The Use of Activity Trackers in Interventions for Childhood Cancer Patients and Survivors: A Systematic Review

Ha, Lauren; Mizrahi, David; Wakefield, Claire E.; Cohn, Richard J.; Simar, David; Signorelli, Christina

doi:10.1089/jayao.2020.0099

Cited by 16 publications

(9 citation statements)

References 63 publications

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“…Firstly, interventions including some kind of counseling [ 54 , 60 , 71 ] and/or goal-setting techniques [ 73 , 86 , 90 ], in addition to consumer-wearable activity trackers, were highlighted as more effective than those without them for improving school-aged children’s daily total steps. These results are in accordance with previous studies’ recommendations about the inclusion of these explicit strategies (e.g., advice about PA benefits, strategies to reduce SB and increase PA, resolution of barriers to PA practice, or goal-setting strategies based on the international guidelines) which make students feel that they are making an informed decision about their health in any kind of program for PA promotion [ 11 , 13 ] and specifically in wearable-based programs [ 27 , 115 ]. Nevertheless, apparently contradictory results showed that consumer-wearable activity trackers-based programs which did not include any exercise routine seem to be more effective than those that included it for improving school-aged children’s daily MVPA levels.…”

Section: Discussionsupporting

confidence: 90%

“…Specifically, the number of reviews focused on the use of wearable activity trackers to increase PA and reduce SB levels has grown exponentially in recent years. However, most of them have been carried out in adults [ 24 – 26 ] or clinical populations [ 16 , 27 ], leaving little evidence on the effectiveness of wearable activity trackers in apparently healthy school-aged children.…”

Section: Introductionmentioning

confidence: 99%

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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

et al. 2022

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Background The popularity of consumer-wearable activity trackers has led the scientific community to conduct an increasing number of intervention studies integrating them to promote physical activity (PA) and to reduce sedentary behavior (SB) levels among school-aged children. Therefore, the aim of the present study was to estimate the effects of consumer-wearable activity tracker-based programs on daily objectively measured PA and SB among apparently healthy school-aged children, as well as to compare the influence of participants’ and programs’ characteristics. Methods Eligibility criteria were: (1) participants: apparently healthy school-aged children (< 18 years old); (2) intervention: aimed to promote PA and/or to reduce SB incorporating consumer-wearable activity trackers; (3) comparator: baseline measurements and/or a control/traditional group; (4) outcomes: objectively measured daily PA and/or SB levels; (5) study design: pre-experimental, quasi-experimental, and true-experimental trials. Relevant studies were searched from eight databases up to December 2020, as well as from four alternative modes of searching. Based on the Cochrane Risk-of-bias tool 2, the risk of bias was assessed following four domains: (1) randomization process; (2) missing outcome data; (3) measurement of the outcomes; and (4) selection of the reported results. Based on a comprehensive systematic review, meta-analyses of the Cohen’s standardized mean difference (d) and 95% confidence interval (CI) with a random-effects model were conducted to estimate the overall effects, as well as the within- and between-study subgroups analyses effects, of the programs on daily total steps, moderate-to-vigorous PA (MVPA), total PA and SB. Results Forty-four publications (i.e., 45 studies) were included in the systematic review (5,620 unique participants; mean age = 12.85 ± 2.84 years) and 40 publications (i.e., 41 studies) in the meta-analysis. Programs had a mean length of 11.78 ± 13.17 weeks and most used a waist-worn consumer-wearable activity tracker (77.78% waist-worn; 22.22% wrist-worn). Programs characteristics were: goal-setting strategies (64.06%); participants’ logbooks (56.25%); counseling sessions (62.50%); reminders (28.13%); motivational strategies (42.19%); and exercise routine (17.19%). Results showed a statistically significant moderate favorable effect on daily total steps (d = 0.612, 95% CI 0.477–0.746), small favorable effect on daily MVPA (d = 0.220, 95% CI 0.134–0.307), trivial favorable effect on daily total PA (d = 0.151, 95% CI 0.038–0.264) and trivial unfavorable effect on daily SB (d = 0.172, 95% CI 0.039–0.305). Subgroups analyses showed a higher effect for daily total steps and daily MVPA levels in females and the physically inactive for daily total steps (p = 0.003–0.044). Programs with educational counseling and/or goal-setting strategies, as well as a greater number of strategies, were more effective for improving children’s daily total steps, and wrist-worn activity trackers were more effective than waist-worn trackers for improving their daily MVPA levels (p = 0.001–0.021). Conclusions Consumer-wearable activity tracker-based programs seem to be effective in promoting school-aged children’s daily total steps and MVPA levels, especially for females and those that are physically inactive. These programs should include specific goal-setting, educational counseling, and wrist-worn trackers as especially effective strategies. However, due to the certainty of evidence being from “low” to “moderate”, future well-designed primary research studies about the topic are needed. PROSPERO: CRD42020222363.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

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

et al. 2022

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“…Our findings are consistent with previous reviews, although these reviews have been limited in their ability to evaluate physical activity interventions involving wearable devices in the wider cancer population due to the evaluation of non-RCT study designs, 24 a specific focus on childhood cancer 75 and systematic reviews of the literature without meta-analyses. 24 , 75 , 76 A small effect on MVPA (SMD = 0.21) was reported in a 2018 meta-analysis of distance-based physical activity interventions (which included the use of pedometers) for cancer survivors. 77 The greater effect size in our findings (SMD = 0.61) could be attributed to greater effectiveness of newer wearable devices (e.g., Fitbits) in more recently published studies.…”

Section: Discussionmentioning

confidence: 99%

“…Nonetheless, this systematic review and meta-analysis reflects the most comprehensive assessment of physical activity tracker and pedometer-based interventions for individuals with cancer available. Unlike previous reviews, 24 , 75 , 76 our review comprehensively evaluated various cancers during different phases of treatment (during adjuvant treatment and post-treatment). Other strengths of our work include the evaluation of RCTs exclusively and the reporting of subgroup analyses that identified potential associations between treatment and intervention characteristics on the effect on health outcomes.…”

Section: Discussionmentioning

confidence: 99%

Effect and feasibility of wearable physical activity trackers and pedometers for increasing physical activity and improving health outcomes in cancer survivors: A systematic review and meta-analysis

Singh

Zopf

Howden

2022

Journal of Sport and Health Science

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“…As a result, families from rural and regional areas have less access to supportive care, experience greater cancer-related financial hardship in survivorship than metropolitan families, and are therefore at highest risk of poor health outcomes [13,14]. Consequently, the delivery of health behavior interventions using distance-delivered technologies is a growing field to address physical inactivity and low fitness levels, as well as to improve access to services among this population [15][16][17].…”

Section: Introductionmentioning

confidence: 99%

A Digital Educational Intervention With Wearable Activity Trackers to Support Health Behaviors Among Childhood Cancer Survivors: Pilot Feasibility and Acceptability Study

Ha¹,

Wakefield²,

Mizrahi³

et al. 2022

JMIR Cancer

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Background Childhood cancer survivors are at increased risk of cardiometabolic complications that are exacerbated by poor health behaviors. Critically, many survivors do not meet physical activity guidelines. Objective The primary aim was to evaluate the feasibility and acceptability of iBounce, a digital health intervention for educating and engaging survivors in physical activity. Our secondary aims were to assess the change in survivors’ physical activity levels and behaviors, aerobic fitness, and health-related quality of life (HRQoL) after participating in the iBounce program. Methods We recruited survivors aged 8 to 13 years who were ≥12 months post cancer treatment completion. The app-based program involved 10 educational modules, goal setting, and home-based physical activities monitored using an activity tracker. We assessed objective physical activity levels and behaviors using cluster analysis, aerobic fitness, and HRQoL at baseline and after the intervention (week 12). Parents were trained to reassess aerobic fitness at home at follow-up (week 24). Results In total, 30 participants opted in, of whom 27 (90%) completed baseline assessments, and 23 (77%) commenced iBounce. Our opt-in rate was 59% (30/51), and most (19/23, 83%) of the survivors completed the intervention. More than half (13/23, 57%) of the survivors completed all 10 modules (median 10, IQR 4-10). We achieved a high retention rate (19/27, 70%) and activity tracker compliance (15/19, 79%), and there were no intervention-related adverse events. Survivors reported high satisfaction with iBounce (median enjoyment score 75%; ease-of-use score 86%), but lower satisfaction with the activity tracker (median enjoyment score 60%). Parents reported the program activities to be acceptable (median score 70%), and their overall satisfaction was 60%, potentially because of technological difficulties that resulted in the program becoming disjointed. We did not observe any significant changes in physical activity levels or HRQoL at week 12. Our subgroup analysis for changes in physical activity behaviors in participants (n=11) revealed five cluster groups: most active, active, moderately active, occasionally active, and least active. Of these 11 survivors, 3 (27%) moved to a more active cluster group, highlighting their engagement in more frequent and sustained bouts of moderate-to-vigorous physical activity; 6 (56%) stayed in the same cluster; and 2 (18%) moved to a less active cluster. The survivors’ mean aerobic fitness percentiles increased after completing iBounce (change +17, 95% CI 1.7-32.1; P=.03) but not at follow-up (P=.39). Conclusions We demonstrated iBounce to be feasible for delivery and acceptable among survivors, despite some technical difficulties. The distance-delivered format provides an opportunity to engage survivors in physical activity at home and may address barriers to care, particularly for regional or remote families. We will use these pilot findings to evaluate an updated version of iBounce. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12621000259842; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=ACTRN12621000259842

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The Use of Activity Trackers in Interventions for Childhood Cancer Patients and Survivors: A Systematic Review

Cited by 16 publications

References 63 publications

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

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

Effect and feasibility of wearable physical activity trackers and pedometers for increasing physical activity and improving health outcomes in cancer survivors: A systematic review and meta-analysis

A Digital Educational Intervention With Wearable Activity Trackers to Support Health Behaviors Among Childhood Cancer Survivors: Pilot Feasibility and Acceptability Study

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