Behavior Change Techniques Present in Wearable Activity Trackers: A Critical Analysis

Abstract

BackgroundWearable activity trackers are promising as interventions that offer guidance and support for increasing physical activity and health-focused tracking. Most adults do not meet their recommended daily activity guidelines, and wearable fitness trackers are increasingly cited as having great potential to improve the physical activity levels of adults.ObjectiveThe objective of this study was to use the Coventry, Aberdeen, and London-Refined (CALO-RE) taxonomy to examine if the design of wearable activity trackers incorporates behavior change techniques (BCTs). A secondary objective was to critically analyze whether the BCTs present relate to known drivers of behavior change, such as self-efficacy, with the intention of extending applicability to older adults in addition to the overall population.MethodsWearing each device for a period of 1 week, two independent raters used CALO-RE taxonomy to code the BCTs of the seven wearable activity trackers available in Canada as of March 2014. These included Fitbit Flex, Misfit Shine, Withings Pulse, Jawbone UP24, Spark Activity Tracker by SparkPeople, Nike+ FuelBand SE, and Polar Loop. We calculated interrater reliability using Cohen's kappa.ResultsThe average number of BCTs identified was 16.3/40. Withings Pulse had the highest number of BCTs and Misfit Shine had the lowest. Most techniques centered around self-monitoring and self-regulation, all of which have been associated with improved physical activity in older adults. Techniques related to planning and providing instructions were scarce.ConclusionsOverall, wearable activity trackers contain several BCTs that have been shown to increase physical activity in older adults. Although more research and development must be done to fully understand the potential of wearables as health interventions, the current wearable trackers offer significant potential with regard to BCTs relevant to uptake by all populations, including older adults.

Wearable sensors: can they benefit patients with chronic kidney disease?

“…Various studies have used and validated activity trackers to measure PA in both healthy controls [88,89] and CKD patients [90][91][92] and showed that this objective measure is more accurate than self-reported PA by questionnaires, which often over-or underestimates a patients' PA level [93]. Studies of Mercer et al demonstrated that even in older adults with a chronic illness, PA increased after wearing an activity tracker [94,95]. But, appropriate behavior changing techniques, such as individual goal setting and feedback on performance, suitable for elderly should be incorporated in the trackers [94,95], and proper support with regard to setting-up the trackers and interpretation of the data should be provided [94].…”

“…Studies of Mercer et al demonstrated that even in older adults with a chronic illness, PA increased after wearing an activity tracker [94,95]. But, appropriate behavior changing techniques, such as individual goal setting and feedback on performance, suitable for elderly should be incorporated in the trackers [94,95], and proper support with regard to setting-up the trackers and interpretation of the data should be provided [94].…”

The Accuracy of Smart Devices for Measuring Physical Activity in Daily Life: Validation Study (Preprint)

“…Various behavior change techniques (BCTs), amongst which self-monitoring of the physical activity [9,10], have proven effective in changing physical activity levels. Consumer-level devices, also referred to as wearables, are increasingly used for the monitoring of physical activity [11].…”

The Use of Wearable Activity Trackers Among Older Adults: Focus Group Study of Tracker Perceptions, Motivators, and Barriers in the Maintenance Stage of Behavior Change (Preprint)

“…Length of use is correlated with age, with those aged 70 years old or older stopping WAT use in only two weeks [12]. Furthermore, little comprehensive evidence exists with regard to long-term use of WATs by older adults [7,8], motivations for long-term use [3,13], and differences between non-users, short-and longterm users.The premise of the present study is that older adults' perceptions and evaluations of WATs, motivations, and barriers vary based on where people are in terms of WAT use stage, which suggests developing different strategies for WAT use initiation and maintenance. Applying the TTM of behavior change, we explore older adults' perceptions and uses of WATs in different stages of WAT adoption.…”

“…Length of use is correlated with age, with those aged 70 years old or older stopping WAT use in only two weeks [12]. Furthermore, little comprehensive evidence exists with regard to long-term use of WATs by older adults [7,8], motivations for long-term use [3,13], and differences between non-users, short-and longterm users.…”