UNDERSTANDING PHYSICAL ACTIVITY BEHAVIOUR IN CANADIANS LIVING WITH CHRONIC DISEASE: A RETROSPECTIVE COHORT STUDY

Abstract

Regular physical activity (PA) can reduce the incidence of many chronic diseases. Rural-dwelling Canadians are at a higher risk of developing chronic diseases than their urban counterparts – potentially due to higher rates of inactivity. There is a scarcity of literature describing PA in these high-risk groups. Smartphones and mHealth apps such as Carrot Rewards (reward-based app downloaded by 1.3+ million Canadians) provide a unique opportunity to measure free-living PA amongst Canadians living with chronic disease. PURPOSE: To determine (1) daily step count averages (data collected by Carrot Rewards) for participants who self-report at least one chronic disease vs. those self-reporting none, and (2) whether these averages vary with living environment. METHODS: In this retrospective cohort study, 12,327 Ontarians (age: M=34.72, SD=13.63, gender: female 62.9%, male 35.3%, other 1.8%), completed a ‘chronic disease’ Carrot Rewards survey adapted from the Canadian Community Health Survey. In this survey, participants could self-report chronic disease diagnoses including: diabetes, cardiovascular disease, chronic obstructive pulmonary disease, cancer and mood/anxiety disorders. Smartphone accelerometers, (HealthKit (iOS), Google Fit (Android) or FitBit) collected step count data which was retrieved by the Carrot Rewards app. Self-reported demographic information indicated participant rural/urban status. RESULTS: 37.7% of survey respondents reported being diagnosed with at least one chronic disease and 33% identified as rural-dwelling. Participants with at least one chronic disease had a significantly lower (p<.001) daily step count average (M=5136.29, SD=3732.83) than those with no diagnosis (M=5724.24, SD=3960.47). Rural-dwelling persons (M=5422.40, SD=3943.49) had lower mean daily step count averages than their urban counterparts (M=5542.61, SD=3858.32), though not statistically significant (p=.123). CONCLUSIONS: This study provides an objective lens into the PA behaviours of understudied Canadian populations. Individuals living with chronic disease had significantly lower daily step counts when compared to their ‘healthy’ counterparts. A fundamental understanding of PA behaviours for at-risk Canadians may help inform the design of targeted PA interventions in the future.