The Acceptability, Feasibility, and Effectiveness of Wearable Activity Trackers for Increasing Physical Activity in Children and Adolescents: A Systematic Review

Abstract

Wearable activity trackers (wearables) embed numerous behaviour change techniques (BCTs) that have previously been shown to increase adult physical activity (PA). With few children and adolescents achieving PA guidelines, it is crucial to explore ways to increase their PA. This systematic review examined the acceptability, feasibility, and effectiveness of wearables and their potential mechanisms of action for increasing PA in 5 to 19-year-olds. A systematic search of six databases was conducted, including data from the start date of each database to December 2019 (PROSPERO registration: CRD42020164506). Thirty-three studies were included. Most studies (70%) included only adolescents (10 to 19 years). There was some—but largely mixed—evidence that wearables increase steps and moderate-to-vigorous-intensity PA and reduce sedentary behaviour. There were no apparent differences in effectiveness based on the number of BCTs used and between studies using a wearable alone or as part of a multi-component intervention. Qualitative findings suggested wearables increased motivation to be physically active via self-monitoring, goal setting, feedback, and competition. However, children and adolescents reported technical difficulties and a novelty effect when using wearables, which may impact wearables’ long-term use. More rigorous and long-term studies investigating the acceptability, feasibility, and effectiveness of wearables in 5 to 19-year-olds are warranted.

Validation of the Apple Watch for Estimating Moderate-to-Vigorous Physical Activity and Activity Energy Expenditure in School-Aged Children

“…Of these, MVPA time tracking is an essential factor in evaluating whether the level of PA is adequate in children. Further, the use of wearable activity monitors is effective at increasing inactive children’s PA level by incorporating self-monitoring and goal setting for MVPA [ 8 ]. Lastly, using Apple Watch, researchers can collect multiple physiological (i.e., heart rate, blood pressure) and behavioral (i.e., PA) profiles in children with minimal burden.…”

“…Such quantification of activity intensities, time, and AEE in real-time has been made possible through the advancement of micro-technology and the deployment of various consumer-based wearable devices, such as activity trackers and smartwatches. Smartwatches, in particular, have recently been recognized as effective tools in monitoring PA patterns in both clinical and research settings due to wear convenience and real-time monitoring of steps, energy expenditure (EE), and intensity of activities [ 6 , 7 , 8 ].…”

Effects of Consumer-Wearable Activity Tracker-Based Programs on Objectively Measured Daily Physical Activity and Sedentary Behavior Among School-Aged Children: A Systematic Review and Meta-analysis

“…To our knowledge, only Ridgers et al [ 28 ], Böhm et al [ 29 ], Cajita et al [ 30 ], and Creaser et al [ 31 ] reviews included intervention studies carried out with both apparently healthy school-aged children and those with diagnosed diseases (e.g., cancer or diabetes) for promoting PA with consumer-wearable activity trackers. However, those reviews have considerable limitations.…”

“…All the above-mentioned reasons could explain the limited evidence found (i.e., low number of publications) in their reviews, due to the inclusion of only five [ 28 , 29 ] or two studies in their analyses [ 30 ]. Regarding the most recent Creaser et al's [ 31 ] review, it included more publications (i.e., 24 studies), but if only effectiveness studies with apparently healthy school-aged children and objectively measured daily PA and SB levels were considered, this would decrease to 11 studies. Moreover, it should be noted that Cajita et al [ 30 ] conducted only a scoping review, whose objective was only to provide an overview of the available research evidence without producing a summary answer to a discrete research question [ 38 ].…”

Daily Physical Activity and Sleep Measured by Wearable Activity Trackers during the Coronavirus Disease 2019 Pandemic: A Lesson for Preventing Physical Inactivity during Future Pandemics

“…Wearable devices that can comfortably be worn on the body and perform several tasks in conjunction with handheld devices, such as smartphones, play a pivotal role in healthcare [6]. Recent systematic reviews have shown that wearable devices are useful for monitoring heart rate and sleep in hospital settings [7], increasing physical activity in children and adolescents [8], improving health-related outcomes in patients with cancer [9], and reducing body weight in individuals with obesity [10]. In addition, during the COVID-19 pandemic, sleep pattern and duration were accurately and effectively monitored by wearable devices [11][12][13][14][15].…”