Can consumer wearable activity tracker-based interventions improve physical activity and cardiometabolic health in patients with chronic diseases? A systematic review and meta-analysis of randomised controlled trials

Franssen, Wouter M. A.; Franssen, Gregor H L M; Spaas, Jan; Solmi, Francesca; Eijnde, Bert O.

doi:10.1186/s12966-020-00955-2

Cited by 121 publications

(157 citation statements)

References 87 publications

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“…The approach to CO breath sampling in Beard et al’s study [ 16 ] and this investigation enabled participants to directly link their smoking behavior to their CO values and track their progress over time. The benefit of tracking one’s behavior and progress via self-guided biofeedback, evident here in smoking behavior, is also well documented in other disease states [ 8 - 10 , 44 - 46 ] lending further support to this approach.…”

Section: Discussionmentioning

confidence: 76%

Assessment of a Personal Interactive Carbon Monoxide Breath Sensor in People Who Smoke Cigarettes: Single-Arm Cohort Study

Marler¹,

Fujii²,

Wong³

et al. 2020

J Med Internet Res

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Background Tobacco use is the leading cause of preventable morbidity and mortality. Existing evidence-based treatments are underutilized and have seen little recent innovation. The success of personal biofeedback interventions in other disease states portends a similar opportunity in smoking cessation. The Pivot Breath Sensor is a personal interactive FDA-cleared (over-the-counter) device that measures carbon monoxide (CO) in exhaled breath, enabling users to link their smoking behavior and CO values, and track their progress in reducing or quitting smoking. Objective The objective of this study is to assess the Pivot Breath Sensor in people who smoke cigarettes, evaluating changes in attitudes toward quitting smoking, changes in smoking behavior, and use experience. Methods US adults (18-80 years of age, ≥10 cigarettes per day [CPD]) were recruited online for this remote 12-week study. Participants completed a screening call, informed consent, and baseline questionnaire, and then were mailed their sensor. Participants were asked to submit 4 or more breath samples per day and complete questionnaires at 1-4, 8, and 12 weeks. Outcomes included attitudes toward quitting smoking (Stage of Change, success to quit, and perceived difficulty of quitting), smoking behavior (quit attempts, CPD reduction, and 7-, 30-day point prevalence abstinence [PPA]), and use experience (impact and learning). Results Participants comprised 234 smokers, mean age 39.9 (SD 11.3) years, 52.6% (123/234) female, mean CPD 20.3 (SD 8.0). The 4- and 12-week questionnaires were completed by 92.3% (216/234) and 91.9% (215/234) of participants, respectively. Concerning attitude outcomes, at baseline, 15.4% (36/234) were seriously thinking of quitting in the next 30 days, increasing to 38.9% (84/216) at 4 weeks and 47.9% (103/215) at 12 weeks (both P<.001). At 12 weeks, motivation to quit was increased in 39.1% (84/215), unchanged in 54.9% (118/215), and decreased in 6.0% (13/215; P<.001). Additional attitudes toward quitting improved from baseline to 12 weeks: success to quit 3.3 versus 5.0 (P<.001) and difficulty of quitting 2.8 versus 4.3 (P<.001). Regarding smoking behavior, at 4 weeks, 28.2% (66/234) had made 1 or more quit attempts (≥1 day of abstinence), increasing to 48.3% (113/234) at 12 weeks. At 4 weeks, 23.1% (54/234) had reduced CPD by 50% or more, increasing to 38.5% (90/234) at 12 weeks. At 12 weeks, CPD decreased by 41.1% from baseline (P<.001), and 7- and 30-day PPA were 12.0% (28/234) and 6.0% (14/234), respectively. Concerning use experience, 75.3% (171/227) reported the sensor increased their motivation to quit. More than 90% (>196/214) indicated the sensor taught them about their CO levels and smoking behavior, and 73.1% (166/227) reported that seeing their CO values made them want to quit smoking. Conclusions Use of the Pivot Breath Sensor resulted in a significant increase in motivation to quit, a reduction in CPD, and favorable quit attempt rates. These outcomes confer increased likelihood of quitting smoking. Accordingly, the results support a role for biofeedback via personal CO breath sampling in smoking cessation. Trial Registration ClinicalTrials.gov NCT04133064; https://clinicaltrials.gov/ct2/show/NCT04133064

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Section: Discussionmentioning

confidence: 76%

Assessment of a Personal Interactive Carbon Monoxide Breath Sensor in People Who Smoke Cigarettes: Single-Arm Cohort Study

Marler¹,

Fujii²,

Wong³

et al. 2020

J Med Internet Res

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“…In comparison, in the HEALD trial, the group receiving pedometers without any counseling (similar to our group B) increased daily steps to a lower extent than the group receiving counseling (30). Meta-analyses provide con icting results regarding the e cacy of counseling as a complement to self-monitoring (8,9). The speci c content of the intervention components may in uence both the implementation and the outcomes of an intervention.…”

Section: The Hypothesis Of Sophiamentioning

confidence: 77%

“…Diabetes care givers are encouraged to give advice on physical activity and such advice may be combined with using a pedometer or a comparable self-monitoring device (4, 5). Pedometers have shown positive effects on increased physical activity in short term in populations with type 2 diabetes (3,(6)(7)(8)(9) and are recommended for use to increase motivation to be physically active (10,11). Yet, it is unclear whether self-monitoring alone, or in combination with counseling is the most feasible and effective alternative (8,9,12).…”

Section: Introductionmentioning

confidence: 99%

“…Pedometers have shown positive effects on increased physical activity in short term in populations with type 2 diabetes (3,(6)(7)(8)(9) and are recommended for use to increase motivation to be physically active (10,11). Yet, it is unclear whether self-monitoring alone, or in combination with counseling is the most feasible and effective alternative (8,9,12). Comparison of available studies is di cult due to heterogeneous intervention setups and the limited reporting of context and implementation of interventions (13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

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Process Evaluation of the Sophia Step Study-A Primary Care Based Three-Armed Randomized Controlled Trial Using Self-Monitoring of Steps With and Without Counseling in Prediabetes and Type 2 Diabetes

Rossen

Hagströmer

Yngve

et al. 2020

Preprint

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Background Describing implementation features of an intervention is required to compare interventions and to inform policy and best practice. The aim of this study was to conduct a process evaluation of the first 12 months of the Sophia Step Study: a primary care based RCT evaluating a multicomponent (self-monitoring of daily steps plus counseling) and a single component (self-monitoring of steps only) physical activity intervention to standard care on cardiometabolic health. Methods The evaluation was guided by the Medical Research Council Guidance for complex interventions. To describe the implementation communication with the health professionals implementing the interventions, attendance records and tracking of days with self-monitored pedometer-determined steps were used. Change in physical activity behaviour was measured at baseline, 6 and 12 months as daily steps by accelerometry. Results From April 2013 to January 2018 188 participants were randomized. Response rate was 49% and drop out was 10%. The interventions were delivered as intended with minor deviation from the protocol and dose received was satisfying for both the multicomponent and single component group. The mean [95% Confidence Interval (CI)] change in daily steps from baseline to 6 months was 941(227, 1655) steps/day for the multicomponent intervention group, 990 (145, 1836) step/day for the single component group and -506 (-1118, 107) for the control group. The mean (95% CI) change in daily steps from baseline to 12 months was 31(-507, 570) steps/day for the multicomponent intervention group, 144 (-566, 853) step/day for the single component group and -890 (-1485, -294) for the control group. There was a large individual variation in daily steps at baseline as well as in step change in all three groups.Conclusions Applying self-monitoring of steps is a feasible method to implement as support for physical activity in the primary care setting both with and without counseling support. While physical activity levels increased after 6 months, maintenance of physical activity is a more realistic expectation in the long term. Physical activity behavior varies among individuals and support for physical activity should be tailored to the person. Trial registration ClinicalTrials.gov, NCT02374788. Registered 2 March 2015 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02374788

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“…Patient led goal-setting, self-monitoring of behavior and non-speci c rewards are examples of BCTs that are effective in improving adherence to PA in both short and long-term (22). A relatively novel and popular method that applies BCTs and has shown to increase PA in healthy populations as well as in populations with OA and other chronic conditions is the utilization of wearable activity trackers (WATs) (23)(24)(25). WATs are sensors that track movement and can be paired with a smartphone, tablet or computer application (App).…”

Section: Pamentioning

confidence: 99%

Patterns of physical activity, adherence to a wearable activity tracker during a 12-week intervention and correlation between physical activity and function in individuals with hip and/or knee osteoarthritis

Östlind

Sant'Anna²,

Eek

et al. 2020

Preprint

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BackgroundOsteoarthritis is a common joint disorder causing pain, functional limitations and an increased risk of comorbidities. Physical activity (PA) is the standard treatment but the majority of individuals with OA do not meet the recommended levels of PA (150 min/week). Monitoring PA with a wearable activity tracker (WAT) could promote PA but increased knowledge on PA patterns and usage of a WAT is needed. The aim of this study was to describe PA patterns and adherence to using a WAT among participants of working age with hip and/or knee OA, during a 12-week intervention. In addition, this study explores the correlation between baseline joint function and subsequent PA.MethodsIndividuals of working age with hip and/or knee OA (n = 75) who used a WAT, Fitbit Flex 2, for 12 weeks as part of an intervention in a cluster-randomized controlled trial were included. Participants were encouraged to monitor their PA in the Fitbit-app. An activity goal of 7,000 steps per day was set. Activity data was collected from the Fitbit. HOOS/KOOS were completed at baseline.ResultsParticipants walked on average 10 593 (SD 3431) steps per day, spent 336.0 (SD 249.9) minutes in moderate/vigorous (MV) PA and used the Fitbit for 88.4% of the 12-week intervention period. Steps per day decreased significantly over the 12 weeks (β-coefficient − 117, 95% CI -166 to -68, p = < 0.001) as well as MVPA per week (β-coefficient − 3.5, 95% CI -6.5 to -0.5, p = 0.02) and adherence to using the Fitbit (β-coefficient − 1.3, 95% CI -1.8 to -0.8, p = < 0.001). There were no significant correlations between baseline function (HOOS/KOOS) and subsequent PA.ConclusionThe majority of participants reached 7,000 steps/day and the recommended 150 minutes in MVPA per week. However, weekly PA decreased gradually over time. Adherence to using the Fitbit was high but also decreased during the intervention. Understanding PA-patterns and the use of a Fitbit to promote PA could be beneficial in tailoring interventions for individuals with hip and/or knee OA.Trial registrationThe C-RCT was registered in ClinicalTrials.gov. Registration number: NCT03354091. Registered 11/27/2017.

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Can consumer wearable activity tracker-based interventions improve physical activity and cardiometabolic health in patients with chronic diseases? A systematic review and meta-analysis of randomised controlled trials

Cited by 121 publications

References 87 publications

Assessment of a Personal Interactive Carbon Monoxide Breath Sensor in People Who Smoke Cigarettes: Single-Arm Cohort Study

Assessment of a Personal Interactive Carbon Monoxide Breath Sensor in People Who Smoke Cigarettes: Single-Arm Cohort Study

Process Evaluation of the Sophia Step Study-A Primary Care Based Three-Armed Randomized Controlled Trial Using Self-Monitoring of Steps With and Without Counseling in Prediabetes and Type 2 Diabetes

Patterns of physical activity, adherence to a wearable activity tracker during a 12-week intervention and correlation between physical activity and function in individuals with hip and/or knee osteoarthritis

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