Role Of Digital Health Wearables In The Wellbeing And Quality Of Life Of Older People And Carers

The number of adults aged 65 and over has increased by 2% across Europe in the past 15 years, and in Northern Ireland by 22% between 2003-2013. The proportion of the population in this age group is projected to increase by 63% to just under 0.5 million by 2033 – which will be a quarter of the population in Northern Ireland. Given Northern Ireland’s Active Ageing Strategy (2015-2021), there is an increasing focus on encouraging physical activity as we get older to preserve mobility and motor skills, and to enjoy the benefits of living longer and to minimise health problems associated with ageing. Over the last two years, we have been investigating the role of wearable activity tracking technologies in self-monitoring of activity by people aged over 55. Example technologies include activity trackers from Fitbit, Garmin and Samsung, and smart watches. Typically, these devices record steps walked, sleep patterns, calories expended and heart rate. Based on empirical investigations, this policy paper describes the benefits of activity monitors for people aged over 55 for self-monitoring of physical activity, for adopting healthy lifestyles, and for increasing or maintaining physical activity as a way to avoid high blood pressure, obesity, diabetes, and other medical conditions associated with weight or lower physical activity. It outlines the role of activity trackers in post-operative monitoring of mobility during rehabilitation, in caring, and for possible use of the data for diagnosis and medical interventions. It then discusses the challenges for adoption of these technologies, given currently, off-the-shelf devices are designed and calibrated for use by physically fit (typically young active people) with unrealistic fitness targets for the older generation

Self-tracking modes: reflexive self-monitoring and data practices

The concept of ‘self-tracking’ (also referred to as life-logging, the quantified self, personal analytics and personal informatics) has recently begun to emerge in discussions of ways in which people can voluntarily monitor and record specific features of their lives, often using digital technologies. There is evidence that the personal data that are derived from individuals engaging in such reflexive self-monitoring are now beginning to be used by actors, agencies and organisations beyond the personal and privatised realm. Self-tracking rationales and sites are proliferating as part of a ‘function creep’ of the technology and ethos of self-tracking. The detail offered by these data on individuals and the growing commodification and commercial value of digital data have led government, managerial and commercial enterprises to explore ways of appropriating self-tracking for their own purposes. In some contexts people are encouraged, ‘nudged’, obliged or coerced into using digital devices to produce personal data which are then used by others. This paper examines these issues, outlining five modes of self-tracking that have emerged: private, communal, pushed, imposed and exploited. The analysis draws upon theoretical perspectives on concepts of selfhood, citizenship, biopolitics and data practices and assemblages in discussing the wider sociocultural implications of the emergence and development of these modes of self-tracking

Feasibility of Using a Commercial Fitness Tracker as an Adjunct to Family-Based Weight Management Treatment: Pilot Randomized Trial.

BACKGROUND: Fitness trackers can engage users through automated self-monitoring of physical activity. Studies evaluating the utility of fitness trackers are limited among adolescents, who are often difficult to engage in weight management treatment and are heavy technology users. OBJECTIVE: We conducted a pilot randomized trial to describe the impact of providing adolescents and caregivers with fitness trackers as an adjunct to treatment in a tertiary care weight management clinic on adolescent fitness tracker satisfaction, fitness tracker utilization patterns, and physical activity levels. METHODS: Adolescents were randomized to 1 of 2 groups (adolescent or dyad) at their initial weight management clinic visit. Adolescents received a fitness tracker and counseling around activity data in addition to standard treatment. A caregiver of adolescents in the dyad group also received a fitness tracker. Satisfaction with the fitness tracker, fitness tracker utilization patterns, and physical activity patterns were evaluated over 3 months. RESULTS: A total of 88 adolescents were enrolled, with 69% (61/88) being female, 36% (32/88) black, 23% (20/88) Hispanic, and 63% (55/88) with severe obesity. Most adolescents reported that the fitness tracker was helping them meet their healthy lifestyle goals (69%) and be more motivated to achieve a healthy weight (66%). Despite this, 68% discontinued use of the fitness tracker by the end of the study. There were no significant differences between the adolescent and the dyad group in outcomes, but adolescents in the dyad group were 12.2 times more likely to discontinue using their fitness tracker if their caregiver also discontinued use of their fitness tracker (95% CI 2.4-61.6). Compared with adolescents who discontinued use of the fitness tracker during the study, adolescents who continued to use the fitness tracker recorded a higher number of daily steps in months 2 and 3 of the study (mean 5760 vs 4148 in month 2, P=.005, and mean 5942 vs 3487 in month 3, P=.002). CONCLUSIONS: Despite high levels of satisfaction with the fitness trackers, fitness tracker discontinuation rates were high, especially among adolescents whose caregivers also discontinued use of their fitness tracker. More studies are needed to determine how to sustain the use of fitness trackers among adolescents with obesity and engage caregivers in adolescent weight management interventions

Episodic use: Practices of care in self-tracking

The development of self-tracking technologies has resulted in a burst of research considering how self-tracking practices manifest themselves in everyday life. Based on a 5-month-long photo elicitation study of Danish self-trackers, we argue that no matter how committed people might be to tracking their activities, their use of self-tracking technologies can be best described as episodic rather than continuous. Using Annemarie Mol’s theoretical framework for understanding care practices as a lens, we show how episodic use can be interpreted through the logic of care. By using self-tracking devices episodically, users employ strategies of care in a way that can be productive and useful. These strategies often come in conflict with the logics of choice that underlie the design of many self-tracking technologies. We argue that this has consequences for the way self-tracking devices need to be imagined, designed, and introduced as part of workplace and insurance-type tracking programs