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

Resonating Experiences of Self and Others enabled by a Tangible Somaesthetic Design

Digitalization is penetrating every aspect of everyday life including a human's heart beating, which can easily be sensed by wearable sensors and displayed for others to see, feel, and potentially "bodily resonate" with. Previous work in studying human interactions and interaction designs with physiological data, such as a heart's pulse rate, have argued that feeding it back to the users may, for example support users' mindfulness and self-awareness during various everyday activities and ultimately support their wellbeing. Inspired by Somaesthetics as a discipline, which focuses on an appreciation of the living body's role in all our experiences, we designed and explored mobile tangible heart beat displays, which enable rich forms of bodily experiencing oneself and others in social proximity. In this paper, we first report on the design process of tangible heart displays and then present results of a field study with 30 pairs of participants. Participants were asked to use the tangible heart displays during watching movies together and report their experience in three different heart display conditions (i.e., displaying their own heart beat, their partner's heart beat, and watching a movie without a heart display). We found, for example that participants reported significant effects in experiencing sensory immersion when they felt their own heart beats compared to the condition without any heart beat display, and that feeling their partner's heart beats resulted in significant effects on social experience. We refer to resonance theory to discuss the results, highlighting the potential of how ubiquitous technology could utilize physiological data to provide resonance in a modern society facing social acceleration.Comment: 18 page

There's a monster in my kitchen: using aversive feedback to motivate behaviour change

In this paper we argue that “persuasive technologies,” developed to motivate behaviour change in users, have so far failed to exploit the established body of empirical research within behavioural science. We propose that persuasive technologies may benefit from both adapting to individual preferences, and a constructive use of aversive, in addition to appetitive, feedback. We detail an example application that demonstrates how this approach can be incorporated into an application designed to train users to adopt more environmentally friendly behaviours in their domestic kitchens

Designing a gamified social platform for people living with dementia and their live-in family caregivers

In the current paper, a social gamified platform for people living with dementia and their live-in family caregivers, integrating a broader diagnostic approach and interactive interventions is presented. The CAREGIVERSPRO-MMD (C-MMD) platform constitutes a support tool for the patient and the informal caregiver - also referred to as the dyad - that strengthens self-care, and builds community capacity and engagement at the point of care. The platform is implemented to improve social collaboration, adherence to treatment guidelines through gamification, recognition of progress indicators and measures to guide management of patients with dementia, and strategies and tools to improve treatment interventions and medication adherence. Moreover, particular attention was provided on guidelines, considerations and user requirements for the design of a User-Centered Design (UCD) platform. The design of the platform has been based on a deep understanding of users, tasks and contexts in order to improve platform usability, and provide adaptive and intuitive User Interfaces with high accessibility. In this paper, the architecture and services of the C-MMD platform are presented, and specifically the gamification aspects. © 2018 Association for Computing Machinery.Peer ReviewedPostprint (author's final draft

Picking pockets on the lawn: the development of tactics and strategies in a mobile game

This paper presents Treasure, an outdoor mobile multiplayer game inspired by Weiser’s notion of seams, gaps and breaks in different media. Playing Treasure involves movement in and out of a wi-fi network, using PDAs to pick up virtual ’coins’ that may be scattered outside network coverage. Coins have to be uploaded to a server to gain game points, and players can collaborate with teammates to double the points given for an upload. Players can also steal coins from opponents. As they move around, players’ PDAs sample network signal strength and update coverage maps. Reporting on a study of players taking part in multiple games, we discuss how their tactics and strategies developed as their experience grew with successive games. We suggest that meaningful play arises in just this way, and that repeated play is vital when evaluating such games

Integrating Diplomacy and Social Media: A Report of the First Annual Aspen Institute Dialogue on Diplomacy and Technology

This report is a result of the first annual Aspen Institute Dialogue on Diplomacy and Technology, or what we call ADDTech. The concept for this Dialogue originated with longtime communications executive and Aspen Institute Trustee Marc Nathanson. Since his tenure as Chairman of the U.S. Broadcasting Board of Governors (BBG), Nathanson has been concerned with how American diplomacy could more rapidly embrace the changing world of social media and other technologies. He is also a graduate of the University of Denver where former Secretary of State Madeleine Albright's father, Josef Korbel, namesake of the Josef Korbel School of International Relations there, was his professor. Thus, Albright, another Institute Trustee, was a natural partner to create the first Dialogue on Diplomacy and Technology. The cast is ably supplemented with Korbel School Dean and former U.S. Ambassador Christopher Hill and Aspen Institute President Walter Isaacson, who himself was also recently the chair of the BBG.The topic for this inaugural dialogue is how the diplomatic realm could better utilize new communications technologies. The group focused particularly on social media, but needed to differentiate among the various diplomacies in play in the current world, viz., formal state diplomacy, public diplomacy, citizen diplomacy and business diplomacy. Each presents its own array of opportunities as well as problems. In this first Dialogue, much of the time necessarily had to be used to define our terms and learn how technologies are currently being used in each case. To help us in that endeavor, we focused on the Middle East. While the resulting recommendations are therefore rather modest, they set up the series of dialogues to come in the years ahead

Smartphones

Many of the research approaches to smartphones actually regard them as more or less transparent points of access to other kinds of communication experiences. That is, rather than considering the smartphone as something in itself, the researchers look at how individuals use the smartphone for their communicative purposes, whether these be talking, surfing the web, using on-line data access for off-site data sources, downloading or uploading materials, or any kind of interaction with social media. They focus not so much on the smartphone itself but on the activities that people engage in with their smartphones

Understanding the fidelity effect when evaluating games with children

There have been a number of studies that have compared evaluation results from prototypes of different fidelities but very few of these are with children. This paper reports a comparative study of three prototypes ranging from low fidelity to high fidelity within the context of mobile games, using a between subject design with 37 participants aged 7 to 9. The children played a matching game on either an iPad, a paper prototype using screen shots of the actual game or a sketched version. Observational data was captured to establish the usability problems, and two tools from the Fun Toolkit were used to measure user experience. The results showed that there was little difference for user experience between the three prototypes and very few usability problems were unique to a specific prototype. The contribution of this paper is that children using low-fidelity prototypes can effectively evaluate games of this genre and style

Raising awareness for water polution based on game activities using internet of things

Awareness among young people regarding the environment and its resources and comprehension of the various factors that interplay, is key to changing human behaviour towards achieving a sustainable planet. In this paper IoT equipment, utilizing sensors for measuring various parameters of water quality, is used in an educational context targeting at a deeper understanding of the use of natural resources towards the adoption of environmentally friendly behaviours. We here note that the use of water sensors in STEM gameful learning is an area which has not received a lot of attention in the previous years. The IoT water sensing and related scenaria and practices, addressing children via discovery, gamification, and educational activities, are discussed in detail