July 6, 2022

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Study: Program using wearables, coaching and cash incentives increased physical activity in teens

A digital health program using a Fitbit wearable and text-based health coaching improved physical activity in teens, according to a study published in JMIR

TOP-LINE DATA

Researchers found that adolescents enrolled in the program met their activity goals for an average of 7 out of eleven possible weeks. The teens also wore their Fitbits for about 91% of days on average, and the study found there were “significant improvements” in tracked daily active minutes.

Participants were also asked to rate the different components of the program, like the quality of the text-based coaching and the Fitbit experience, rated on a seven-point scale. All of these metrics were rated at least a five. 

Though the study found participants demonstrated a statistically significant decrease in body fat percentage, the change in BMI percentile for age and sex was nonsignificant.

HOW IT WAS DONE

The study included 28 participants between the ages of 13 and 18 with a BMI in the 90th percentile or higher. Two participants were lost in follow-up, so only 26 were included in the final analysis. 

The teens had a daily goal of an hour of active minutes or 10,000 steps during the 12-week program. They also set weekly personal goals based on their previous accomplishments and could receive cash incentives if that goal was met. 

The participants also received text-based coaching based on their achievements on weekdays. 

BACKGROUND

Wearables are an increasingly big business, and several tech giants tout their own versions. Fitbit was officially acquired by Google at the beginning of 2021. 

Other studies have used wearable devices as part of digital health programs to push increased activity in different populations with some success. However, a study published late last year found digital interventions like wearables and apps that aim to improve physical activity may not be effective for people in low socioeconomic status groups.

CONCLUSION

Researchers noted several potential weaknesses with the study. It didn’t include a control group, and the sample size was small. Participants were largely white and most were using private insurance, so the results may not be generalizable to a more diverse group. There also could be measurement errors from the Fitbits, and researchers didn’t assess the potential effects on puberty on the study’s participants.  

The authors said follow-up research should evaluate each of the program’s components individually with a larger sample size and a more diverse population for a longer time. 

“The pilot program improved adolescent physical activity and physical health,” they wrote. “A larger factorial design trial with adaptive daily goals may clarify the role of each program component in driving physical activity.”