Can a Free Wearable Activity Tracker Change Behavior? The Impact of Trackers on Adults in a Physician-Led Wellness Group.
Can a Free Wearable Activity Tracker Change Behavior? The Impact of Trackers on Adults in a Physician-Led Wellness Group.
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DOI：
10.2196/resprot.6534
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发表时间：
2016-11-30
影响因子：
1.7
通讯作者：
Phillips J
中科院分区：
文献类型：
--
作者：
Gualtieri L;Rosenbluth S;Phillips J
可穿戴活动跟踪器（跟踪器）是用于跟踪步数和其他健康指标的越来越受欢迎的设备。追踪器有可能使那些需要增加体力活动的人受益，例如年龄较大并面临重大健康挑战的成年人。这些人群最不可能购买追踪器，最有可能在使用它们时面临挑战，但一旦这些障碍被消除，它们可能会从使用中获得教育，激励和健康益处。这项试点研究的目的是调查以前从未使用过跟踪器的慢性疾病成年人使用跟踪器的情况。具体来说，我们的目标是确定（1）参与者是否会接受并使用跟踪器来增加他们的身体活动;（2）除了成本和培训之外，是否存在使用障碍;（3）跟踪器是否会教育参与者他们的基线和持续活动水平并支持行为改变;以及（4）临床结果是否会显示参与者健康状况的改善。这项研究是在家庭医生有限责任公司提供的12周医生领导的健康小组中对患者（N=10）进行的。在健康小组的第二周，患者被给予追踪器，并在结束后2至4周接受采访。研究人员分析了访谈记录，以提取有关参与者态度和行为变化的主题，并收集和分析了参与者的临床数据，包括研究过程中的体重和低密度脂蛋白（LDL）胆固醇。在使用追踪器的12至14周内，临床结果、对追踪器的态度和身体活动行为都有所改善。参与者平均每周减轻0.5磅（SD 0.4），平均总体重减轻5.97磅（P=.004）。其他短期临床结果包括LDL水平降低9.2%（P= 0.038）。所有参与者都报告说，他们的幸福感和对自己过上更积极生活的能力的信心都有所增加。通过对访谈记录的定性分析，我们确定了以下6个主要的态度主题：（1）购买追踪器的障碍包括成本、感知价值和选择困惑;（2）许多人对追踪者的态度发生了变化，一半的参与者表示兴奋和希望，一半的人表示犹豫或恐惧，所有参与者在访谈时对他们的跟踪器感到积极;（3）跟踪器作为基线活动水平的教育工具;（4）跟踪器提供了关于身体活动的具体反馈，这促使了行为改变;（5）追踪器的使用加强了健康小组的活动和目标;（6）尽管对追踪器使用的承诺没有动摇，但外部环境影响了一些参与者的持续使用。我们的研究结果表明，在主要由患有慢性疾病的老年人组成的健康团体中添加跟踪器可以支持教育和行为改变，以便更加积极地进行身体活动。追踪器通过提供有形的、可见的提醒来提高参与者的自我效能感，提醒他们致力于增加活动，并立即反馈步数和每日步数目标的进展。虽然接受程度很高，态度最终也是积极的，但需要培训和支持，预计参与者的使用会在短期内下降。未来的研究将进一步考虑追踪器在患有慢性疾病的老年人中的潜力，这些老年人不太可能购买追踪器，研究将使用更大的样本，持续更长的时间，并评估独立于健康组的结果。
Wearable activity trackers (trackers) are increasingly popular devices used to track step count and other health indicators. Trackers have the potential to benefit those in need of increased physical activity, such as adults who are older and face significant health challenges. These populations are least likely to purchase trackers and most likely to face challenges in using them, yet may derive educational, motivational, and health benefits from their use once these barriers are removed. The aim of this pilot research is to investigate the use of trackers by adults with chronic medical conditions who have never used trackers previously. Specifically, we aim to determine (1) if participants would accept and use trackers to increase their physical activity; (2) if there were barriers to use besides cost and training; (3) if trackers would educate participants on their baseline and ongoing activity levels and support behavior change; and (4) if clinical outcomes would show improvements in participants’ health. This study was conducted with patients (N=10) in a 12-week physician-led wellness group offered by Family Doctors, LLC. Patients were given trackers in the second week of The Wellness Group and were interviewed 2 to 4 weeks after it ended. The study investigators analyzed the interview notes to extract themes about the participants’ attitudes and behavior changes and collected and analyzed participants’ clinical data, including weight and low-density lipoprotein (LDL) cholesterol over the course of the study. Over the 12 to 14 weeks of tracker use, improvements were seen in clinical outcomes, attitudes towards the trackers, and physical activity behaviors. Participants lost an average of 0.5 lbs per week (SD 0.4), with a mean total weight loss of 5.97 lbs (P=.004). Other short-term clinical outcomes included a 9.2% decrease in LDL levels (P=.038). All participants reported an increase in well-being and confidence in their ability to lead more active lives. We identified the following 6 major attitudinal themes from our qualitative analysis of the interview notes: (1) barriers to tracker purchase included cost, perceived value, and choice confusion; (2) attitudes towards the trackers shifted for many, from half of the participants expressing excitement and hope and half expressing hesitation or trepidation, to all participants feeling positive towards their tracker at the time of the interviews; (3) trackers served as educational tools for baseline activity levels; (4) trackers provided concrete feedback on physical activity, which motivated behavior change; (5) tracker use reinforced wellness group activities and goals; and (6) although commitment to tracker use did not waver, external circumstances influenced some participants’ ongoing use. Our findings suggest that adding trackers to wellness groups comprising primarily older adults with chronic medical conditions can support education and behavior change to be more physically active. The trackers increased participant self-efficacy by providing a tangible, visible reminder of a commitment to increasing activity and immediate feedback on step count and progress towards a daily step goal. While acceptance was high and attitudes ultimately positive, training and support are needed and short-term drop-off in participant use is to be expected. Future research will further consider the potential of trackers in older adults with chronic medical conditions who are unlikely to purchase them, and studies will use larger samples, continue over a longer period of time, and evaluate outcomes independent of a wellness group.