Dr Melissa Stoneham writes:
Wearable technology – is this one of those emerging terms that clearly shows I am not keeping up with the times?
I confess I am no IT junkie and I do know about some of the more contemporary wearable technology including pedometers, smartwatches and Fitbits. But these are just the tip of the iceberg – there is an abundance of wearable technologies, with two examples being the Smart Shoe and the Smart Hoodie.
The “Smart Shoe” provides health analytics, has Bluetooth connectivity to enable personalised messages from a coach, and includes auto lacing and regulated temperature control.
The “Smart Hoodie” sends pre-programmed text messages triggered by gesture movements. To my surprise, Amsterdam even hosted a five day music festival which included a “Wearable Technology: Powered Art and Fashion” show.
The world of wearable technology is advancing rapidly in terms of technology, functionality, size and real-time applications. According to an article published in the American Journal of Preventive Medicine, public health researchers needs to be aware of these innovations and utilise them.
Studies have identified that wearables have adequate validity and reliability for activity measurement, that their use in chronic disease populations is feasible, and that most individuals are open to sharing device data with researchers and healthcare systems.
Yet Phillips and her colleagues noted that, although useful to a point, wearable technologies’ capacity to translate external motivations into internal ones for sustainable behavioural changes and clinical value remains unknown.
The article, titled Wearable Technology and Physical Activity in Chronic Disease: Opportunities and Challenges, aimed to demystify some of these values by summarising current and potential uses for wearables, discussing challenges to using wearables and identifying future directions for researchers and clinicians for chronic disease prevention and management.
The article categorised wearable-derived data for chronic disease research and management into two categories – epidemiological and health promotion. Epidemiological uses included monitoring activity, describing activity context and correlating and tracking individual disease trajectories. The health promotion uses focused more on behaviour change strategies such as self-monitoring, goal-setting and social support.
The authors suggest that epidemiological studies have typically relied on self-reported physical activity estimates with a key example being the accelerometer. Limited battery power, fluctuations in activity over periods of time and high costs were some of the identified barriers associated with this equipment.
The advantage of wearables for these types of studies included the ability of the user to recharge or have coin cell batteries (can last more than 12 months) that translate to continuous, objective, real-time activity data which can be collected over longer time periods resulting in greater insight into activity patterns across time.
The authors also suggested that wearables exhibit adequate validity in comparison with research-grade monitors and are more cost efficient, making them an attractive alternative for larger studies.
A further advantage of wearables was identified as the ability to measure physical activity patterns before, during and after medical treatments. For example, physical activity may decline prior to hospitalisation or with disease complication onset, or activity levels may decline more rapidly prior to disease onset or in individuals with a more aggressive disease.
It was suggested that physical activity data from wearables could be used to monitor disease onset, treatment adherence and predict prognostic outcomes among high-risk and chronic disease populations in the hospital and outpatient setting.
In the health promotion context, 13 wearable devices were investigated and it was found that many emulated real life behaviour change techniques such as self-monitoring, goal-setting, social support. It was also identified that those suffering from chronic conditions were happy to use the devices, and perceived them as useful.
The challenges associated with wearables from a health promotion perspective were that in isolation, wearables would not work for all individuals for a variety of reasons and should be used as part of a comprehensive intervention (just like health promotion in real life!). The benefits included low cost, high feasibility and providing an accessible way to promote physical activity.
An adjunct to care
The authors of this paper were the first to state that significant work is needed to better understand the most efficient ways to fully integrate wearables into chronic care and management, yet they perceived wearable data, when used in conjunction with other data and strategies, as a way to increase physical activity, improve health and disease outcomes and reduce healthcare costs.
A conceptual model of how wearables could ideally be integrated into research and clinical practice for chronic disease prevention and management was provided in the article. Phillips suggested that combined with larger data sets such as geographic information system, global positioning system or patient-reported outcomes, combined with knowledge on how to better use data from wearables, wearables could create innumerable opportunities to provide patients with proactive interventions to prevent disease, reduce severity or control progression to a clinical syndrome.
This article provides information on the relatively new technology of wearables and they are looking promising. Consumers seem to have embraced wearables. The Huffington Post reported that the number of wearable devices being shipped to consumers is expected to reach 130 million this year.
The next challenge will be encouraging their use in research and engaging with a diverse range of health professionals and researchers to ensure they consider wearables within their suite of research methods – because whether it benefits doctors, health promoters or consumers, the adoption of wearables is in a growth phase and they will present be a new way to build engagement and create accurate, far-reaching views and benefits of and to both personal and population health.
*The Article: Wearable Technology and Physical Activity in Chronic Disease: Opportunities and Challenges, by Siobhan M. Phillips, Lisa Cadmus-Bertram, Dori Rosenberg, Matthew P. Buman and Brigid M. Lynch. American Journal of Preventive Medicine; 54 (4) – January 2018.
The Public Health Advocacy Institute WA (PHAIWA) JournalWatch service reviews 10 key public health journals on a monthly basis, providing a précis of articles that highlight key public health and advocacy related findings, with an emphasis on findings that can be readily translated into policy or practice.
The Journals reviewed include:
Australian & New Zealand Journal of Public Health (ANZJPH)
Journal of Public Health Policy (JPHP)
Health Promotion Journal of Australia (HPJA)
Medical Journal of Australia (MJA)
Journal for Water Sanitation and Hygiene Development
Tobacco Control (TC)
American Journal of Public Health (AMJPH)
Health Promotion International (HPI)
American Journal of Preventive Medicine (AJPM)
These reviews are then emailed to all JournalWatch subscribers and are placed on the PHAIWA website. To subscribe click to Journal Watch click here.