Jawbone UP Research Articles

TRACK & ACT: a pragmatic randomised controlled trial exploring the comparative effectiveness of pedometers and activity trackers for changing physical activity and sedentary behaviour in inactive individuals

BackgroundPedometers have been shown to be effective for increasing physical activity, however the potential additional effects of activity trackers, and their added capacity to simultaneously modify sedentary behaviour, has not been thoroughly explored. This study aimed to explore the comparative effectiveness of two activity trackers and a pedometer for improving daily step count and moderate-vigorous physical activity (MVPA), and reducing sedentary behaviour in inactive adults.Methods48 inactive participants were allocated to one of three groups based on their workplace. Each group randomly received either a Fitbit ONE, Jawbone UP or Digi-Walker SW200 pedometer (PED) for 8-weeks and an orientation session to their respective device. Participants were informed about the study aims and were provided with their respective devices and where applicable, the associated Apps. Participants intentionally received no other active intervention components to simulate as closely as possible the experience of purchasing a device ‘off the shelf’. Step count, MVPA and time in sedentary behaviour were measured using accelerometry (Actigraph GT3X+) at baseline and four-, eight- and 16-weeks. Analyses were conducted using linear mixed-effect regression models to compare changes from baseline. Post-hoc tests of model estimates compared each activity tracker group to the pedometer group. Model estimates are reported for baseline-16 week follow-up.ResultsAt baseline, average (standard deviation) step count, MVPA and time spent sedentary was 6557 (2111) steps/day, 23 (13) minutes/day and 10.3 (1.0) hours/day in the PED group, 7156 (1496) steps/day, 26 (12) minutes/day and 9.3 (1.2) hours/day in the ONE group and 6853 (1281) steps/day, 29 (10) minutes/day and 10.1 (1.0) hours/day in the UP group. At 16-weeks, based on estimates from the linear mixed-effect regression model, the ONE and UP groups increased step count by 129 steps/day (95% CI − 1497, 1754) and 504 steps/day more (95% CI − 1120, 2130), respectively, than the PED group. For MVPA, the ONE and UP groups increased by 2.3 min/day (95% CI − 10.9, 15.4) and 2.7 min/day more (95% CI − 10.5, 15.8), respectively, than the PED group. For sedentary behaviour, the ONE group had 34 min/day more in time spent sedentary than the PED group (95% CI − 35, 104), while the UP group had 53 min/day more in time spent sedentary than the PED group (95% CI − 18, 123).ConclusionsAll three groups demonstrated an increase in steps and MVPA, and a decrease in time spent in sedentary behaviour, however there was substantial individual variation in these outcomes indicating considerable uncertainty about the relative effectiveness of activity trackers and pedometers in improving PA and sedentary behaviour. Randomised controlled trials with adequate sample sizes are indicated.Trial registrationACTRN12623000027617 (retrospectively registered 11/1/2023).

Does Online Social Connectivity Promote Physical Activity in a Wearable Tracker-Based Intervention? A Pilot Randomized Controlled Study

Wearable activity trackers have gained popularity among individuals who want to track their physical activity (PA). The features of wearable tracking technology that are known to facilitate positive behavior changes such as self-monitoring and social connectedness) are well documented; yet, the existing evidence is not conclusive in the literature requiring further investigation. This study was an 8-week pilot randomized controlled study examining the effectiveness of PA intervention incorporating a wearable activity tracker’s online connectivity feature. Forty participants were equally randomized into either an individual-based (n = 20) or a connected group (n = 20). A Jawbone UP24 tracker was provided to all participants in both groups as a means of self-monitoring PA for eight weeks, but the connected group was additionally instructed to share their PA levels with the others using the accompanying smartphone application. Participants’ weekly step counts were evaluated each week to examine the change in PA. Participants’ biometric variables such as body weight, body mass index, waist circumference, blood pressure, and psychological status, including self-efficacy (SE) and exercise motivation (EM), were measured from both groups before and after the intervention period. Additionally, the social support questionnaire (SSQ) was measured among the connected group. The statistical significance level was set at <0.05. The average step counts for eight weeks were significantly increased only in the connected group (p < 0.001). Significant differences in step count improved from the baseline to week 8 in the connected user group (p < 0.01), but only baseline vs. week 7 in the individual users. Also, no significant interaction effects for biometric variables, EM, and SE were founded. However, SSQ was significantly improved in the connected user group (p < 0.001). PA intervention combining a wearable activity tracker and online social connectivity feature shows a greater effectiveness of promoting PA than a wearable tracker alone

A Mixed Methods Study on Engagement and Satisfaction with a Digitally-Enhanced Pilot Intervention Among African American and Hispanic Women.

African American and Hispanic women report less physical activity (PA) than non-Hispanic White women. As such, a digitally-enhanced 16-week social support pilot intervention was conducted to promote PA among African American and Hispanic women dyads. This study quantitatively and qualitatively examined the engagement and satisfaction of participants (N = 30; 15 dyads) assigned to the intervention. Intervention participants received telephone counseling calls based on motivational interviewing and a Jawbone UP activity monitor. Intervention engagement and satisfaction data were collected from the Jawbone UP, call logs, self-report questionnaires conducted at the 16-week follow-up, and two post-intervention focus groups. Nonparametric tests assessed group differences across engagement and satisfaction measures, and a manually-driven coding scheme was used to evaluate emerging themes from qualitative text. Participants demonstrated high engagement in the telephone counseling sessions and moderate engagement with the Jawbone UP. Friend/co-worker dyads and participants who were 45years and older were more likely to use the device. Qualitative results emphasized participants' appreciation for the counseling calls, the Jawbone UP, and the overall dyadic framework of the study to collectively nurture social support and accountability for PA. Overall, the intervention group reacted positively to study components. Additional research is needed to understand the role of technology in facilitating long-lasting PA change via social support in minority populations.

Criterion validity for step counting in four consumer-grade physical activity monitors among older adults with and without rollators

BackgroundFew studies have investigated the measurement properties of consumer-grade physical activity monitors (PAMs) in older adults. Therefore, we investigated the criterion validity of consumer-grade PAMs in older adults and whether the measurement properties differed between older adults with and without rollators and whether worn on the hip or at the wrist.MethodsConsumer-grade PAMs were eligible for inclusion in this study if they: 1) could be fastened at the hip as well as on the wrist, 2) were simple in function and design and thus easy to use for participants with minimal technical skills, 3) included step-counting as outcome measure and 4) were powered by a button cell battery. Participants performed self-paced walking for six minutes while two physiotherapists counted their steps with a click-counter. The average of the two counts was used as criterion. The participants wore 16 monitors, four located bilaterally on both hips and wrists. Our prior expectation was that all monitors would have at least moderate criterion validity for all participants, good criterion validity for participants walking without a rollator and poor criterion validity for participants walking with a rollator.ResultsFour physical activity monitors were included in this study; Misfit Shine, Nokia GO, Jawbone UP Move and Garmin Vivofit 3. A total of 103 older adults participated.Nokia GO was excluded from this study due to technical issues. Therefore, we present results on the frequency of data loss, ICC (1, 2) and percentage measurement error for Misfit Shine, Garmin Vivofit 3 and Jawbone UP Move located on four different positions.ConclusionsThe hip-worn PAMs did not differ significantly in terms of measurement error or criterion validity. Wrist-worn monitors cannot adequately measure number of steps in a population of older adults using rollators. The hip-worn PAMs were superior to wrist-worn PAMs among older adults with and without rollators.

Older adults' experiences of using a wearable activity tracker with health professional feedback over a 12-month randomised controlled trial.

ObjectiveWearable activity trackers can help older adults remain physically active. However, knowledge of the user experience during long-term use is scarce. Therefore, this study examined older adults’ experiences with, and perceptions of, wearable activity trackers combined with health professional feedback after a year’s use as part of a randomised controlled trial.MethodsTwenty older adults (73.6 ± 5.5 years) who had used a Jawbone UP24 activity tracker for 12 months during a randomised controlled trial were recruited for this study. All participants had at least one chronic condition. Acceptability data relating to activity tracker wear time was combined with focus group data to explore participants experiences of long-term activity tracker use. Data was analysed using thematic analysis.ResultsThe activity tracker was well-accepted with the device worn on an average of 86% of possible days and participants reported an overall positive experience. Four themes were identified: (a) increased sense of awareness of activity levels is related to motivation; (b) the level of engagement with the activity tracker influences the user experience; (c) the role of feedback from a health professional in providing ongoing support; d) the role of habits in supporting long-term behaviour change.ConclusionsThe use of an activity tracker combined with health professional support can assist older adults to maintain their activity levels over 12 months. Consideration should be given to the previous technology experience of users and the design and accuracy of an activity tracker when recommending their use in a research or clinical setting.

Social Support Patterns of Middle-Aged and Older Adults Within a Physical Activity App: Secondary Mixed Method Analysis.

BackgroundPhysical activity (PA) is critical for maintaining independence and delaying mobility disability in aging adults. However, 27 to 44% of older adults in the United States are meeting the recommended PA level. Activity trackers are proving to be a promising tool to promote PA adherence through activity tracking and enhanced social interaction features. Although social support has been known to be an influential behavior change technique to promote PA, how middle-aged and older adults use the social interaction feature of mobile apps to provide virtual support to promote PA engagement remains mostly underexplored.ObjectiveThis study aimed to describe the social support patterns of middle-aged and older adults using a mobile app as part of a behavioral PA intervention.MethodsData from 35 participants (mean age 61.66 [SD 6] years) in a 12-week, home-based activity intervention were used for this secondary mixed method analysis. Participants were provided with a Jawbone Up24 activity monitor and an Apple iPad Mini installed with the UP app to facilitate self-monitoring and social interaction. All participants were given an anonymous account and encouraged to interact with other participants using the app. Social support features included comments and likes. Thematic coding was used to identify the type of social support provided within the UP app and characterize the levels of engagement from users. Participants were categorized as superusers or contributors, and passive participants were categorized as lurkers based on the literature.ResultsOver the 12-week intervention, participants provided a total of 3153 likes and 1759 comments. Most participants (n=25) were contributors, with 4 categorized as superusers and 6 categorized as lurkers. Comments were coded as emotional support, informational support, instrumental support, self-talk, and other, with emotional support being the most prevalent type.ConclusionsOur cohort of middle-aged and older adults was willing to use the social network feature in an activity app to communicate with anonymous peers. Most of our participants were contributors. In addition, the social support provided through the activity app followed social support constructs. In sum, PA apps are a promising tool for delivering virtual social support to enhance PA engagement and have the potential to make a widespread impact on PA promotion.Trial RegistrationClinicalTrials.gov NCT01869348; https://clinicaltrials.gov/ct2/show/NCT01869348

Validity of Activity Trackers in Estimating Energy Expenditure During High-Intensity Functional Training

ABSTRACTPurpose: The purpose of this study was to evaluate the agreement of five commercially available accelerometers in estimating energy expenditure while performing an acute bout of high-intensity functional training (HIFT). Methods: Participants (n = 47; average age: 28.5 ± 11.6 years) consisted of recreationally active, healthy adults. Each participant completed a session of HIFT: a 15-minute workout consisting of 12 repetitions each of air-squats, sit-ups, push-ups, lunges, pull-ups, steps-ups, and high-knees; performed circuit-style by completing as many rounds as possible. During this session, each participant wore the Cosmed K4b2 portable metabolic analyzer (PMA) and five different accelerometers (ActiGraph GT3X, Nike Fuelband, Fitbit One, Fitbit Charge HR, and Jawbone UP Move). Results: Four of the five activity trackers reported lower (p < .05) total EE values compared to the PMA during the acute bout of HIFT. The waist-mounted device (ActiGraph, 182.55 ± 37.93 kcal) was not significantly different from, and most closely estimated caloric expenditure compared to the PMA (144.99 ± 37.13 kcal) (p = .056). A repeated-measures ANOVA showed that all activity trackers were significantly different from the reference measure (PMA) (p < .05). Systematic relative agreement between the activity trackers was calculated, exhibiting a significant ICC = 0.426 (F [46,230] = 5.446 [p < .05]). Conclusion: The wrist- and hip-mounted activity trackers did not accurately assess energy expenditure during HIFT exercise. With the exception of the ActiGraph GT3X, the remaining four activity trackers showed inaccurate estimates of the amount of kilocalories expended during the HIFT exercise bout compared to the PMA.

Changes in Self-Reported Health and Psychosocial Outcomes in Older Adults Enrolled in Sedentary Behavior Intervention Study.

To estimate changes in self-reported health and psychosocial factors associated with a 12-week sedentary behavior intervention for older adults. Exploratory secondary analysis of pilot randomized controlled trial. Kaiser Permanente Washington. Sixty adults aged 60 to 89 with body mass index ≥30 kg/m2. Participants were randomized to the I-STAND intervention or control group. I-STAND involved 6 coaching sessions, a study workbook, Jawbone UP activity tracker to prompt breaks from sitting, and activPAL feedback on objective sitting time. At baseline and 12-week follow-up, participants completed a survey with validated measures of self-reported health outcomes (depression, stress, memory/concentration, sleep, pain, ability to do daily activities, energy, and quality of life) and modified scales measuring psychosocial factors (perceived benefits/barriers, social support, self-efficacy, and sedentary habit strength) regarding sedentary behavior. Generalized linear models assessed associations between group assignment and change in each self-reported health and psychosocial score, adjusting for baseline scores. I-STAND participants demonstrated improvements in self-efficacy (β = 0.35, 95% confidence interval [CI]: 0.10 to 0.60) and reduced habit strength (β= -0.23, 95% CI: -0.42 to -0.04) compared to control participants. There were no significant differences in self-reported health outcomes, although power was limited in this exploratory analysis. A sedentary behavior reduction intervention for older adults resulted in improvements for some psychosocial factors. Health outcomes may require longer than 12 weeks to observe improvements.

Breast Cancer Survivors' Experiences With an Activity Tracker Integrated Into a Supervised Exercise Program: Qualitative Study.

BackgroundThere is growing evidence that physical activity is related to a better prognosis after a breast cancer diagnosis, whereas sedentary behavior is associated with worse outcomes. It is therefore important to stimulate physical activity and reduce sedentary time among patients with breast cancer. Activity trackers offer a new opportunity for interventions directed at stimulating physical activity behavior change.ObjectiveThis study aimed to explore the experience of patients with breast cancer who used an activity tracker in addition to a supervised exercise intervention in the randomized UMBRELLA Fit trial.MethodsA total of 10 patients with breast cancer who completed cancer treatment participated in semistructured in-depth interviews about their experience with and suggestions for improvements for the Jawbone UP2 activity tracker.ResultsThe activity tracker motivated women to be physically active and created more awareness of their (sedentary) lifestyles. The women indicated that the automatically generated advice (received via the Jawbone UP app) lacked individualization and was not applicable to their personal situations (ie, having been treated for cancer). Furthermore, women felt that the daily step goal was one-dimensional, and they preferred to incorporate other physical activity goals. The activity tracker’s inability to measure strength exercises was a noted shortcoming. Finally, women valued personal feedback about the activity tracker from the physiotherapist.ConclusionsWearing an activity tracker raised lifestyle awareness in patients with breast cancer. The women also reported additional needs not addressed by the system. Potential improvements include a more realistic total daily physical activity representation, personalized advice, and personalized goals.

The validity of using activity monitors to detect step count after lumbar fusion surgery

Purpose: Measuring step count using activity monitors is an increasingly popular method of quantifying physical activity, however it is unknown whether gait irregularities or the use of gait aids affect the accuracy of these devices. This study evaluates the validity of the ActivPAL3, Fitbit Flex, and Jawbone UP Move activity monitors for measuring step count in hospital inpatients after lumbar fusion.Methods: The ActivPAL3 was tested on the thigh, the Fitbit, and the Jawbone were tested on the wrist and thigh, each monitor was tested 20 times. Validity was examined by calculating the percentage of steps detected by each monitor compared to the criterion measure of observed step count, the Standard Error of Measurement, and the Intraclass Correlation Coefficient.Results: The ActivPAL3 detected 85% (SD 27%) of observed steps. On the wrist, the Fitbit detected 24% (SD 34%) and the Jawbone detected 17% (SD 40%) of observed steps. On the thigh, the Fitbit detected 66% (SD 42%) and the Jawbone detected 22% (SD 35%) of observed steps.Conclusion: The ActivPAL3 activity monitor is a sufficiently valid tool to detect step count immediately after lumbar fusion. Wrist worn monitors are not recommended in this population, particularly with patients using gait aids.Implications for RehabilitationWalking may be quantified using activity monitoring, as both an assessment tool and as an adjunct to treatmentThe ActivPAL3 is sufficiently valid for use after lumbar fusion surgeryThe Fitbit Flex and Jawbone UP Move had low accuracy, particularly when a gait aid was used

Acceptability of a sitting reduction intervention for older adults with obesity

BackgroundOlder adults spend more time sitting than any other age group, contributing to poor health outcomes. Effective behavioral interventions are needed to encourage less sitting among older adults, specifically those with obesity, but these programs must be acceptable to the target population. We explored participant acceptance of a theory-based and technology-enhanced sitting reduction intervention designed for older adults (I-STAND).MethodsThe 12-week I-STAND intervention consisted of 6 health coaching contacts, a study workbook, a Jawbone UP band to remind participants to take breaks from sitting, and feedback on sitting behaviors (generated from wearing an activPAL device for 7 days at the beginning and mid-point of the study). Semi-structured interviews were conducted with 22 participants after they completed the intervention. Interview transcripts were iteratively coded by a team, and thematic analysis was used to identify and refine emerging themes.ResultsOverall, participants were satisfied with the I-STAND intervention, thought the sedentary behavior goals of the intervention were easy to incorporate, and found the technologies to be helpful additions to (but not substitutes for) health coaching. Barriers to standing more included poor health, ingrained sedentary habits, lack of motivation to change sedentary behavior, and social norms that dictate when it is appropriate to sit/stand. Facilitators to standing more included increased awareness of sitting, a sense of accountability, daily activities that involved standing, social support, and changing ways of interacting in the home environment. Participants reported that the intervention improved physical health, increased energy, increased readiness to engage in physical activity, improved mood, and reduced stress.ConclusionsThe technology-enhanced sedentary behavior reduction intervention was acceptable, easy to incorporate, and had a positive perceived health impact on older adults with obesity.Trial registrationThe I-STAND study was registered at clinicaltrials.gov (ID: NCT02692560) February 2016.

Accuracy and precision of consumer-level activity monitors for stroke detection during wheelchair propulsion and arm ergometry.

The purpose of this study was to evaluate whether consumer-level activity trackers can estimate wheelchair strokes and arm ergometer revolutions. Thirty able-bodied participants wore three consumer-level activity trackers (Garmin VivoFit, FitBit Flex, and Jawbone UP24) on the wrist. Participants propelled a wheelchair at fixed frequencies (30, 45 and 60 strokes per minute (spm)) three minutes each and at pre-determined varied frequencies, (30–80 spm) for two minutes. Participants also freely wheeled through an obstacle course. 10 other participants performed arm-ergometry at 40, 60 and 80 revolutions per minute (rpm), for three minutes each. Mean percentage error (MPE(SD)) for 30 spm were ≥46(26)% for all monitors, and declined to 3-6(2–7)% at 60 spm. For the obstacle course, MPE ranged from 12-17(7–13)% for all trackers. For arm-ergometry, MPE was at 1-96(0–37)% with the best measurement for the Fitbit at 60 and 80 rpm, and the Garmin at 80rpm, with MPE = 1(0–1)%. The consumer-level wrist-worn activity trackers we tested have higher accuracy/precision at higher movement frequencies but perform poorly at lower frequencies.

Reducing Sedentary Time for Obese Older Adults: Protocol for a Randomized Controlled Trial.

BackgroundOlder adults have high rates of obesity and are prone to chronic health conditions. These conditions are in part due to high rates of sedentary time (ST). As such, reducing ST could be an innovative strategy for improving health outcomes among obese older adults. To test this theory, we developed a novel, technology-enhanced intervention to reduce sitting time (I-STAND) and pilot tested it to assess the feasibility, acceptability, and preliminary effects of the intervention on ST and biometric outcomes.ObjectiveThe current paper aims to describe the rationale, design, and methods of the I-STAND sitting reduction pilot trial.MethodsOlder adults with obesity (n=60) were recruited from a large health care system and randomized to receive I-STAND or a healthy living intervention. I-STAND combined personal coaching with a technology-enhanced intervention (Jawbone UP band) to cue breaks from sitting. Participants completed self-report and biometric assessments at baseline and 3 months. Additional qualitative results were collected from a subset of I-STAND participants (n=22) to further inform the feasibility and acceptability of the interventions. The primary outcome was total hours of daily sitting time measured by the activPAL device. Secondary outcomes included sit-to-stand transitions, bouts of sitting longer than 30 minutes, physical function, blood pressure, fasting glucose, cholesterol, and depressive symptoms.ResultsStudy enrollment has ended and data processing is underway.ConclusionsData from randomized trials on sitting reduction are needed to inform novel approaches to health promotion among older adults with obesity. Our trial will help fill this gap. The methods used in our study can guide future research on using technology-based devices to assess or prompt sedentary behavior reduction, or those interested in behavioral interventions targeting obese older adults with novel approachesTrial RegistrationClinicalTrials.gov: NCT02692560; https://clinicaltrials.gov/ct2/show/NCT02692560 (Archived by WebCite at http://www.webcitation.org/6wppLTWAl)

The feasibility and RE-AIM evaluation of the TAME health pilot study

BackgroundConducting 5 A’s counseling in clinic and utilizing technology-based resources are recommended to promote physical activity but little is known about how to implement such an intervention. This investigation aimed to determine the feasibility and acceptability, using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework, of a pragmatic, primary care-based intervention that incorporated 5 A’s counseling and self-control through an activity monitor.MethodsPrimary care patients (n = 40) 55–74 years of age were recruited and randomized to receive a pedometer or an electronic activity monitor (EAM), Jawbone UP24, to monitor activity for 12 weeks. Participants were also invited to a focus group after completing the intervention. Stakeholders (n = 36) were recruited to provide feedback.ResultsThe intervention recruitment rate was 24.7%. The attrition rate was 20% with a significantly higher rate for the pedometer group (p = 0.02). The EAM group increased their minutes of physical activity by 11.1 min/day while the pedometer maintained their activity (0.2 min/day), with no significant group difference. EAM participants liked using their monitor and would continue wearing it while the pedometer group was neutral to these statements (p < 0.05). Over the 12 weeks there were 490 comments and 1094 “likes” given to study peers in the corresponding application for the UP24 monitor. Some EAM participants enjoyed the social interaction feature while others were uncomfortable talking to strangers. Participants stated they would want counseling from a counselor and not their physician or a nurse. Other notable comments included incorporating multiple health behaviors, more in-person counseling with a counselor, and having a funding source for sustainability.ConclusionsOverall, the study was well-received but the results raise a number of considerations. Practitioners, counselors, and researchers should consider the following before implementing a similar intervention: 1) utilize PA counselors, 2) target multiple health behaviors, 3) form a social support group, 4) identify a funding source for sustainability, and 5) be mindful of concerns with technology.Trial registrationclinicaltrials.gov- NCT02554435. Registered 24 August 2015.

Determining the Reliability of Several Consumer-Based Physical Activity Monitors

Limited research exists on the reliability of consumer-based physical activity monitors (CPAMs) despite numerous studies on their validity. Consumers often purchase CPAMs to assess their physical activity (PA) habits over time, emphasizing CPAM reliability more so than their validity; therefore, the purpose of this study was to investigate the reliability of several CPAMs. In this study, 30 participants wore a pair of four CPAM models (Fitbit One, Zip, Flex, and Jawbone Up24) for a total of eight monitors, while completing seven activities in the laboratory. Activities were completed in two consecutive five-minute bouts. Participants then wore either all wrist- or hip-mounted CPAMs in a free-living setting for the remainder of the day. Intra-monitor reliability for steps (0.88–0.99) was higher than kcals (0.77–0.94), and was higher for hip-worn CPAMs than for wrist-worn CPAMs (p &lt; 0.001 for both). Inter-monitor reliability in the laboratory for steps (0.81–0.99) was higher than kcals (0.64–0.91) and higher for hip-worn CPAMs than for wrist-worn CPAMs (p &lt; 0.001 for both). Free-living correlations were 0.61–0.98, 0.35–0.96, and 0.97–0.98 for steps, kcals, and active minutes, respectively. These findings illustrate that all CPAMs assessed yield reliable estimations of PA. Additionally, all CPAMs tested can provide reliable estimations of physical activity within the laboratory but appear less reliable in a free-living setting.

Using consumer-grade wearables and novel measures of sleep and activity to analyze changes in behavioral health during an 8-month simulated Mars mission

For analyzing changes in an individual's health over time, this research has developed objective measures for comparing behavioral patterns, including sleep quality and activity scores. These novel measures of behavioral health have provided insight about how sleep debt accumulates after long, extended days, how sleep disruption and recovery from wakefulness occur during the night, and when cross-correlations exist between measures. This data-driven approach to quantifying behavioral patterns is informed by minute-by-minute data from consumer-grade, wrist-worn wearables. In this 8-month longitudinal study, Jawbone UP wristbands and the Jawbone UP API were utilized to collect minute-by-minute data about the behavior of crewmembers participating in a simulated Mars mission. To study the challenges of living and working on the planet Mars, for eight months, these crewmembers were confined to a Mars-like habitat, living in close quarters, isolated from the rest of humanity at a high elevation on Mauna Loa volcano in Hawaii, wearing mock spacesuits while exploring the volcanic terrain, consuming shelf-stable foods, restricted in water usage, relying on solar energy, and delayed in communications with 20-min lag-times for delivering messages to and from the crew. Analyzing the behavior of these astronaut-like individuals has led to the development of objective measures for quantifying sleep patterns, that have potential for contributing to the development of next-generation, smart wearables.

Accuracy of step count measured by physical activity monitors: The effect of gait speed and anatomical placement site

IntroductionConsumer-based physical activity monitors (PAMs) are becoming increasingly popular, with multiple global organisations recommending physical activity levels that equate to 10,000 steps per day for optimal health. We therefore aimed to compare the step count of five PAMs to a visual step count to identify the most accurate monitors at varying gait speeds, along with the optimal anatomical placement site. MethodsParticipants completed 3min on a treadmill for five speeds (5.0km/h, 6.5km/h, 8.0km/h, 10km/h, 12km/h). An Actigraph wGT3XBT-BT was placed on the waist and wrist, a FitBit One on the waist, and a Fitbit Flex, Fitbit Charge HR and Jawbone UP24 on both wrists. A video of participant’s lower limbs was recorded for visual count. Analyses of variance (ANOVAs) were conducted to examine the effects of gait speed and device placement site on step count accuracy. ResultsThirty-one participants (mean age 24.3±5.2yrs) took part. Step count error ranged from 41.3±13.8% for the wrist-worn Actigraph to only 0.04±4.3% and −0.3±4.0% for the waist-worn Fitbit One and Actigraph, respectively. Across all gait speeds, waist-worn devices achieved better accuracy than those on the wrist (p<0.001). The Jawbone was the most accurate wrist-worn consumer-based device at slower speeds (p=0.026), with the Fitbit Flex, and Fitbit Charge HR increasing in accuracy to match the Jawbone at higher speeds. ConclusionThe accuracy and reliability of consumer-based PAMs and the Actigraph is affected by anatomical placement site and walking speed. The Fitbit One and Actigraph on the waist were the strongest performers across all speeds.

The impact of an m-Health financial incentives program on the physical activity and diet of Australian truck drivers

BackgroundChronic diseases are high in truck drivers and have been linked to work routines that promote inactivity and poor diets. This feasibility study examined the extent to which an m-Health financial incentives program facilitated physical activity and healthy dietary choices in Australian truck drivers.MethodsNineteen men (mean [SD] age = 47.5 [9.8] years; BMI = 31.2 [4.6] kg/m2) completed the 20-week program, and used an activity tracker and smartphone application (Jawbone UP™) to regulate small positive changes in occupational physical activity, and fruit, vegetable, saturated fat and processed/refined sugar food/beverage choices. Measures (baseline, end-program, 2-months follow-up; April–December 2014) were accelerometer-determined proportions of work time spent physically active, and a workday dietary questionnaire. Statistical (repeated measures ANOVA) and thematic (interviews) analyses assessed program impact.ResultsNon-significant increases in the mean proportions of work time spent physically active were found at end-program and follow-up (+1%; 7 mins/day). Fruit (p = 0.023) and vegetable (p = 0.024) consumption significantly increased by one serve/day at end-program. Non-significant improvements in saturated fat (5%) and processed/refined sugar (1%) food/beverage choices were found at end-program and follow-up. Overall, 65% (n = 11) of drivers demonstrated positive changes in physical activity, and at least one dietary choice (e.g. saturated fat) at follow-up. Drivers found the financial incentives component of the program to be a less effective facilitator of change than the activity tracker and smartphone application, although this technology was easier to use for monitoring of physical activity than healthy dietary choices.ConclusionsNot all drivers benefitted from the program. However, positive changes for different health behaviours were observed in the majority of participants. Outcomes from this feasibility study inform future intervention development for studies with larger samples.Trial registrationANZCTR12616001513404. Registered November 2nd, 2016 (retrospectively registered).

Assessing the Impact of a Novel Smartphone Application Compared With Standard Follow-Up on Mobility of Patients With Knee Osteoarthritis Following Treatment With Hylan G-F 20: A Randomized Controlled Trial.

BackgroundOsteoarthritis (OA) is a leading cause of disability in the United States. Although no disease-modifying therapies exist, patients with knee OA who increase walking may reduce risk of functional limitations.ObjectiveThe objective of the study is to evaluate the impact of a mobile app (OA GO) plus wearable activity monitor/pedometer (Jawbone UP 24) used for 90 days on the mobility of patients with knee OA treated with hylan G-F 20.MethodsPatients with knee OA aged 30 to 80 years who were eligible to receive hylan G-F 20 and were familiar with smartphone technology were enrolled in this randomized, multicenter, open-label study. Patients who had a body mass index above 35 kg/m2 were excluded. All patients received a single 6-mL injection of hylan G-F 20 and wore the Jawbone monitor. The patients were then randomized 1:1 to Jawbone and OA GO (Group A; n=107) with visible feedback (unblinded) or Jawbone only (Group B; n=104) with no visible feedback (blinded). The primary endpoint was mean change from baseline in steps per day at day 90 between Groups A and B.ResultsBaseline characteristics were similar between groups. There were significant differences between the increases in least squares (LS) mean number of steps per day (1199 vs 467, P=.03) and the mean percentage change (35.8% vs 11.5%, P=.02) from baseline in favor of Group A over Group B. There was a greater reduction in pain from baseline during the 6-minute walk test in Group A versus Group B. (LS mean change: −55.3 vs −33.8, P=.007). Most patients (65.4%) and surveys of physicians (67.3%) reported they would be likely or very likely to use/recommend the devices. Patient Activity Measure-13 scores improved from baseline (LS mean change for Groups A and B: 5.0 vs 6.9), with no significant differences between groups. The occurrence of adverse events was similar in the 2 groups.ConclusionsUse of a novel smartphone app in conjunction with a wearable activity monitor provided additional improvement on mobility parameters such as steps per day and pain with walking in the 6-minute walk test in patients with knee OA who were treated with hylan G-F 20. Results also highlight the amenability of patients and physicians to using mobile health technology in the treatment of OA and suggest further study is warranted.

Comparison of four Fitbit and Jawbone activity monitors with a research-grade ActiGraph accelerometer for estimating physical activity and energy expenditure

Background/aimConsumer-based physical activity (PA) monitors have become popular tools to track PA behaviours. Currently, little is known about the validity of the measurements provided by consumer monitors. We aimed to...