Parental Perspectives of a Wearable Activity Tracker for Children Younger Than 13 Years: Acceptability and Usability Study

Background There is increasing availability of, and interest in, wearable activity trackers for children younger than 13 years. However, little is known about how children and parents use these activity trackers or perceive their acceptability. Objective This study primarily aimed to ascertain parental perspectives on the acceptability and usability of wearables designed to monitor children’s physical activity levels. Secondary aims were to (1) identify practical considerations for future use in physical activity interventions and promotion initiatives; (2) determine use of different features and functions incorporated into the accompanying app; and (3) identify parents’ awareness of their child’s current physical activity levels. Methods In total, 36 children (18 boys and 18 girls) aged 7-12 years were asked to wear a wrist-worn activity tracker (KidFit) for 4 consecutive weeks and to use the accompanying app with parental assistance and guidance. Each week, one parent from each family (n=25; 21 mothers and 4 fathers) completed a Web-based survey to record their child’s activity tracker use, app interaction, and overall experiences. At the end of the 4-week period, a subsample of 10 parents (all mothers) participated in face-to-face interviews exploring perceptions of the acceptability and usability of wearable activity trackers and accompanying apps. Quantitative and qualitative data were analyzed descriptively and thematically, respectively. Thematic data are presented using pen profiles, which were constructed from verbatim transcripts. Results Parents reported that they and their children typically found the associated app easy to use for activity tracking, though only step or distance information was generally accessed and some difficulties interpreting the data were reported. Children were frustrated with not being able to access real-time feedback, as the features and functions were only available through the app, which was typically accessed by, or in the presence of, parents. Parents identified that children wanted additional functions including a visual display to track and self-monitor activity, access to the app for goal setting, and the option of undertaking challenges against schools or significant others. Other barriers to the use of wearable activity trackers included discomfort of wearing the monitor because of the design and the inability to wear for water- or contact-based sports. Conclusions Most parents reported that the wearable activity tracker was easy for their child or children to use and a useful tool for tracking their children’s daily activity. However, several barriers were identified, which may impact sustained use over time; both the functionality and wearability of the activity tracker should therefore be considered. Overall, wearable activity trackers for children have the potential to be integrated into targeted physical activity promotion initiatives.

[1]  Nicola D. Ridgers,et al.  Encouraging play in the natural environment: a child-focused case study of Forest School , 2012 .

[2]  C. MacPhail,et al.  Process guidelines for establishing Intercoder Reliability in qualitative studies , 2016 .

[3]  B. Saelens,et al.  Results From the United States of America's 2016 Report Card on Physical Activity for Children and Youth. , 2016, Journal of physical activity & health.

[4]  A. Miah,et al.  Mobile, wearable and ingestible health technologies: towards a critical research agenda , 2017 .

[5]  Greet Cardon,et al.  Socio-economic determinants of physical activity across the life course: A "DEterminants of DIet and Physical ACtivity" (DEDIPAC) umbrella literature review , 2018, PloS one.

[6]  L. Cadmus-Bertram,et al.  Randomized Trial of a Fitbit-Based Physical Activity Intervention for Women. , 2015, American journal of preventive medicine.

[7]  M. McNarry,et al.  Feasibility and Effectiveness of Using Wearable Activity Trackers in Youth: A Systematic Review , 2016, JMIR mHealth and uHealth.

[8]  Charlotte L. Ridgway,et al.  Physical activity awareness of British adolescents. , 2011, Archives of pediatrics & adolescent medicine.

[9]  Morwenna Kirwan,et al.  Activity Trackers Implement Different Behavior Change Techniques for Activity, Sleep, and Sedentary Behaviors , 2017, Interactive journal of medical research.

[10]  Victoria A. Goodyear,et al.  Young people’s uses of wearable healthy lifestyle technologies; surveillance, self-surveillance and resistance , 2019 .

[11]  Walter R. Thompson WORLDWIDE SURVEY OF FITNESS TRENDS FOR 2013 , 2012 .

[12]  Duncan J Macfarlane,et al.  Validity of the international physical activity questionnaire short form (IPAQ-SF): A systematic review , 2011, The international journal of behavioral nutrition and physical activity.

[13]  Mary Beth Rosson,et al.  Use and Adoption Challenges of Wearable Activity Trackers , 2015 .

[14]  V. Goodyear,et al.  The Motivational Impact of Wearable Healthy Lifestyle Technologies: A Self-determination Perspective on Fitbits With Adolescents , 2017 .

[15]  M. Moreno,et al.  Using A Facebook Group As An Adjunct To A Pilot mHealth Physical Activity Intervention: A Mixed Methods Approach. , 2015, Studies in health technology and informatics.

[16]  C. Roberts,et al.  Results From Wales' 2016 Report Card on Physical Activity for Children and Youth: Is Wales Turning the Tide on Children's Inactivity? , 2016, Journal of physical activity & health.

[17]  C. Sargent,et al.  Daily Rhythms of Hunger and Satiety in Healthy Men during One Week of Sleep Restriction and Circadian Misalignment , 2016, International journal of environmental research and public health.

[18]  W. Nilsen,et al.  Health behavior models in the age of mobile interventions: are our theories up to the task? , 2011, Translational behavioral medicine.

[19]  Nicola D Ridgers,et al.  Using formative research to develop CHANGE!: a curriculum-based physical activity promoting intervention , 2011, BMC public health.

[20]  Youngwon Kim,et al.  Classification Accuracy of a Wearable Activity Tracker for Assessing Sedentary Behavior and Physical Activity in 3–5-Year-Old Children , 2018, International journal of environmental research and public health.

[21]  Lora Giangregorio,et al.  Behavior Change Techniques Present in Wearable Activity Trackers: A Critical Analysis , 2016, JMIR mHealth and uHealth.

[22]  R. Oberhoffer,et al.  Feasibility of Physical Activity Assessment with Wearable Devices in Children Aged 4–10 Years—A Pilot Study , 2018, Front. Pediatr..

[23]  J. Hussey,et al.  The measurement of physical activity in children , 2007 .

[24]  G. Schofield,et al.  Social support for youth physical activity: Importance of siblings, parents, friends and school support across a segmented school day , 2007, The international journal of behavioral nutrition and physical activity.

[25]  Matthew B. Miles,et al.  Qualitative Data Analysis: An Expanded Sourcebook , 1994 .

[26]  Tripat Simran Kaur Grewal Awareness of Physical Activity Levels and Sedentary Behaviour: An Assessment of Awareness of Physical Activity Levels and Sedentary Behaviour Among Parents and Children , 2013 .

[27]  K. Avis,et al.  Comparison of a Commercial Accelerometer with Polysomnography and Actigraphy in Children and Adolescents. , 2015, Sleep.

[28]  Margaret Schneider,et al.  Validation of the Fitbit Zip for monitoring physical activity among free-living adolescents , 2016, BMC Research Notes.

[29]  Megan A. Moreno,et al.  A Fitbit and Facebook mHealth intervention for promoting physical activity among adolescent and young adult childhood cancer survivors: A pilot study , 2017, Pediatric blood & cancer.

[30]  Elizabeth J Lyons,et al.  Behavior Change Techniques Implemented in Electronic Lifestyle Activity Monitors: A Systematic Content Analysis , 2014, Journal of medical Internet research.

[31]  Kevin Patrick,et al.  Mobile health: the killer app for cyberinfrastructure and consumer health. , 2011, American journal of preventive medicine.

[32]  P. Freedson,et al.  The Physical Activity Tracker Testing in Youth (P.A.T.T.Y.) Study: Content Analysis and Children’s Perceptions , 2017, JMIR mHealth and uHealth.

[33]  Nicola D. Ridgers,et al.  A cluster-randomised controlled trial to promote physical activity in adolescents: the Raising Awareness of Physical Activity (RAW-PA) Study , 2017, BMC Public Health.

[34]  A. Timperio,et al.  Wearable Activity Tracker Use Among Australian Adolescents: Usability and Acceptability Study , 2018, JMIR mHealth and uHealth.

[35]  S. Edney,et al.  Users’ experiences of wearable activity trackers: a cross-sectional study , 2017, BMC Public Health.

[36]  N. Ridgers,et al.  Is wearable technology an activity motivator, or a fad that wears thin? , 2017, The Medical journal of Australia.

[37]  K. Mackintosh,et al.  Validity and reliability of the Fitbit Zip as a measure of preschool children’s step count , 2017, BMJ Open Sport & Exercise Medicine.

[38]  Willem Van Mechelen,et al.  Feasibility and Effectiveness of Online Physical Activity Advice Based on a Personal Activity Monitor: Randomized Controlled Trial , 2009, Journal of medical Internet research.

[39]  C. Abraham,et al.  The Behavior Change Technique Taxonomy (v1) of 93 Hierarchically Clustered Techniques: Building an International Consensus for the Reporting of Behavior Change Interventions , 2013, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[40]  J. Bruce German,et al.  Wearing, Thinking, and Moving: Testing the Feasibility of Fitness Tracking with Urban Youth , 2016 .

[41]  Zakkoyya H. Lewis,et al.  TITLE AND ABSTRACT 1 a ) TITLE : Identi � cation as a randomized trial in the title 1 a ) , 2016 .

[42]  J. Bruce German,et al.  A Feasibility Study of Wearable Activity Monitors for Pre-Adolescent School-Age Children , 2014, Preventing chronic disease.

[43]  Shigeru Inoue,et al.  The pandemic of physical inactivity: global action for public health , 2012, The Lancet.

[44]  S. Biddle,et al.  Lack of knowledge of physical activity guidelines: can physical activity promotion campaigns do better? , 2013, BMJ Open.

[45]  Mark S Tremblay,et al.  Introduction to the Canadian 24-Hour Movement Guidelines for Children and Youth: An Integration of Physical Activity, Sedentary Behaviour, and Sleep. , 2016, Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme.

[46]  Julie B. Wang,et al.  Wearable Sensor/Device (Fitbit One) and SMS Text-Messaging Prompts to Increase Physical Activity in Overweight and Obese Adults: A Randomized Controlled Trial. , 2015, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[47]  V. Braun,et al.  What can "thematic analysis" offer health and wellbeing researchers? , 2014, International journal of qualitative studies on health and well-being.

[48]  I. Janssen,et al.  Systematic review of the health benefits of physical activity and fitness in school-aged children and youth , 2010, The international journal of behavioral nutrition and physical activity.

[49]  Walter R. Thompson WORLDWIDE SURVEY OF FITNESS TRENDS FOR 2017 , 2016 .

[50]  Janice S. Withycombe,et al.  Use of a Fitness Tracker to Promote Physical Activity in Children With Acute Lymphoblastic Leukemia , 2016, Pediatric blood & cancer.