Feasibility, acceptability and validation of wearable devices for climate change and health research in the low-resource contexts of Burkina Faso and Kenya: Study protocol

Barteit, Sandra; Boudo, Valentin; Ouedraogo, Aristide; Zabré, Pascal; Ouremi, Lucienne; Sié, Ali; Munga, Stephen; Obor, David; Kwaro, Daniel; Huhn, Sophie; Bunker, Aditi; Sauerborn, Rainer; Gunga, Hanns‐Christian; Maggioni, Martina Anna; Bärnighausen, Till

doi:10.1371/journal.pone.0257170

Cited by 26 publications

(14 citation statements)

References 59 publications

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“…However, this approach is hardly possible in populations where wearables are not commonly used [ 92 ]. A few studies are ongoing in low-income countries, among others is a study exploring the feasibility of consumer-grade wearable devices in Burkina Faso and Kenya [ 93 ]. However, not only wearables data present an obstacle for studies in low-resource contexts but also weather and climate data are not as widely available with less granular spatial distribution of weather stations, especially in remote regions [ 94 ].…”

Section: Discussionmentioning

confidence: 99%

Wearables for Measuring Health Effects of Climate Change–Induced Weather Extremes: Scoping Review

Koch¹,

Matzke²,

Huhn³

et al. 2022

JMIR Mhealth Uhealth

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Background Although climate change is one of the biggest global health threats, individual-level and short-term data on direct exposure and health impacts are still scarce. Wearable electronic devices (wearables) present a potential solution to this research gap. Wearables have become widely accepted in various areas of health research for ecological momentary assessment, and some studies have used wearables in the field of climate change and health. However, these studies vary in study design, demographics, and outcome variables, and existing research has not been mapped. Objective In this review, we aimed to map existing research on wearables used to detect direct health impacts and individual exposure during climate change–induced weather extremes, such as heat waves or wildfires. Methods We conducted a scoping review according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) framework and systematically searched 6 databases (PubMed [MEDLINE], IEEE Xplore, CINAHL [EBSCOhost], WoS, Scopus, Ovid [MEDLINE], and Google Scholar). The search yielded 1871 results. Abstracts and full texts were screened by 2 reviewers (MK and IM) independently using the inclusion and exclusion criteria. The inclusion criteria comprised studies published since 2010 that used off-the-shelf wearables that were neither invasive nor obtrusive to the user in the setting of climate change–related weather extremes. Data were charted using a structured form, and the study outcomes were narratively synthesized. Results The review included 55,284 study participants using wearables in 53 studies. Most studies were conducted in upper–middle-income and high-income countries (50/53, 94%) in urban environments (25/53, 47%) or in a climatic chamber (19/53, 36%) and assessed the health effects of heat exposure (52/53, 98%). The majority reported adverse health effects of heat exposure on sleep, physical activity, and heart rate. The remaining studies assessed occupational heat stress or compared individual- and area-level heat exposure. In total, 26% (14/53) of studies determined that all examined wearables were valid and reliable for measuring health parameters during heat exposure when compared with standard methods. Conclusions Wearables have been used successfully in large-scale research to measure the health implications of climate change–related weather extremes. More research is needed in low-income countries and vulnerable populations with pre-existing conditions. In addition, further research could focus on the health impacts of other climate change–related conditions and the effectiveness of adaptation measures at the individual level to such weather extremes.

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Section: Discussionmentioning

confidence: 99%

Wearables for Measuring Health Effects of Climate Change–Induced Weather Extremes: Scoping Review

Koch¹,

Matzke²,

Huhn³

et al. 2022

JMIR Mhealth Uhealth

Self Cite

View full text Add to dashboard Cite

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“…Our results are reported in line with the Consolidated Standards of Reporting Trials (CONSORT) extension for randomized pilot and feasibility trials (28) (Supplementary material S1). This study is further detailed in the protocol paper; for details, see (4).…”

Section: Methodsmentioning

confidence: 99%

“…We conducted purposive block randomization with the existing HDSS population and randomly drew n = 170 individuals through the database (n = 150 study population, oversampling of n = 20). Refer to the protocol paper for exact details on randomization and sampling (4).…”

Section: Sampling and Study Populationmentioning

confidence: 99%

“…The project was designed in close collaboration with the CRSN team and community leaders, like village chiefs and household heads, to ensure their awareness and acceptance. The field team contacted study participants, as well as family members and community leaders, to inform them about the study and obtain informed consent via fingerprint [for details, see protocol paper (4)]. Study participants could withdraw their participation at any time.…”

Section: Study Proceduresmentioning

confidence: 99%

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Using wearable devices to generate real-world, individual-level data in rural, low-resource contexts in Burkina Faso, Africa: A case study

Huhn

Matzke

Koch

et al. 2022

Front. Public Health

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BackgroundWearable devices may generate valuable data for global health research for low- and middle-income countries (LMICs). However, wearable studies in LMICs are scarce. This study aims to investigate the use of consumer-grade wearables to generate individual-level data in vulnerable populations in LMICs, focusing on the acceptability (quality of the devices being accepted or even liked) and feasibility (the state of being workable, realizable, and practical, including aspects of data completeness and plausibility).MethodsWe utilized a mixed-methods approach within the health and demographic surveillance system (HDSS) to conduct a case study in Nouna, Burkina Faso (BF). All HDSS residents older than 6 years were eligible. N = 150 participants were randomly selected from the HDSS database to wear a wristband tracker (Withings Pulse HR) and n = 69 also a thermometer patch (Tucky thermometer) for 3 weeks. Every 4 days, a trained field worker conducted an acceptability questionnaire with participants, which included questions for the field workers as well. Descriptive and qualitative thematic analyses were used to analyze the responses of study participants and field workers.ResultsIn total, n = 148 participants were included (and n = 9 field workers). Participant's acceptability ranged from 94 to 100% throughout the questionnaire. In 95% of the cases (n = 140), participants reported no challenges with the wearable. Most participants were not affected by the wearable in their daily activities (n = 122, 83%) and even enjoyed wearing them (n = 30, 20%). Some were concerned about damage to the wearables (n = 7, 5%). Total data coverage (i.e., the proportion of the whole 3-week study duration covered by data) was 43% for accelerometer (activity), 3% for heart rate, and 4% for body shell temperature. Field workers reported technical issues like faulty synchronization (n = 6, 1%). On average, participants slept 7 h (SD 3.2 h) and walked 8,000 steps per day (SD 5573.6 steps). Acceptability and data completeness were comparable across sex, age, and study arms.ConclusionWearable devices were well-accepted and were able to produce continuous measurements, highlighting the potential for wearables to generate large datasets in LMICs. Challenges constituted data missingness mainly of technical nature. To our knowledge, this is the first study to use consumer-focused wearables to generate objective datasets in rural BF.

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“…Wearables can generate a solid database for global health research, particularly for morbidity measurements [235], large-scale studies, and modeling and descriptive studies. Topics such as climate change-induced impacts focusing on extreme weather events as an outcome and impact on health [236] may be approached. For example, 1 study [20] measured the physiological response of farm workers to climate conditions with wearables to investigate heat-related illness in a high-income setting.…”

Section: Global Health and Low-resource Contextsmentioning

confidence: 99%

The Impact of Wearable Technologies in Health Research: Scoping Review

Huhn¹,

Axt²,

Gunga³

et al. 2022

JMIR Mhealth Uhealth

Self Cite

117

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Background Wearable devices hold great promise, particularly for data generation for cutting-edge health research, and their demand has risen substantially in recent years. However, there is a shortage of aggregated insights into how wearables have been used in health research. Objective In this review, we aim to broadly overview and categorize the current research conducted with affordable wearable devices for health research. Methods We performed a scoping review to understand the use of affordable, consumer-grade wearables for health research from a population health perspective using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) framework. A total of 7499 articles were found in 4 medical databases (PubMed, Ovid, Web of Science, and CINAHL). Studies were eligible if they used noninvasive wearables: worn on the wrist, arm, hip, and chest; measured vital signs; and analyzed the collected data quantitatively. We excluded studies that did not use wearables for outcome assessment and prototype studies, devices that cost >€500 (US $570), or obtrusive smart clothing. Results We included 179 studies using 189 wearable devices covering 10,835,733 participants. Most studies were observational (128/179, 71.5%), conducted in 2020 (56/179, 31.3%) and in North America (94/179, 52.5%), and 93% (10,104,217/10,835,733) of the participants were part of global health studies. The most popular wearables were fitness trackers (86/189, 45.5%) and accelerometer wearables, which primarily measure movement (49/189, 25.9%). Typical measurements included steps (95/179, 53.1%), heart rate (HR; 55/179, 30.7%), and sleep duration (51/179, 28.5%). Other devices measured blood pressure (3/179, 1.7%), skin temperature (3/179, 1.7%), oximetry (3/179, 1.7%), or respiratory rate (2/179, 1.1%). The wearables were mostly worn on the wrist (138/189, 73%) and cost <€200 (US $228; 120/189, 63.5%). The aims and approaches of all 179 studies revealed six prominent uses for wearables, comprising correlations—wearable and other physiological data (40/179, 22.3%), method evaluations (with subgroups; 40/179, 22.3%), population-based research (31/179, 17.3%), experimental outcome assessment (30/179, 16.8%), prognostic forecasting (28/179, 15.6%), and explorative analysis of big data sets (10/179, 5.6%). The most frequent strengths of affordable wearables were validation, accuracy, and clinical certification (104/179, 58.1%). Conclusions Wearables showed an increasingly diverse field of application such as COVID-19 prediction, fertility tracking, heat-related illness, drug effects, and psychological interventions; they also included underrepresented populations, such as individuals with rare diseases. There is a lack of research on wearable devices in low-resource contexts. Fueled by the COVID-19 pandemic, we see a shift toward more large-sized, web-based studies where wearables increased insights into the developing pandemic, including forecasting models and the effects of the pandemic. Some studies have indicated that big data extracted from wearables may potentially transform the understanding of population health dynamics and the ability to forecast health trends.

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Feasibility, acceptability and validation of wearable devices for climate change and health research in the low-resource contexts of Burkina Faso and Kenya: Study protocol

Cited by 26 publications

References 59 publications

Wearables for Measuring Health Effects of Climate Change–Induced Weather Extremes: Scoping Review

Wearables for Measuring Health Effects of Climate Change–Induced Weather Extremes: Scoping Review

Using wearable devices to generate real-world, individual-level data in rural, low-resource contexts in Burkina Faso, Africa: A case study

The Impact of Wearable Technologies in Health Research: Scoping Review

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