Succeeding with prolonged usage of consumer-based activity trackers in clinical studies: a mixed methods approach

Lack of physical activity (PA) is a risk factor for death and non-communicable disease. Despite this, more than one fourth of adults worldwide do not follow PA guidelines. As part of a feasibility study to test a complex intervention for increasing PA, we included a consumer-based activity tracker (AT) as a tool to measure PA outcomes and to track heart rate during exercise sessions. The aim of the present study was to identify factors that increase wear time when using a consumer-based AT for monitoring of participants in clinical research.

Sixteen participants aged 55-74 years, with obesity, sedentary lifestyle, and elevated cardiovascular risk were recruited to a 12-month feasibility study. Participants wore a Polar M430 AT to collect continuous PA data during a six-month intervention followed by 6 months of follow-up. We performed quantitative wear time analysis, tested the validity of the AT, and completed two rounds of qualitative interviews to investigate how individual wear-time was linked to participant responses.

From 1 year of tracking, mean number of valid wear days were 292 (SD = 86), i.e. 80%. The Polar M430 provides acceptable measurements for total energy expenditure. Motivations for increased wear time were that participants were asked to wear it and the ability to track PA progress. Perceived usefulness included time keeping, heart rate- and sleep tracking, becoming more conscious about day-to-day activity, and improved understanding of which activity types were more effective for energy expenditure. Sources of AT annoyance were measurement inaccuracies and limited instruction for use. Suggestions for improvement were that the AT was big, unattractive, and complicated to use.

Adherence to wearing a consumer-based AT was high. Results indicate that it is feasible to use a consumer-based AT to measure PA over a longer period. Potential success factors for increased wear time includes adequate instruction for AT use, allowing participants to choose different AT designs, and using trackers with accurate measurements. To identify accurate trackers, AT validation studies in the target cohort may be needed.

U.S. National Library of Medicine, Clinical Trial registry: NCT03807323 ; Registered 16 September 2019 - Retrospectively registered.