Quantification of Differences in Sleep Measurement by a Wrist-Worn Consumer Wearable Compared to Research-Grade Accelerometry and Sleep Diaries of Female Adults in Free-Living Conditions

Cindy R Hu,1 Caitlin Delaney,2 Jorge E Chavarro,2– 4 Francine Laden,1– 3 Rachel Librett,4 Laura Katuska,4 Emily R Kaplan,5 Li Yi,4,6 Michael Rueschman,5 Joe Kossowsky,7 Jukka-Pekka Onnela,8 Brent A Coull,8 Susan Redline,3,5 Peter James,1,6,9 Jaime E Hart1,2 1Department of Environmental Health, Harvard T.H. Chan School of Public Health; Boston, Boston, MA, USA; 2Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School; Boston, Boston, MA, USA; 3Department of Epidemiology, Harvard T.H. Chan School of Public Health; Boston, Boston, MA, USA; 4Department of Nutrition, Harvard T.H. Chan School of Public Health; Boston, Boston, MA, USA; 5Division of Sleep of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital and Harvard Medical School; Boston, Boston, MA, USA; 6Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute; Boston, Boston, MA, USA; 7Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children’s Hospital and Harvard Medical School; Boston, Boston, MA, USA; 8Department of Biostatistics, Harvard T.H. Chan School of Public Health; Boston, Boston, MA, USA; 9Department of Public Health Sciences, University of California, Davis School of Medicine; Davis, Davis, CA, USACorrespondence: Cindy R Hu, Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA, 02115, USA, Email [email protected]: The objective of this study is to compare sleep measurements by a consumer-wearable with research-standard actigraphy coupled with sleep diaries in free-living female adults.Methods: Forty-seven females in the Nurses’ Health Study 3 (NHS3) participated in the Sleep and Physical Activity Validation Substudy (SPAVS), where they were asked to concurrently wear a consumer wearable (Fitbit Charge, Models 3 or 5) and a research-grade accelerometer (Actigraph, GT3X+ or Actisleep) on the same wrist and fill out a smartphone-based sleep diary for fourteen consecutive days. We compared measures of total sleep time (TST), time in bed (TIB), and sleep efficiency (SE) from the consumer wearable with actigraphy measures as our research-standard reference for TST and SE and self-reported sleep diary as our reference for TIB. We calculated mean absolute percent error (MAPE) and intra-class correlations (ICC), as well as Bland-Altman analyses to compute mean difference and limits of agreement.Results: For all three measures, the consumer wearable underestimated sleep parameters relative to research-standard actigraphy, with a mean bias of − 16.0 minutes and − 11.2 minutes for TST and TIB, respectively, and − 1.0% for SE. In terms of agreement, TST (MAPE = 11.18%; ICC = 0.79) and TIB (MAPE = 10.45%; ICC = 0.74) had similar MAPES and ICCs, while and SE (MAPE = 5.09%; ICC = 0.39) had a lower ICC.Conclusion: In the NHS3 SPAVS, the wearable sleep measurements modestly underestimated wrist actigraphy measures of TST, TIB, and SE from sleep over multiple days; within sleep measures assessed, TST and TIB had greater agreement with research-grade accelerometry than SE.Keywords: wearables, fitbit, sleep, actigraphy, accelerometer, wome

State and federal revenues from tobacco consumed by minors

OBJECTIVES: The purpose of this study was to estimate the value of cigarettes consumed in 1997 by youths younger than 18 years. METHODS: Price, population, and consumption data were used to compute conservative and comprehensive estimates, which were then averaged. RESULTS: An estimated 3.76 million daily smokers aged 12 through 17 years consume an estimated 924 million packs of cigarettes per year, generating $222 million in federal tax revenues,$293 million in state tax revenues, and $480 million in tobacco company profits, and producing a retail value of$1.86 billion. CONCLUSIONS: The revenues from cigarettes smoked by youths could be used to enforce laws prohibiting the sale of tobacco to minors

YMCA Hiking Patterns at Rocky Mountain National Park: Implications for Public Health

Background:There is little data on hiking patterns in national parks to support hiking behavior as a vehicle to meet the joint YMCA, CDC, and National Park Service initiatives to encourage physical activity through public land use.Methods:The YMCA of the Rockies hiking program provided data from Hike Report forms completed after 343 supervised hikes for one summer season in Rocky Mountain National Park (ROMO) to assess visitor hiking patterns.Results:Of the total hikes, 64.4% were categorized as easy, 27.1% moderate, and 8.5% difficult. There were 1937 individual hikers which represented 13.3% of the estimated potential hiker sample. The majority of hikers (69%) only took easy hikes with 72.7% participating in only one hike and 27.3% doing two or more hikes. Energy cost estimates for hike categories indicated mean MET levels between 4.0 to 5.7.Conclusion:Hiking patterns at ROMO may be reflective of general population inactivity suggesting the need to design strategies to promote visitor hiking.</jats:sec

An Introduction to Parks, Recreation, and Public Health: Collaborative Frameworks for Promoting Physical Activity

The purpose of parks and recreation as well as public health is to seek the highest possible quality of life for individuals and communities. Unfortunately, little discourse has occurred between the parks and recreation and public health professions. This missed opportunity has resulted in an incomplete understanding of the spectrum of issues shared by the fields, a slow transdisciplinary learning curve, and a dearth of knowledge-based linkages between science and practice. The goal of the 2006 Cooper Institute Conference on Parks, Recreation, and Public Health: Collaborative Frameworks for Promoting Physical Activity was to highlight opportunities and advance cooperation between parks, recreation, and public health researchers and practitioners that result in collaborations that influence public health decisions at the macro (agency) and micro (individual) levels. This article introduces the discussion on scientific and practice issues in parks, recreation, and public health. By establishing a baseline of frameworks for strengthening collaboration we hope to improve the health and quality of life through parks and recreation-based physical activity.</jats:p