Using Novel Technology within a School-Based Setting to Increase Physical Activity: A Pilot Study in School-Age Children from a Low-Income, Urban Community

Abstract

Background Less than half of American children meet national physical activity (PA) recommendations. This study tested the feasibility, acceptability, and preliminary effectiveness of using wearable PA monitors to increase PA in school-age children. Methods In Phase 1 of this study, conducted in 2014, 32 fifth-grade students enrolled in a low-resource middle school were given a waist-worn Fitbit Zip monitor for 4 weeks to test its feasibility (adherence) and acceptability. Adherence, wear time of ≥8 hours per day, was examined. Feedback was solicited from parents through structured interviews. In Phase 2, conducted in 2015, 42 sixth-grade students were assigned, by classroom, to one of three conditions (Fitbit + goal and incentive-based intervention, Fitbit only, or control) to test the feasibility of the wrist-worn Fitbit Charge and its preliminary effectiveness in increasing PA over 6 weeks. Results In Phase 1, average adherence was 64.1%. In Phase 2, it was 73.4% and 80.2% for participants in the Fitbit + intervention and Fitbit only groups, respectively (p = .07). After controlling for baseline values, weight status, and sex, there were no significant group differences in changes in MVPA or steps from baseline to follow-up. Conclusions While moderately acceptable, wearable PA monitors did not increase PA levels in this sample. They may be more effective within a coordinated school-based physical activity program.

Translatability of a Wearable Technology Intervention to Increase Adolescent Physical Activity: Mixed Methods Implementation Evaluation

“…The findings from this study support previous research that shows that wearable technology interventions are both acceptable among adolescents [ 11 ] and feasible for implementation within the school setting [ 10 ]. Overall, there were few sex differences in adolescent males’ and females’ experiences and perceptions of RAW-PA, apart from males being significantly more likely than females to like the Facebook page and weekly videos.…”

“…There is a dearth of data about wearable activity tracker ownership in adolescents, although one study found that approximately 25% of adolescents owned such devices, with more males than females reporting ownership [ 9 ]. Of note, school-based research has shown that wearable activity monitors have moderate acceptability among school-aged children in low-income communities [ 10 ]. Furthermore, there is some initial evidence that adolescents are generally positive about the use of wearable technology for tracking physical activity, and use device features to set goals and undertake challenges against friends [ 11 ].…”

“…Furthermore, there is some initial evidence that adolescents are generally positive about the use of wearable technology for tracking physical activity, and use device features to set goals and undertake challenges against friends [ 11 ]. From a school's perspective, wearable technology interventions have the potential to be highly implementable, given the low burden placed on teachers to deliver and potential minimal interference with existing school practices [ 10 ].…”

Comparison of a Wearable Tracker with Actigraph for Classifying Physical Activity Intensity and Heart Rate in Children

“…The Fitbit brand trackers have been largely used in intervention studies as a self-monitoring tool for the promotion of physical activity in children [28,29,30,31,32,33]. However, given that the accuracy of the Fitbit monitors for children was unknown, a caveat of these previous studies was that the researchers applied a research-grade monitor such as ActiGraph or a SenseWear armband to ensure a collection of accurate estimates of PA data [28]. However, using those research-grade activity monitors in addition to Fitbit monitors may have hindered achieving high adherence rates due to the increased burden of participants, especially in children.…”

Towards remote monitoring in pediatric care and clinical trials—Tolerability, repeatability and reference values of candidate digital endpoints derived from physical activity, heart rate and sleep in healthy children

“…Data from screening days (n = 175) and all days with a watch wear time < 50% between 6AM and 10PM were excluded from analyses regarding daytime measurements (146 study days), while all days with a watch wear time < 50% between 0AM and 5AM (268 study days) were excluded from analyses regarding nocturnal measurements. This 50% threshold has been chosen in earlier studies as well [ 13 , 14 ].…”