Kelly A Grindrod*, School of Pharmacy, University of Waterloo, Waterloo, Canada Lora Giangregorio, Faculty of Applied Health Sciences, University of Waterloo, Waterloo, Canada Kathryn Mercer, School of Pharmacy, University of Waterloo, Waterloo, Canada Track: Research Presentation Topic: Consumer empowerment, patient-physician relationship, and sociotechnical issues Presentation Type: Poster presentation Submission Type: Single Presentation Last modified: 2014-06-27

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Background. Physical inactivity and sedentary behavior increase the risk of chronic illness and death. Similar to walking programs that promote goals such as 10,000 steps per day, the newest generation of “wearable” activity trackers offers potential as a multifaceted intervention to help people become more active.

Objectives. The objective of our study was to examine the usability and usefulness of wearable activity trackers for older adults living with chronic illness.

Methods. We recruited a purposive sample of 32 participants over age 50, who had been previously diagnosed with a chronic illness, including vascular disease, diabetes, arthritis and osteoporosis. Participants ranged in age from 52-84 (mean 64) and 75% were female with a mean body mass index of 31kg/m2. Over a 3-week period, participants began by using a simple pedometer (Sportline or Mio) followed by four wearable activity trackers (Fitbit Zip, Misfit Shine, Jawbone Up 24, Withings Pulse) in random order. Study devices were selected to represent the range of wearable products and features available on the Canadian market. Participants wore each device in their normal daily life for at least 3 days and evaluated it using a questionnaire developed from the Technology Acceptance Model. We used focus groups to explore participant experiences. We used a grounded theory approach to data collection and analysis.

Results. Prior to enrolling, few participants were aware of wearable activity trackers. Most had also been asked by a physician to exercise more and cited this as motivation for testing the devices. No participant planned to purchase the simple pedometer after the study, citing poor accuracy and data loss, whereas 73% planned to purchase a wearable activity tracker. Preferences varied but 50% would consider buying a Fitbit and 42% would consider buying a Misfit, Jawbone or Withings. The simple pedometer had a mean acceptance score of 56/95 compared to 63 for the Withings, 65 for the Misfit and Jawbone and 68 for the Fitbit. The Fitbit was the simplest to use and the clear display meant participants with low technical competency could use it without regularly consulting the website or mobile device. While many struggled to activate and interpret the Misfit display, it was the most comfortable. With the Jawbone, participants were often surprised by their interest in sleep data but many were frustrated a mobile device was needed to see the step count. Finally, the Withings had a clear display and many felt the heart rate function was useful, but only the most technically competent participants could set it up independently.

Conclusion. For older adults living with chronic illness, wearable activity trackers may be a useful and acceptable strategy for improving physical activity throughout the day. To improve usability, older users may benefit from devices that have better compatibility with less expensive Android smartphones and tablets, comprehensive paper-based user manuals and apps that interpret user data. To promote adoption, clinicians could help raise awareness but many new users will need support to both set-up the device and to learn how to interpret their data.