digital health

Impact map of digital health wearables research programme

Figure: Impact map of our digital health wearables research programme developed by Dr Ana-Despina Tudor

Blog-author

Dr. Ana-Despina Tudor on behalf of the project team.

Project details

In our digital health wearables research programme funded by Sir Halley Stewart Trust and the ESRC Impact Acceleration Award, we have been investigating the role of wearable activity monitoring technologies in the health and well-being of people - aged 55 years and over, carers, and the people being cared for.

Activity monitoring technologies such as those from Samsung, Fitbit and Garmin, help to track activity, exercise, food, weight and sleep. 

We have focussed on three areas where these devices could play a role:

  1. in active health and ageing;
  2. support towards social isolation and loneliness; and 
  3. for self-monitoring and self-management of health.

Research programme

In our research programme, activity monitors were used by 21 participants in the 55-82 age range for a six-month period to track activity, exercise, food, weight and sleep. As a result of these activity monitors, participants reported a greater awareness of their physical activity, food intake, the need to pace themselves and build in adequate rest times, to diagnose and solve solutions for non-optimal sleep, and they developed a general realisation that activity monitors revealed trends that could be reported to their GPs or carers.

Furthermore, the two-year research programme has involved a number of surveys, workshops and interviews with people aged over 55 years, carers, health professionals, local charities who provide services and support to older people, carers and their families, and manufacturers of digital health wearables. 

Our project partners are local charities that support older people, carers and their families in the community: Age UK Milton Keynes and Carers MK; Samsung UK; and University of Oxford.  

Impact generation through knowledge exchange

We are investigating the impact of our research programme - what have been the beneficial changes, if any, as a result of our research. Since June 2017, we have been conducting a number of knowledge exchange meetings and workshops that have involved end-users of these activity monitors, manufacturers of digital health wearables and mobile health apps, digital health researchers, representatives of local charities (from Age UK MK and Carers MK), and public health practitioners from local city council, and medical educators.

We have analysed the data that we have collected in our research programme including the knowledge exchange workshops and meetings. We have used the framework of five types of impact in the book Fast track to impact by Professor Mark Reed (page 10).

Impact map

We have mapped our research programme's evidence to the five types of impact in the Figure above. We explain what the five types of impact mean for our project. We have added an 'additional impact' type - called sociological impacts.

Based on the evidence, we have distinguished between the impact that we have already 'achieved' and the impact that is 'planned' or is 'expected' to happen.

We will be presenting the 'impact map' and the underlying evidence in the symposium on 16 January 2018.

Next steps

In future blog-posts, we will discuss the types of impact and give concrete examples from our research programme.

PROJECT TEAM

Academics: Dr. Duncan Banks (OU), Dr. Kate Hamblin (Oxford University) Dr. Caroline Holland (OU), Dr. George Leeson (Oxford University) Ms. Catherine McNulty (OU), Professor Shailey Minocha (OU) and Dr. Ana-Despina Tudor (OU)

CollaboratorsAge UK MK (Jane Palmer, Bob Strudwick and Phil Warburton), Carers MK (Sue Bowering and Robert Benn) and Samsung UK and the ActivAge project (Rohit Ail, Ahmad Bangesh and Qian Shen)

Research Managers: Louise Thomas (OU) and Katia Padvalkava (Oxford University)

Perspective of carers on the role of activity trackers in their caring role

Photos from one of our project's workshops with carers, manufacturers of activity trackers and related apps, researchers, and colleagues from Age UK Milton Keynes (photos taken by Dr Duncan Banks, The Open University, UK)

Blog-author

Dr. Ana-Despina Tudor on behalf of the project team.

Project details

In our digital health wearables research programme funded by Sir Halley Stewart Trust and the ESRC Impact Acceleration Award, we have been investigating the role of wearable activity monitoring technologies in the health and well-being of people - aged 55 years and over, carers, and the people being cared for.

Example technologies include activity trackers from Fitbit, Garmin and Samsung, and smart watches. Typically, these devices record steps walked, floors climbed, sleep patterns, calories expended and heart rate.

Carers and people being cared for

We have conducted a survey with 38 carers and interviewed ten carers who had participated in the survey and had agreed to be interviewed.

Interviews with carers

Three of the carers we have interviewed are between 45-54, three are between 55-64, four are between 65-74 and one was above 85 years old. Eight out of 10 are female. The ages of the people they care for range from 18 years old to 86.

All the carers that we interviewed were family carers who care part-time for family members- in the evenings/night, or live in the neighbourhood, or visit the family member who they are caring for every day or over the weekend.

Four carers care for their partners (86, 60, 65 and 70 years old), six carers care for family members – one carer looks after his father (89 years old), two carers look for their mother (75 and 86 respectively), and three carers look after their children (18, 22, and 40 years old).

The medical conditions of the persons being cared for ranges from post-stroke patients, to chronic conditions, such as ME and Alzheimer’s.

In the interviews, carers discussed:

  • how they would integrate activity trackers in their caring activities; and
  • their expectations from these devices.

Results

For each of the themes from our data, we have included some quotes from the carers.

Being informed about the well-being of the person they care for

Carers would like that the person they care for wears an activity tracker which informs carers about the status of the wearer. For instance, they would like to know about the well-being of the person they care for when they are not around or to know if the person being cared for is generally active during the day.

“I think to see that she's moving around would be helpful. Because I'm always worried, when I'm not in the house with her, that if something had happened to her, I might not know. So, I could see if she was in bed and didn't get up.” [part-time carer who cares for her mother]

Further carers are interested to know if the tracker recorded that the person they care for had a good night sleep, if the tracker recorded that their vital signs are within the normal range.

“It would also be useful to see his sleep patterns, because I know his medication affects his sleep quite a lot.” [part-time carer who cares for her son]

Being informed in case of emergency, if something happens to the person they care for

Many carers shared their concerns of knowing what happens to the person they care for when they are not around. They believe that a way to monitor remotely the well-being of the person they care for is to receive alerts in case of emergency: such as if the person they care for is having a heart-related problem, gets lost (in case of dementia) or is unable to move after a fall:

“If things go outside of those [set] parameters, like his heart rate drops below a certain level, or his temperature drops below a certain level, or he has been inactive for a set amount of time then I would get a call saying, “Check on Dad”. That’s the sort of alert I would need.” [part-time carer who cares for his father and lives in the neighbouhood]

In some cases, carers would also like activity trackers to be able to record the mood of the person being cared for and be alerted in case the mood is very low, so that they can contact them during the day.

“I guess I might want it to alert me, you know, if he had a really frowny face, you know, I might want an alert to that” [part-time carer who cares for her husband]

Data sharing with medical professionals

One aspect that has come in all our conversations with carers is having access to the data recorded by the activity tracker worn by the people they care for. Carers would like to be able to inform medical professionals on the general health status of the people they care for, in between visits.

One such example comes from a carer who would like to use the monitored sleep patterns to inform the medical professionals about how medication affects the sleep of her son. In this case, the data could serve as an “objective proof” of how a certain treatment is working for the person being cared for:

“A particular drug affects his sleep at the moment. I would like to suggest to his consultant that they reduce it, or change it. This would help to show what his sleep pattern is like on that drug.” [part-time carer who cares for her son]

Data sharing brings ethical concerns: carers mentioned that they will need to ask for permission from the persons they care for to view their recorded data, and to be able to share it with the medical professionals, if required. 

Concerns of carers 

Among the concerns expressed by carers is that the people being cared for might feel demotivated to use the device if their well-being is not improving or if they don’t see any visible progress in their condition.

Other concerns were forgetting to wear the tracker, ease of charging it, of putting the strap on for older people and their understanding of the device and the data.

Project team

Academics: Dr. Duncan Banks (OU), Dr. Kate Hamblin (Oxford University) Dr. Caroline Holland (OU), Dr. George Leeson (Oxford University) Ms. Catherine McNulty (OU), Professor Shailey Minocha (OU) and Dr. Ana-Despina Tudor (OU)

Collaborators: Age UK MK (Jane Palmer), Carers MK (Sue Bowering and Robert Benn) and Samsung UK (Rohit Ail and Qian Shen)

Research Managers: Louise Thomas (OU) and Katia Padvalkava (Oxford University)

Perspective of medical professionals on the role of activity trackers in health and well-being of people aged over 55 years

Figure: Role of activity monitors, as discussed by medical professionals in our empirical research

Figure: Role of activity monitors, as discussed by medical professionals in our empirical research

Project details

In our digital health wearables research programme funded by Sir Halley Stewart Trust and the ESRC Impact Acceleration Award, we have been investigating the role of wearable activity monitoring technologies in the health and well-being of people - aged 55 years and over, carers, and the people being cared for.

Example technologies include activity trackers from Fitbit, Garmin and Samsung, and smart watches. Typically, these devices record steps walked, floors climbed, sleep patterns, calories expended and heart rate.

Research strand involving medical professionals

In this blog-post, we discuss the views of medical professionals on the role of activity monitors of medical professionals:

  • for keeping fit and as a preventative measure towards medical conditions;
  • for increasing physical activity  during prehabilitation; the process of enhancing functional capacity of the individual before an operation to enable him or her to withstand the stress of surgery has been termed as prehabilitation;
  • for monitoring of activity during rehabilitation; and
  • for monitoring of mobility when suffering from a medical condition.

RESEARCH DATA SOURCES

  • Survey with medical professionals where we received  84 responses.
  • Interviews with 10 medical professionals including a physiotherapist, GPs, a geriatrician and A&E consultants. All the interviews were audio-recorded and the data was transcribed verbatim. The data was analysed inductively in NVivo, a qualitative data analysis software package, through thematic analysis and axial coding.

RESULTS

From the survey, we learned that the majority of medical professionals find activity monitors to be useful for people aged over 55. However, they have never recommended such devices to patients, due to ethical considerations related to costs and lack of available support with using this technology. The biggest concern of medical professionals is the accuracy of the data from these off-the-shelf activity monitors, their reliability, and the possible difficulty of interpreting the data from these devices by the users.

We have analysed the our interviews with medical professionals by applying the method of thematic analysis.

For each of the roles that the medical professionals have identified for activity monitors, we have included some example-quotes from our interview data to illustrate the theme. Although the context of the interviews was for people aged over 55 years, you will note that the comments of medical professionals are, in fact, applicable for people of all ages.

Keeping fit

Medical professionals identified the role of activity monitors in supporting people to keep fit and in the prevention of various medical conditions that are normally associated with weight and lack of physical activity. They mentioned diabetes, obesity, and heart and circulatory diseases, and how the risks of suffering from these conditions increase as people age.

An A&E consultant said:

"Obesity and diabetes go together, so if you can keep the population more mobile, then you’d hope that their obesity levels would fall and that their diabetes would be less prevalent…then, on top of that, there would be all the secondary cardiovascular things like strokes, high blood pressure and other things."  [A&E consultant]

The physiotherapist in our participant-set said:

“I think the older population in particular, we know everyone’s living longer, we know we’re getting more medical conditions and increased medical dependency. The evidence shows that the more active- the benefits of exercise in reducing the risk of diabetes, osteoporosis, and improving balance.”  [Physiotherapist]

A General Practitioner [GP] said:

“That’s quite important because the point of the wearable is to have activity and to be more active than usual and to get healthy. That’s the point you wear a wearable.” [GP]

Pre-surgery preparation

For an elective surgery, patients have to be optimised for the surgery – checking on nutrition levels and maintaining some physical activity. A physical activity programme aims to increase aerobic capacity, and muscle and core strength ahead of the surgery. 

A surgeon mentioned about the role of activity monitors in this pre-surgery optimisation.

“about the optimisation of patients for surgery, so pre-optimisation is giving nutrition and doing many things including physical exercise. So, it has been shown that if you want to decrease, for example, the anastomatic leakage, if you make the patient have physical exercise two or three weeks before surgery, it is very effective as well as it’s effective to stop smoking or to take milkshakes for nutrition and so on. So, in elective surgery it will be very useful to say to other patients before surgery, “You are having an operation in three weeks, every day you have to do at least half an hour of activity.” It has been proved that it works.” [Surgeon]

Rehabilitation

For post-surgery rehabilitation or for maintaining some physical activity after a medical incident, the activity monitors could be useful for monitoring the necessary level of mobility that is required.

“Okay. Let’s say after a heart attack, so cardiac rehab. Again, there’s a very important part of recovery where they have exercise and have physio. That might be useful. Again, pneumonia rehab after a bad episode of COPD or something. Any sort of rehab programme where they are doing activities, this would be useful.” [GP]
“If you have the device, and you are able to walk, even inside your home, then, after being inside the home, I can see them going out in the garden. Then, aiming to the local shop and then, aiming to something more.” [Geriatrician]

For monitoring of medical condition

For patients, an activity monitor helps them to monitor their physical activity and to check whether they are keeping up with the level of activity that they have been advised. For medical professionals, these devices can give them an insight into their patients’ level of activity.

“In my Parkinson’s patients, … I would be using it [the activity tracker] for them to show me that they [patients] were gradually increasing their activity levels. I would be looking for trend[s]. Most of my Parkinson’s patients are very inactive and they shouldn’t be. I would be looking at using that during a six-week block of physiotherapy treatment to show an increase trend of how they’re moving. Also, an ideal situation, over six months I’d like them to maintain the levels I achieve after a six-week block.” [Physiotherapist]

CONCLUSIONS

All the medical professionals with whom we have interacted in this project have discussed the role of physical activity and especially walking in staying fit and healthy for people of all ages. As we have discussed in our previous blog-post, activity monitors enable people aged over 55 years :

  • to raise awareness of their activity levels; and
  • to improve and maintain their activity levels.

One of the GPs summarised the significance of walking for people of all ages by saying:

“Obviously we say to people that walking is free, doesn’t cost much and it’s very good exercise, because once you tell somebody how inactive [they] are, they say, “I can’t afford going to the gym,” or they say, “I just joined the gym.” As you know, joining a gym does not necessarily mean that they are active at all; they just pay the money and they don’t go, so we say, “Walking.” Walking is just simple and doesn’t cost money, and you can do it and so on.” [GP]

As we continue with our data analysis, we will share the results with you through this blog.

PROJECT TEAM

Academics: Dr. Duncan Banks (OU), Dr. Kate Hamblin (Oxford University) Dr. Caroline Holland (OU), Dr. George Leeson (Oxford University) Ms. Catherine McNulty (OU), Professor Shailey Minocha (OU) and Dr. Ana-Despina Tudor (OU)

Collaborators: Age UK MK (Jane Palmer), Carers MK (Sue Bowering and Robert Benn) and Samsung UK (Rohit Ail and Qian Shen)

Research Managers: Louise Thomas (OU) and Katia Padvalkava (Oxford University)

Role of wearable activity monitors in improving the level of activity in people aged over 55 years

Pictures: Dashboard of a activity tracker, a wearable activity tracker, a participant who we interviewed on Skype showing us the clip-on activity tracker, and another participant who we interviewed in a face-to-face setting

Project details

In our digital health wearables research programme funded by Sir Halley Stewart Trust and the ESRC Impact Acceleration Award, we have been investigating the role of wearable activity monitoring technologies in the health and well-being of people - aged 55 years and over, carers, and the people being cared for.

Example technologies include activity trackers from Fitbit, Garmin and Samsung, and smart watches. Typically, these devices record steps walked, floors climbed, sleep patterns, calories expended and heart rate.

In this blog-post, we discuss how the activity monitors are helping people aged over 55 years towards their activity and fitness:

  • to raise awareness of their activity levels;
  • to improve and maintain their activity levels.

Research Data sources

  • Survey with people aged over 55 years who are using the activity trackers on their experience of using activity monitors for self-monitoring and self-management of health: n=516 (female: 341; male: 173; 2 respondents didn't specify their gender) of the following age groups: 
    • 55-64 years: 362;
    • 65-74 years: 139;
    • 75-84 years: 13; and
    • 85 and older: 1.
  • Interviews with 10 participants aged over 55 years.

How the use of devices has influenced people over 55 years?

The survey results for question 13 (n=476) show that, out of all the participants, 375 said that they are now  more conscious of their level of activity; followed by 256 who said that they compared their own progress in time, and 217 who had become more active now (please see the data-chart below).

Q13: How has the use of devices influenced you? (please choose ALL that apply)

Answered: 476, skipped: 40

Presentation1.jpg

Some of the comments from the survey-participants on how the use of activity monitors have influenced them:

It is very useful for me to understand how the type of activity I'm involved helps me to build my level of fitness. (65-74 years, female, survey)

I am more informed on what I am eating, how much sleep I am getting and how active I am. (55-64 years, female, survey)

The device motivates me to be active through beating challenges and meeting targets. (55-64 years, male, survey)

People find it helpful to compare their fitness and health levels over previous days, weeks or months (256 participants in the survey and in the data-chart above):

“So I wear it all the time and the [tracker] sends me a weekly report so I can look at what my heart rate has been doing for the whole week, which is a really useful function.” (65-74 age, male, interview)

Improving and maintaining activity levels and health

On a day-to-day basis, the activity trackers make them aware of their inactivity/activity:

“I haven’t gone very far today. And I’ll look at it, like now, and I’ll say, “I’ve only done 1,000 steps”. Come on, come on, get up and move around, do something”. (55-64 years, female, interview)

In terms of monitoring health related issues, activity trackers have helped people monitor their activity if they suffer from any heart-related conditions and lung conditions such as chronic obstructive pulmonary disease (COPD). Trackers have helped them to stay active, which has had a positive influence on their medical condition.

A male user who has an untreatable lung condition has used his activity tracker to improve his step count which in turn has improved his condition over time:

When I first got the activity tracker, I had a poor period of health for about three months. […] Then got really busy. […] this year […] I’m well online to meet my minimum target of 20,000 a day. I’ll probably exceed that by the end of the year unless my health turns bad and knocks me back a bit. […]

...but the one [thing] I can say is that since I started with the lung condition the more I’ve been walking the less problem I’ve had with it. Whether that’s a proper correlation or not, I don’t know. That’s certainly been the fact, the more walking I’ve done the less problems my lungs have been.” (65-74 years, male, interview)

ESRC Impact Acceleration Award

Despite the wide-spread use of wearable activity monitors by older people (e.g. gifts by concerned relatives) and carers, our research has shown that the functionality of these devices is not informed by the kinds of activities that these users undertake, their digital skills, their data requirements, data management and security. In the project that has received the ESRC Impact Acceleration Award, we are involved in a knowledge exchange programme to communicate the requirements to manufacturers for improving the design of activity monitoring technologies (and digital health wearables, in general) for older users, carers and medical professionals.

Project team

Academics: Dr. Duncan Banks (OU), Dr. Kate Hamblin (Oxford University) Dr. Caroline Holland (OU), Dr. George Leeson (Oxford University) Ms. Catherine McNulty (OU), Professor Shailey Minocha (OU) and Dr. Ana-Despina Tudor (OU)

Collaborators: Age UK MK (Jane Palmer), Carers MK (Sue Bowering and Robert Benn) and Samsung UK (Rohit Ail and Qian Shen)

Research Managers: Louise Thomas (OU) and Katia Padvalkava (Oxford University)

Wearable Activity Trackers for Carers and those they care for

Photos from the workshop at Carers Milton Keynes offices in Central Milton Keynes (photos taken by Dr. Duncan Banks), February 2017

Wearable activity trackers (e.g. wrist-bands from Fitbit or Jawbone, or smart watches from Apple or Samsung), track daily fitness levels such as heart rate, sleep patterns, or calories expended. We have been exploring the potential of this kind of device for carers and the people they care for.

Project details

As a part of a project funded by the Sir Halley Stewart Trust, The Open University has worked with Carers MK (Milton Keynes) to run a survey and subsequently a workshop with some of the participants from the survey. Our aim was to ask the opinions of carers about using digital health wearables (whether or not they already use them). Their inputs will help us to understand whether and how wearables could be effectively used if they became a part of healthcare: caring, monitoring and self-management of health.

Observations from the data

From a preliminary analysis of the data we have made some initial observations:

For carers: Carers may not sleep well or may not get the chance to go out for a walk or a run, but may not realise that they haven’t had a lot of physical activity during the day. Walking has been shown to improve mental performance and reduce cognitive decline as we age, and our previous research showed that walking with others can help reduce social isolation and loneliness. Carers in this study said they would find devices useful to monitor their own health and activity – specifically, their sleep patterns and level of activity.

For people they care for: Carers felt that activity monitors could also be useful for the people that they care for. In the survey, carers mentioned interest in data about the person they cared for including: sleep patterns, calories expended, a map of the area walked and distance and steps walked, activity data over a period of time, heart rate, UV exposure, data that shows some movement has taken place, and warning that a condition is deteriorating for some reason. A carer in the workshop mentioned concern about monitoring the weight of her daughter because of her health condition. 

The carers felt that people who are being cared for could feel in control of their health and well-being through using such devices to monitor: exercise levels, dietary needs, sleep patterns, reminders for medications, and reminders to move. They might also get a sense of safety and confidence from being able to track the whereabouts of their carer; and a sense of security (‘security knowing that [their] condition was monitored for deterioration so that they didn’t have to remember or make contact’).

Caring or monitoring at a distance: Carers discussed the advantage of being able to monitor well-being from a distance, e.g. if they don’t live together, if the carer or the person being cared for has gone out for an errand or a walk - ‘to monitor health in a low-key way that is not intrusive and give them independence to cope when they are doing well’.

Concerns about these devices: However, carers expressed concerns about the use of such devices. These devices seldom cater for accessibility and age-related impairments, such as those associated with memory, vision, dexterity. They generally require interfacing with Tablets or smart-phones for transfer and display of data and some need charging every day. So, there are technical requirements and usability barriers for optimal use of these devices. Carers were also concerned about the people being cared for and themselves not knowing how to make sense of the data from these devices – and whether this data may ‘create confusion and unnecessary worry’

Carers were concerned that if the person being cared for is very old, there might be issues about their ability to use such devices, to remember to wear them and to make use of them for self-monitoring. Motivation to use a wearable might be a problem.

The data from these devices, although not always accurate, provides useful trends on the activity levels and sleep patterns which may influence people to change their life styles. The data collected over a period of time may provide useful insights to healthcare professionals.

Participation in the survey

If you are a carer and are interested in contributing to this research, please visit this link https://www.surveymonkey.co.uk/r/health-wearables-for-the-person-being-cared-for or http://bit.ly/2iN4YSd to participate in this survey. The survey will take 6-8 minutes to complete.

The university’s Human Research Ethics Committee has approved this research. If you have any questions about the project or the survey, please contact Professor Shailey Minocha: shailey.minocha@open.ac.uk

Contributors to this strand of research on carers

Mrs. Sue Bowering and Mr. Robert Benn, Carers MK (Milton Keynes)

Professor Shailey Minocha, Dr Caroline Holland, Dr Duncan Banks, Ms. Catherine McNulty and Dr. Ana-Despina Tudor, The Open University, UK

This project (May 2016 - April 2017) has been funded by the Sir Halley Stewart Trust. The views expressed in this article are those of the project team and not necessarily those of the Trust.

Role of wearable activity-tracking technologies on the well-being and quality of life of people aged 55 and over

About the project

In our Sir Halley Stewart Trust-funded digital health wearables project (May 2016 - April 2017) and in collaboration with Age UK Milton Keynes, we are investigating whether and how wearable activity-tracking technologies can acceptably contribute towards self-monitoring of activity and health by people aged 55 years and over. Example technologies include those from Fitbit, Jawbone, or smart watches from Apple or Samsung. Typically, these devices record steps walked, sleep patterns, or calories expended.

Empirical research

Our aim has been to determine the potential of these technologies in improving the physical and mental well-being of older people through active lifestyles, and the possible use of data by medical professionals for diagnosis and timely interventions. We have applied a number of data-collection methods such as workshops, surveys and diaries to investigate:

  • experiences of the people aged 55 and over who are already using these technologies;
  • experiences of people aged 55 and over who haven’t used these activity-trackers before and who were given devices in this project – challenges of adoption, whether/how the behaviours of these participants changes; and
  • usability aspects related to the design and use of these devices.

Some preliminary observations from our data

People aged 55 years and over who are already using these activity-trackers (from a month to over an year) and who filled up our survey (n=510) reported that the use of these technologies had ‘made them more conscious of their level of activity’:

  • (79.24%) and 45.55% of the participants said that they were more active since using these devices;
  • 27.75% felt more fit since using these devices and 42.58% reported that they felt better informed about their diet, sleep and activity-levels; and
  • 31.83% of the participants stated that they shared the data with family, friends, activity groups (e.g. walking groups), medical/healthcare professionals and even insurance companies.

We gave activity-trackers to 21 participants in the 55 - 82 age-range. Through monthly workshops, diaries, and one-to-one interviews, we investigated the changes in behaviours of our participants.

Our investigations show:

  • an increase in activity levels in all the participants;
  • increased awareness of food intake; and
  • sharing of data with the GPs to diagnose some specific conditions related to the data from these devices – e.g. the non-optimal sleep patterns (one of them now has a sleep-treatment plan in place). 

The workshop-discussions since June 2016 have uncovered a number of challenges people over 55 years experience with using the activity-trackers - from opening the packaging, accessing the instructions/manuals online, knowing about and using the features of the device, making sense of the data and knowing what is optimal for them (10,000 steps/day might not be a target for somebody recovering from a knee surgery, for example).

Conclusions

Given the UK’s ageing profile and as part of the agendas of Active and Healthy Ageing and digital NHS, there is an increasing focus on maintaining health in later life and encouraging physical activity to preserve mobility and motor skills, and self-monitoring of health and medical conditions. The wider implications of our project are in determining how digital health wearables can be used for self-monitoring and self-management of health by older people; for remote-monitoring of specific conditions such as Parkinson's by carers and doctors, challenges for adoption of such devices; and the ethical/privacy dilemmas of sharing and usage of data.

Authors

  • Professor Shailey Minocha, Dr Duncan Banks, Dr Caroline Holland and Catherine McNulty, The Open University, UK
  • Jane Palmer, Age UK Milton Keynes

This project (May 2016 - April 2017) has been funded by the Sir Halley Stewart Trust. The views expressed in this blog-post are those of the authors and not necessarily those of the Trust.

Role of wearable activity-tracking technologies on the well-being and quality of life of people aged 55 and over

About the project

Our research project at UK’s Open University and in collaboration with Age UK Milton Keynes aims to investigate whether there are changes in behaviour in people aged over 55 years through the use of wearable activity-tracking technologies. Example technologies include those from Fitbit, Jawbone, or smart watches from Apple or Samsung. Typically, these devices record steps walked, sleep patterns, or calories expended.  

The benefits of regular physical activity for older adults and those with chronic disease and/or mobility limitations are indisputable. Regular physical activity attenuates many of the health risks associated with obesity, cardiovascular disease, diabetes, depression and anxiety, and cognitive decline. As physical activity levels among older adults (both with and without chronic disease) are low, facilitating an increase in activity levels is an important public health issue. Walking has been identified as an ideal means of low-impact, low-risk physical activity that can boost physical and mental wellbeing. Our previous research has shown that walking with others can help reduce social isolation and loneliness among people aged 55 and over.

Research strand related to participants trying out activity trackers

In our year-long project (May 2016 – April 2017), in collaboration with Age UK Milton Keynes and funded by the Sir Halley Stewart Trust, we have given activity-trackers to 21 participants in the age range from 55 – 82. Through monthly workshops, diaries that the participants are maintaining and sharing with us on a weekly basis, and through one-to-one interviews with them, we are investigating how the behaviours of our participants is changing – whether there is an increase in their activity such as walking or gardening, lifestyle changes, attitudes towards food/diet, and so on.

Our preliminary data analysis shows: increase in activity levels in all the participants; increased awareness of food intake; and sharing of data with the GPs to diagnose the non-optimal sleep patterns (one of them now has a treatment plan in place for poor sleep). A couple of participants have joined the gym when they realised that their desk-based work-life doesn’t give them the opportunity to stay active during the week. One of the participants who as high-sensitivity to ultraviolet rays is able to plan her outings by viewing the snapshot of the current UV level and by setting an exposure reminder to help protect herself. An 80+ participant is able to plan her days based on the activity levels that her device provides – having some rest-days in between hectic days so as not to over-tire herself.

A couple of quotes from our participants:

“I have been thinking about how the Fitbit has changed my daily routine and there is no doubt that it has changed my view of exercise. I am feeling better and the additional exercise continues to help with the osteoarthritis in my knees.  I have set my daily target as 5000 steps and I am now achieving this on most days, I feel I have failed if I don’t.” 
“I am still checking the number of steps but I don’t feel as disappointed if I haven’t reached my target.  There is no doubt that it has made me more aware of the need for exercise and I now park at the far side of the car park and walk to the shop – not much but its progress.”

Latest news about our project

We have launched a survey that is aimed at medical professionals to explore whether they use the data from these devices for diagnosis and intervention. Most importantly, do medical professionals use data from these devices to determine the behaviour or lifestyle changes in people aged over 55 years?  If you are a doctor or healthcare professional, please visit https://www.surveymonkey.co.uk/r/role-in-medical-consultations or http://bit.ly/2cPr852 to participate in this survey. It will take 3-5 minutes to complete this survey.