Evaluating the impact of physical activity apps and wearables: interdisciplinary review

Background: Although many smartphone apps and wearables have been designed to improve physical activity, their rapidly evolving nature and complexity present challenges for evaluating their impact. Traditional methodologies, such as randomized controlled trials (RCTs), can be slow. To keep pace with rapid technological development, evaluations of mobile health technologies must be efficient. Rapid alternative research designs have been proposed, and efficient in-app data collection methods, including in-device sensors and device-generated logs, are available. Along with effectiveness, it is important to measure engagement (ie, users’ interaction and usage behavior) and acceptability (ie, users’ subjective perceptions and experiences) to help explain how and why apps and wearables work. Objectives: This study aimed to (1) explore the extent to which evaluations of physical activity apps and wearables: employ rapid research designs; assess engagement, acceptability, as well as effectiveness; use efficient data collection methods; and (2) describe which dimensions of engagement and acceptability are assessed. Method: An interdisciplinary scoping review using 8 databases from health and computing sciences. Included studies measured physical activity, and evaluated physical activity apps or wearables that provided sensor-based feedback. Results were analyzed using descriptive numerical summaries, chi-square testing, and qualitative thematic analysis. Results: A total of 1829 abstracts were screened, and 858 articles read in full. Of 111 included studies, 61 (55.0%) were published between 2015 and 2017. Most (55.0%, 61/111) were RCTs, and only 2 studies (1.8%) used rapid research designs: 1 single-case design and 1 multiphase optimization strategy. Other research designs included 23 (22.5%) repeated measures designs, 11 (9.9%) nonrandomized group designs, 10 (9.0%) case studies, and 4 (3.6%) observational studies. Less than one-third of the studies (32.0%, 35/111) investigated effectiveness, engagement, and acceptability together. To measure physical activity, most studies (90.1%, 101/111) employed sensors (either in-device [67.6%, 75/111] or external [23.4%, 26/111]). RCTs were more likely to employ external sensors (accelerometers: P=.005). Studies that assessed engagement (52.3%, 58/111) mostly used device-generated logs (91%, 53/58) to measure the frequency, depth, and length of engagement. Studies that assessed acceptability (57.7%, 64/111) most often used questionnaires (64%, 42/64) and/or qualitative methods (53%, 34/64) to explore appreciation, perceived effectiveness and usefulness, satisfaction, intention to continue use, and social acceptability. Some studies (14.4%, 16/111) assessed dimensions more closely related to usability (ie, burden of sensor wear and use, interface complexity, and perceived technical performance). Conclusions: The rapid increase of research into the impact of physical activity apps and wearables means that evaluation guidelines are urgently needed to promote efficiency through the use of rapid research designs, in-device sensors and user-logs to assess effectiveness, engagement, and acceptability. Screening articles was time-consuming because reporting across health and computing sciences lacked standardization. Reporting guidelines are therefore needed to facilitate the synthesis of evidence across disciplines

Managing obesity through mobile phone applications: a state-of-the-art review from a user-centred design perspective

Evidence has shown that the trend of increasing obesity rates has continued in the last decade. Mobile phone applications, benefiting from their ubiquity, have been increasingly used to address this issue. In order to increase the applications’ acceptance and success, a design and development process that focuses on users, such as User-Centred Design, is necessary. This paper reviews reported studies that concern the design and development of mobile phone applications to prevent obesity, and analyses them from a User-Centred Design perspective. Based on the review results, strengths and weaknesses of the existing studies were identified. Identified strengths included: evidence of the inclusion of multidisciplinary skills and perspectives; user involvement in studies; and the adoption of iterative design practices. Weaknesses included the lack of specificity in the selection of end-users and inconsistent evaluation protocols. The review was concluded by outlining issues and research areas that need to be addressed in the future, including: greater understanding of the effectiveness of sharing data between peers; privacy; and guidelines for designing for behavioural change through mobile phone applications

A Mobile Health Monitoring Application for Obesity Management and Control Using the Internet-of-Things 1Mohamed

Obesity is one of the most serious and dangerous nutritional diseases around the world. Usually, people develop patterns of unhealthy eating that lead to increased body weight and accumulation of fat in the body. This mass happens due to an imbalance between the energy intake from food and energy consumed in the body. One of the primary treatments for this serious health risk include diets, physical activity, weight-loss training and adoption of health programs that promote healthy eating. As such, reliable mechanism to prevent and control the obesity levels is vital. It led many experts and researchers who are interested in the health sector to explore more solutions that help to combat the obesity phenomenon. This paper presents a mobile health application intended to increase the awareness levels of parents and children about the obesity risks and help them to sustain balanced and healthy eating lifestyle. The proposed mobile application is an educational tool for the evaluation of interventions to prevent obesity risk levels. The application is based on the Internet-of-Things approach, which allows tracking food intake, remote capturing and constant monitoring of children data with interactive feedback displayed on the mobile application

How a Diverse Research Ecosystem Has Generated New Rehabilitation Technologies: Review of NIDILRR’s Rehabilitation Engineering Research Centers

Over 50 million United States citizens (1 in 6 people in the US) have a developmental, acquired, or degenerative disability. The average US citizen can expect to live 20% of his or her life with a disability. Rehabilitation technologies play a major role in improving the quality of life for people with a disability, yet widespread and highly challenging needs remain. Within the US, a major effort aimed at the creation and evaluation of rehabilitation technology has been the Rehabilitation Engineering Research Centers (RERCs) sponsored by the National Institute on Disability, Independent Living, and Rehabilitation Research. As envisioned at their conception by a panel of the National Academy of Science in 1970, these centers were intended to take a “total approach to rehabilitation”, combining medicine, engineering, and related science, to improve the quality of life of individuals with a disability. Here, we review the scope, achievements, and ongoing projects of an unbiased sample of 19 currently active or recently terminated RERCs. Specifically, for each center, we briefly explain the needs it targets, summarize key historical advances, identify emerging innovations, and consider future directions. Our assessment from this review is that the RERC program indeed involves a multidisciplinary approach, with 36 professional fields involved, although 70% of research and development staff are in engineering fields, 23% in clinical fields, and only 7% in basic science fields; significantly, 11% of the professional staff have a disability related to their research. We observe that the RERC program has substantially diversified the scope of its work since the 1970’s, addressing more types of disabilities using more technologies, and, in particular, often now focusing on information technologies. RERC work also now often views users as integrated into an interdependent society through technologies that both people with and without disabilities co-use (such as the internet, wireless communication, and architecture). In addition, RERC research has evolved to view users as able at improving outcomes through learning, exercise, and plasticity (rather than being static), which can be optimally timed. We provide examples of rehabilitation technology innovation produced by the RERCs that illustrate this increasingly diversifying scope and evolving perspective. We conclude by discussing growth opportunities and possible future directions of the RERC program

Relationship between smartphone addiction and physical activity in Chinese international students in Korea

Background and Aims Excessive usage of smartphones may induce social problems, such as depression and impairment of social and emotional functioning. Moreover, its usage can impede physical activity, but the relationship between smartphone addiction and physical activity is obscure. Therefore, we examined the relationship and the impact of excessive smartphone use on physical activity. Methods This study collected data through the structured questionnaire consisting of general characteristics, the number and hours of smartphone usage, and the Smartphone Addiction Proneness Scale (SAPS) from 110 Chinese international students in Korea. The body composition and physical activity, such as the total daily number of steps and consumed calories, were measured. Results In this study, high-risk smartphone users showed less physical activity, such as the total number of steps taken and the average consumed calories per day. Moreover, their body composition, such as muscle mass and fat mass, was significantly different. Among these factors, the hours of smartphone use revealed the proportional relationship with smartphone addiction (β = 0.209, p = 0.026), while the average number of walking steps per day showed a significant reverse proportional tendency in participants with smartphone addiction (β = –0.883, p < 0.001). Conclusions Participants with smartphone addiction were less likely to walk for each day. Namely, smartphone addiction may negatively influence physical health by reducing the amount of physical activity, such as walking, resulting in an increase of fat mass and a decrease of muscle mass associated with adverse health consequences

Personalization in Game Design for Healthcare: a Literature Review on its Definitions and Effects

Personalization, the involvement of stakeholders in the design process, is often applied in serious game design for health. It is expected to enhance the alignment of a game to the preferences and capacities of the end-user, thereby increasing the end-user’s motivation to interact with the game, which finally might enhance the aimed-for health effects of the game. However, the nature and effect of personalization have never been systematically studied, making assumptions regarding personalization ungrounded. In this literature review, we firstly provide a proposal of our Personalized Design Process-model, where personalization is defined as stakeholder involvement in the Problem Definition-, Product Design- and/or Tailoring Phase. Secondly, we conducted a systematic literature review on this model, focusing on health and its effects. In this review, 62 of the 2579 found studies were included. Analysis showed that a minority of the studies were of methodologically higher quality and some of these tested the health effect by contrasting tailored versus non-tailored games. Most studies involved stakeholders in the Tailoring Design Phase. Therefore, we conclude that involving stakeholders in the Tailoring Phase is valuable. However, to know if personalization is effective in the Product Design- and the Problem Definition Phase, more studies are needed

Game-Based Learning, Gamification in Education and Serious Games

The aim of this book is to present and discuss new advances in serious games to show how they could enhance the effectiveness and outreach of education, advertising, social awareness, health, policies, etc. We present their use in structured learning activities, not only with a focus on game-based learning, but also on the use of game elements and game design techniques to gamify the learning process. The published contributions really demonstrate the wide scope of application of game-based approaches in terms of purpose, target groups, technologies and domains and one aspect they have in common is that they provide evidence of how effective serious games, game-based learning and gamification can be

Co-located Augmented Play-spaces:Past, Present, and Perspectives

In recent years, many different studies regarding Co-located Augmented Play-spaces (CAPs) have been published in a wide variety of conferences and journals. We present an overview. The work presented in these papers includes end user's perspectives as well as researcher's perspective. We place these within four aspects in this review: 1) Argumentation, the underlying reasons or the higher end goals to investigate interactive play from a user's perspective, 2) Systems, the kind of systems that are created, this includes their intended use which fits the end user's perspective, 3) Evaluation, the way in which the researchers evaluate the system, 4) Contribution, the goal of the studies from the researcher's perspective; what does the study contribute to the research community. CAPs are often multimodal in nature; this survey pays attention to the multimodal characteristics in relation to all four aspects. This overview contributes a clearer view on the current literature, points out where new opportunities lie, and hands us the tools for what we think is important: bringing the end-user and research perspective together in intervention based evaluations. In short, this paper discusses CAPs: their past, the present, and the perspectives

Smart Sensing Technologies for Personalised Coaching

People living in both developed and developing countries face serious health challenges related to sedentary lifestyles. It is therefore essential to find new ways to improve health so that people can live longer and can age well. With an ever-growing number of smart sensing systems developed and deployed across the globe, experts are primed to help coach people toward healthier behaviors. The increasing accountability associated with app- and device-based behavior tracking not only provides timely and personalized information and support but also gives us an incentive to set goals and to do more. This book presents some of the recent efforts made towards automatic and autonomous identification and coaching of troublesome behaviors to procure lasting, beneficial behavioral changes