to support healthcare professionals and patients with embedding an activity tracker in the daily clinical practice of a specialized mental healthcare center and gaining knowledge about the implementation process. An action research design was used to let healthcare professionals and patients learn about how and when they can use an activity tracker. Data collection was performed in the specialized center with audio recordings of conversations during therapy, reflection sessions with the therapists, and semi-structured interviews with the patients. Analyses were performed by directed content analyses. Twenty-eight conversations during therapy, four reflection sessions, and eleven interviews were recorded. Both healthcare professionals and patients were positive about the use of activity trackers and experienced it as an added value. Therapists formulated exclusion criteria for patients, a flowchart on when to use the activity tracker, defined goals, and guidance on how to discuss (the data of) the activity tracker. The action research approach was helpful to allow therapists to learn and reflect with each other and embed the activity trackers into their clinical practice at a specialized mental healthcare center.

Background: Smartphone applications and wearable activity trackers have become popular tools in recent years in managing chronic diseases such as diabetes. More recently, studies have focused on connecting patient-generated health data from mobile devices directly to health care providers and educators. However, not much is known regarding the patient experience in using these mobile devices for diabetes management, particularly the implications of allowing educators direct access to patients’ diet and exercise data. Objective: The objective of this study was to identify patients’ perceived benefits and concerns about using a smartphone application and wristband activity tracker to monitor diet and physical activity, as well as the perceived benefits and concerns of allowing educators access to such data. Methods: We conducted a qualitative, descriptive study as an axillary study to a clinical trial testing a connected interface to link patient self-monitoring diet and physical activity to a nationally used electronic diabetes education system. Our axillary study examined 13 type 2 diabetes patients’ views on perceived benefits and concerns about using a smartphone application and wristband activity tracker to monitor diet and physical activity for three months. A focus group interview was administered to obtain general and specific understanding of the use of smartphone applications and activity trackers during the study period. The central interview questions guiding the discussion included “What did you think about the UP24 wristband and app?”, “What are your thoughts about the connection of UP24 data with Chronicle, the Web-based diabetes education system, so that your diabetes educators can see your behavior?”, and “Has knowing that someone else has access to your diet and exercise data affected your behavior and self-monitoring?” The interviewer also asked specific questions to gain deeper understanding of the following topics: (1) the app and wristband features used to record and monitor diet and physical activity, (2) materials used for intervention orientation, (3) additional data (eg, weight and blood glucose) that participants would like to share with educators, and (4) suggestions for improvement in diabetes self-management and communication with educators and physicians. The focus group sessions were audio-recorded and transcribed. Transcribed data were analyzed to identify key themes based on interpretive coding procedures. Results: We identified 11 key themes under three major categories and described these themes with illustrative quotations. The three major categories of themes covered (1) self-monitoring themes: varied experience and self-monitoring patterns and adherence exist among patients using the wearable tracker and its companion smartphone application; (2) themes related to sharing self-monitoring of diet and physical activity data with diabetes educators: sharing self-monitoring diet influences patient self-monitoring adherence and dietary and activity changes, and communication with educators; and (3) research study-related themes: technical barriers, utilization of manuals and tutorial videos in beginning use of the connected health tools, and desired features on combining lifestyle data with glucose data and caregiver access. Conclusions: Connected technology aiming to incorporate patient-generated health lifestyle data into clinical workflow should consider patient perspectives in terms of their experience and motivation for generating and sharing such data and technical barriers in using such tools.

Reporting adherence, validity and physical activity measures of wearable activity trackers in medical research: A systematic review

BackgroundThe association between physical activity, sedentary behavior and health-related quality of life in children and adolescents has been mostly investigated in those young people with chronic disease conditions. No systematic review to date has synthesized the relationship between physical activity, sedentary behavior and health-related quality of life in the general healthy population of children and adolescents. The purpose of this study was to review systematically the existing literature that evaluated the relations between physical activity, sedentary behavior and health-related quality of life in the general population of children and adolescents.MethodsWe conducted a computer search for English language literature from databases of MEDLINE, EMBASE, PSYCINFO and PubMed-related articles as well as the reference lists of existing literature between 1946 and the second week of January 2017 to retrieve eligible studies. We included the studies that assessed associations between physical activity and/or sedentary behavior and health-related quality of life among the general population of children and adolescents aged between 3–18 years. The study design included cross-sectional, longitudinal and health intervention studies. We excluded the studies that examined associations between physical activity, sedentary behavior and health-related quality of life among children and adolescents with specific chronic diseases, and other studies and reports including reviews, meta-analyses, study protocols, comments, letters, case reports and guidelines. We followed up the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement in the reporting of this review. The risk of bias of the primary studies was assessed by the Newcastle-Ottawa Scale. We synthesized the difference in health-related quality of life scores between different levels of physical activity and sedentary time.ResultsIn total, 31 studies met the inclusion criteria and were synthesized in the review. Most of the included studies used a cross-sectional design (n = 21). There were six longitudinal studies and three school-based physical activity intervention studies. One study used both cross-sectional and longitudinal designs. We found that higher levels of physical activity were associated with better health-related quality of life and increased time of sedentary behavior was linked to lower health-related quality of life among children and adolescents. A dose-response relation between physical activity, sedentary behavior and health-related quality of life was observed in several studies suggesting that the higher frequency of physical activity or the less time being sedentary, the better the health-related quality of life.ConclusionsThe findings in this study suggest that school health programs promoting active lifestyles among children and adolescents may contribute to the improvement of health-related quality of life. Future research is needed to extend studies on longitudinal relationships between physical activity, sedentary behavior and health-related quality of life, and on effects of physical activity interventions on health-related quality of life among children and youth.

Seasonality is an important factor in children's physical activity (PA) and sedentary behavior (SB); thus, the aim of this study was to explore the seasonal characteristics of Chinese preschool children's PA and SB. Preschool children (n = 65) from a kindergarten middle class in Changsha, the capital city of Hunan Province in Central China, were recruited, and a three-axis accelerometer (ActiGraph GT3X-BT) was used to longitudinally track their PA and SB status. One-way repeated-measures ANOVA (Analysis of Variance) and Friedman tests were employed for analysis, with significance set at P < .05. The levels of both total of physical activity and moderate-to-vigorous physical activity were the highest in spring and the lowest in winter. The level of SB was the opposite, being the lowest in spring and the highest in winter, whereas there were no significant differences in light physical activity across different seasons. The seasonality of PA in preschool children may be influenced by several factors, such as gender, time period, preschool education curriculum, and weather conditions. Seasonal variation in PA and SB are considered important for child educators, who should combine related factors to construct potentially ideal interventions to promote the PA of children during different seasons.

High sedentary behaviour and low physical activity levels at 12 months after cardiac rehabilitation: A prospective cohort study.

BackgroundSedentary behaviors and physical activity are likely to be affected by the COVID-19 outbreak, and sedentary lifestyles can increase subjective fatigue. The nonpharmaceutical policies imposed as a result of the COVID-19 pandemic may also have adverse effects on fatigue.ObjectiveThis study has two aims: to examine the changes in sedentary behaviors and physical activity of company workers in response to the COVID-19 pandemic in Japan and to examine relationships between changes in these sedentary behaviors and physical activity and changes in fatigue.MethodsData from a nationwide prospective online survey conducted in 2019 and 2020 were used. On February 22, 2019, an email with a link to participate in the study was sent to 45,659 workers, aged 20 to 59 years, who were randomly selected from a database of approximately 1 million individuals. A total of 2466 and 1318 participants, who self-reported their occupation as company workers, answered the baseline and follow-up surveys, respectively. Surveys captured fatigue, workday and daily domain-specific sedentary behaviors and physical activity, and total sedentary behaviors and physical activity. We used multivariable linear regression models to estimate associations of changes in sedentary behaviors and physical activity with changes in fatigue.ResultsIncreases in public transportation sitting during workdays, other leisure sitting time during workdays, and other leisure sitting time were associated with an increase in the motivation aspect of fatigue (b=0.29, 95% CI 0-0.57, P=.048; b=0.40, 95% CI 0.18-0.62, P<.001; and b=0.26, 95% CI 0.07-0.45, P=.007, respectively). Increases in work-related sitting time during workdays, total sitting time during workdays, and total work-related sitting time were significantly associated with an increase in the physical activity aspect of fatigue (b=0.06, 95% CI 0-0.12, P=.03; b=0.05, 95% CI 0.01-0.09, P=.02; and b=0.07, 95% CI 0-0.14, P=.04, respectively). The motivation and physical activity aspects of fatigue increased by 0.06 for each 1-hour increase in total sitting time between baseline and follow-up (b=0.06, 95% CI 0-0.11, P=.045; and b=0.06, 95% CI 0.01-0.10, P=.009, respectively).ConclusionsOur findings demonstrated that sedentary and active behaviors among company workers in Japan were negatively affected during the COVID-19 outbreak. Increases in several domain-specific sedentary behaviors also contributed to unfavorable changes in workers’ fatigue. Social distancing and teleworking amid a pandemic may contribute to the sedentary lifestyle of company workers. Public health interventions are needed to mitigate the negative effects of the COVID-19 pandemic or future pandemics on sedentary and physical activity behaviors and fatigue among company workers.

The goal of this review was to investigate factors associated with physical activity and sedentary behavior in people with Parkinson disease (PD). The magnitude of these associations was investigated in line with the International Classification of Functioning, Disability and Health components. A systematic literature review was conducted until February 2023, searching four databases (PubMed, EMBASE, Web of Science, and Scopus) for original articles investigating associations with physical activity or sedentary behavior in people with PD. Two independent researchers performed data extraction, and the risk of bias in the included studies was assessed using the Quality in Prognosis Studies tool. Meta-analyses were conducted to determine the magnitude of the associations, and significant regression models from the included studies were described. Forty-two studies were included. Twenty-one factors associated with overall physical activity were identified. Higher levels of physical activity had a small association with cognition and body mass index and a fair association with 17 factors related to self-efficacy, physical function, mobility, quality of life, age, PD symptoms, and more. Better manual dexterity and functional gait had moderate to good associations with higher levels of physical activity. The regression model with the higher magnitude was composed mostly of contextual factors, except for the body max index. The magnitude of factors associated with physical activity intensity or sedentary behavior could not be identified. Functional gait and manual dexterity were the strongest factors related to physical activity in people with PD. Further investigation is needed to understand the factors associated with physical activity intensity and sedentary behavior. This study emphasizes the significance of considering contextual factors alongside body function and structure, activity and participation, and the health condition to enhance physical activity improvement during the rehabilitation process. By adopting such a holistic approach, rehabilitation professionals can optimize the overall health and well-being of individuals with Parkinson disease.

Physical activity and sedentary behavior is important modifiable behavioral factors for health; thus, researchers have focused on identifying correlates and determinants of physical activity and sedentary behavior. These information is essential to inform the development of behavioral change interventions and programs (i.e., promoting physical activity while minimizing sedentary behavior). Given that physical activity and sedentary behavior is multi-dimensional, and patterns of these behaviors vary by cultural contexts, having a population-specific understanding of how individual-, family-, and cultural-level factors interdependently influence physical activity and sedentary behavior is of importance. This study discusses the background and concept of a biocultural perspective in physical activity and sedentary behavior, which introduced by Malina in 2008, and presents future research recommendations that are appropriate for the context of South Korea. By taking a holistic approach, the biocultural perspective emphasizes the importance of integrating the understanding of biological traits (i.e., age, sex, maturity status, ethnicity, and genetics) with psychological, social, and environmental determinants to better understand the physical activity and sedentary behavior of children and adolescents. The biocultural perspective offers a theoretical framework on the sphere of physical activity and sedentary behavior, in which factors influencing physical activity and sedentary behavior are viewed as being coordinated and not isolated.