Fighting Hypertension In The Digital Age - A Lifestyle Intervention To Promote Physical Activity

Abstract

PURPOSE: Although activity trackers are widely utilized, little is known about the effectiveness of activity trackers alone or combined with additional behavior change strategies to promote healthy lifestyles in individuals with pre-hypertension or hypertension. The purpose of the study was to determine the effectiveness of wearable activity trackers alone or in combination with behavior change strategies for promoting physical activity (PA) among individuals with pre-hypertension or hypertension. METHODS: A sample of 44 adults with pre-hypertension or hypertension (68% female) were randomized to receive either a Fitbit Charge HR 3 alone (FB) or the Fitbit in combination with behavior change strategies delivered by a trained health coach (FB+) for 12 weeks. Activity behaviors were assessed using ActiGraph wGT3X-BT, and psychological measures of social support, self-efficacy, self-regulation, and self-motivation were assessed using validated questionnaires. Compliance of wear time and daily activity data were tracked by Fitbit. The within-group and between-group effect size of Cohen’s d for change scores were calculated in the PA outcomes and psychological measures. The effect of the intervention on change in PA was tested with multiple linear regression controlling for demographic variables. RESULTS: Participants in FB+ had higher adherence with an average of 70.4 valid days (at least 10 h/day) out of 84 days in total compared to FB (65.0 days). The FB+ group showed significant increases in daily steps (+1854 steps/day, p < .01), moderate and vigorous physical activity (MVPA; +26 mins/day, p < .05), and decreases in sedentary time (-63 mins/day, p < .01). A similar pattern was found in participants from the FB but with smaller change from baseline to post-intervention (steps: +764/day, p < .1; MVPA: +10 mins/day, p < .05; sedentary time: -89 mins/day, p < .01). Participants from FB+ had significantly greater increases in MVPA/day compared to FB only group with a between-group effect size of 0.6 (p < .05). CONCLUSIONS: The study indicated that the usage of Fitbit for self-monitoring is effective in increasing PA and reducing sedentary time among pre-hypertensive and hypertensive participants. Additional behavior change support amplified the intervention effectiveness for promoting MVPA.