The effect of ongoing feedback on physical activity levels following an exercise intervention in older adults: a randomised controlled trial protocol Use of the Fitbit to Measure Adherence to a Physical Activity Intervention Among Overweight or Obese, Postmenopausal Women: Self-Monitoring Trajectory During 16 Weeks The influence of a consumer-wearable activity tracker on sedentary time and prolonged sedentary bouts: secondary analysis of a randomized controlled trial Wearable Activity Technology And Action-Planning (WATAAP) to promote physical activity in cancer survivors: Randomised controlled trial protocol A Community-Based Physical Activity Counselling Program for People With Knee Osteoarthritis: Feasibility and Preliminary Efficacy of the Track-OA Study Organizational-Level Strategies With or Without an Activity Tracker to Reduce Office Workers’ Sitting Time: Rationale and Study Design of a Pilot Cluster-Randomized Trial Effect and Process Evaluation of a Smartphone App to Promote an Active Lifestyle in Lower Educated Working Young Adults: Cluster Randomized Controlled Trial Design and baseline characteristics of participants in the Enhancing Physical Activity and Reducing Obesity through Smartcare and Financial Incentives (EPAROSFI): A pilot randomized controlled trial. Randomized Trial of a Fitbit-Based Physical Activity Intervention for Women. Feasibility and preliminary efficacy of a physical activity counseling intervention using Fitbit in people with knee osteoarthritis: the TRACK-OA study protocol Use of Consumer Wearable Devices to Promote Physical Activity: A Review of Health Intervention Studies Mobile and Wearable Device Features that Matter in Promoting Physical Activity. Wearable Sensor/Device (Fitbit One) and SMS Text-Messaging Prompts to Increase Physical Activity in Overweight and Obese Adults: A Randomized Controlled Trial. Balanced: a randomised trial examining the efficacy of two self-monitoring methods for an app-based multi-behaviour intervention to improve physical activity, sitting and sleep in adults Feasibility and Acceptability of a Wearable Technology Physical Activity Intervention With Telephone Counseling for Mid-Aged and Older Adults: A Randomized Controlled Pilot Trial Study design and methods for the ACTIVity And TEchnology (ACTIVATE) trial. Effectiveness of an Activity Tracker- and Internet-Based Adaptive Walking Program for Adults: A Randomized Controlled Trial Utilizing wearable technology to increase physical activity in future physicians: A randomized trial Impact of Electronic Feedback and Peer Comparisons on Residents' Physical Activity Level. Effects of a 12‐week mHealth program on peak VO2 and physical activity patterns after completing cardiac rehabilitation: A randomized controlled trial Promoting physical activity using an activity monitor and a tailored web-based advice: design of a randomized controlled trial [ISRCTN93896459] Loss‐Framed Financial Incentives and Personalized Goal‐Setting to Increase Physical Activity Among Ischemic Heart Disease Patients Using Wearable Devices: The ACTIVE REWARD Randomized Trial Continuous glucose monitoring counseling improves physical activity behaviors of individuals with type 2 diabetes: A randomized clinical trial.
Background Physical inactivity ranks as a major contributing factor in the development and progression of chronic disease . Lifestyle interventions reduce the progression of chronic disease , however , compliance decreases over time and health effects only persist as long as the new lifestyle is maintained . Telephone counselling ( TC ) is an effective way to provide individuals with ongoing support to maintain lifestyle changes . Remote physical activity monitoring and feedback ( RAMF ) via interactive technologies such as activity trackers and smartphones may be a cost-effective alternative to TC , however , this comparison has not been made . This study , therefore , aims to determine the effect of ongoing feedback ( TC vs. RAMF ) on the maintenance of physical activity following a 12-week individualised lifestyle program , and the effect of this on health risk factors and health services usage . Methods and design A r and omised controlled trial with a parallel groups design . A total of 150 adults ( ≥60 years ) who participate in a 12-week face-to-face individualised lifestyle program will be r and omised to twelve months of RAMF ( n = 50 ) , TC ( n = 50 ) , or usual care ( n = 50 ) . Participants r and omised to RAMF will use a smartphone activity tracker app , synced to a wrist worn activity tracker , to provide them with automated feedback regarding compliance to prescribed activity targets . Telephone counselling involves a follow-up phone call every fortnight for the first three months and a monthly call for the remaining nine months of the follow-up period . The primary outcome measures are physical activity compliance ( accelerometry and Active Australia survey ) . Secondary outcome measures include cardiorespiratory fitness , muscle strength , dynamic balance , quality of life , blood pressure , body composition , and health services usage . Measures will be made before and after the individualised lifestyle program , and at three , six and twelve months during the intervention . Discussion The results of this study will help to determine the efficacy of RAMF devices on compliance to prescribed physical activity compared to the current gold st and ard of TC . If the remote monitoring proves effective , it may provide a cost efficient alternative method of assisting maintenance of behaviour change from lifestyle interventions .Trial registration ACTRN12615001104549 . Retrospectively Registered 20/10/2015 Background Direct-to-consumer trackers and devices have potential to enhance theory-based physical activity interventions by offering a simple and pleasant way to help participants self-monitor their behavior . A secondary benefit of these devices is the opportunity for investigators to objective ly track adherence to physical activity goals across weeks or even months , rather than relying on self-report or a small number of accelerometry wear periods . The use of consumer trackers for continuous monitoring of adherence has considerable potential to enhance physical activity research , but few studies have been published in this rapidly developing area . Objective The objective of the study was to assess the trajectory of physical activity adherence across a 16-week self-monitoring intervention , as measured by the Fitbit tracker . Methods Participants were 25 overweight or obese , postmenopausal women enrolled in the intervention arm of a r and omized controlled physical activity intervention trial . Each participant received a 16-week technology-based intervention that used the Fitbit physical activity tracker and website . The overall study goal was 150 minutes/week of moderate to vigorous intensity physical activity ( MVPA ) and 10,000 steps/day ; however , goals were set individually for each participant and up date d at Week 4 based on progress . Adherence data were collected by the Fitbit and aggregated by Fitabase . Participants also wore an ActiGraph GT3X+ accelerometer for 7 days prior to the intervention and again during Week 16 . Results The median participant logged 10 hours or more/day of Fitbit  wear on 95 % of the 112 intervention days , with no significant decline in wear over the study period . Participants averaged 7540 ( SD 2373 ) steps/day and 82 minutes/week ( SD 43 ) of accumulated “ fairly active ” and “ very active ” minutes during the intervention . At Week 4 , 80 % ( 20/25 ) of women chose to maintain/increase their individual MVPA goal and 72 % ( 18/25 ) of participants chose to maintain/increase their step goal . Physical activity levels were relatively stable after peaking at 3 weeks , with only small declines of 8 % for steps ( P=.06 ) and 14 % for MVPA ( P=.05 ) by 16 weeks . Conclusions These data indicate that a sophisticated , direct-to-consumer activity tracker encouraged high levels of self-monitoring that were sustained over 16 weeks . Further study is needed to determine how to motivate additional gains in physical activity and evaluate the long-term utility of the Fitbit tracker as part of a strategy for chronic disease prevention . Trial Registration Clinical trials.gov NCT01837147 ; http:// clinical trials.gov/ct2/show/NCT01837147 ( Archived by WebCite at http://www.webcitation.org/6d0VeQpvB Objective A recent meta- analysis surmised pedometers were a useful panacea to independently reduce sedentary time ( ST ) . To further test and exp and on this deduction , we analyzed the ability of a consumer-wearable activity tracker to reduce ST and prolonged sedentary bouts ( PSB ) . We originally conducted a 12-month r and omized control trial where 800 employees from 13 organizations were assigned to control , activity tracker  , or one of two activity tracker plus incentive groups design ed to increase step count . The primary outcome was accelerometer measured moderate-to-vigorous physical activity . Results We conducted a secondary analysis on accelerometer measured daily ST and PSB bouts . A general linear mixed model was used to examine changes in ST and prolonged sedentary bouts , followed by between-group pairwise comparisons . Regression analyses were conducted to examine the association of changes in step counts with ST and PSB . The changes in ST and PSB were not statistically significant and not different between the groups ( P < 0.05 ) . Increases in step counts were concomitantly associated with decreases in ST and PSB , regardless of intervention ( P < 0.05 ) . Caution should be taken when considering consumer-wearable activity trackers as a means to reduce sedentary behavior . Trial registration NCT01855776 Registered : August 8 , Background / Objective : Colorectal and gynecologic cancer survivors are at cardiovascular risk due to comorbidities and sedentary behaviour , warranting a feasible intervention to increase physical activity . The Health Action Process Approach ( HAPA ) is a promising theoretical framework for health behaviour change , and wearable physical activity trackers offer a novel means of self-monitoring physical activity for cancer survivors . Method : Sixty-eight survivors of colorectal and gynecologic cancer will be r and omised into 12-week intervention and control groups . Intervention group participants will receive : a Fitbit Alta ™ to monitor physical activity , HAPA-based group sessions , booklet , and support phone-call . Participants in the control group will only receive the HAPA-based booklet . Physical activity ( using accelerometers ) , blood pressure , BMI , and HAPA constructs will be assessed at baseline , 12-weeks ( post-intervention ) and 24-weeks ( follow-up ) . Data analysis will use the Group x Time interaction from a General Linear Mixed Model analysis . Conclusions : Physical activity interventions that are acceptable and have robust theoretical underpinnings show promise for improving the health of cancer survivors Background Physical activity can improve health outcomes in people with knee osteoarthritis ( OA ) ; however , participation in physical activity is very low in this population . Objective The objective of our study was to assess the feasibility and preliminary efficacy of the use of wearables ( Fitbit Flex ) and telephone counselling by a physical therapist ( PT ) for improving physical activity in people with a physician-confirmed diagnosis of knee OA , or who have passed 2 vali date d criteria for early OA . Methods We conducted a community-based feasibility r and omized controlled trial . The immediate group ( n=17 ) received a brief education session by a physical therapist , a Fitbit Flex activity tracker , and a weekly telephone call for activity counselling with the physical therapist . The delayed group ( n=17 ) received the same intervention 1 month later . All participants were assessed at baseline ( T0 ) , and the end of 1 month ( T1 ) and 2 months ( T2 ) . Outcomes were ( 1 ) mean moderate to vigorous physical activity time , ( 2 ) mean time spent on sedentary behavior , ( 3 ) Knee Injury and Osteoarthritis Outcome Score ( KOOS ) , and ( 4 ) Partners in Health Scale . Feasibility data were summarized with descriptive statistics . We used analysis of covariance to evaluate the effect of the group type on the outcome measures at T1 and T2 , after adjusting for blocking and T0 . We assessed planned contrasts of changes in outcome measures over measurement periods . Results We identified 46 eligible individuals ; of those , 34 ( 74 % ) enrolled and no one dropped out . All but 1 participant adhered to the intervention protocol . We found a significant effect , with the immediate intervention group having improved in the moderate to vigorous physical activity time and in the Partners in Health Scale at T0 to T1 compared with the delayed intervention group . The planned contrast of the immediate intervention group at T0 to T1 versus the delayed group at T1 to T2 showed a significant effect in the sedentary time and the KOOS symptoms subscale , favoring the delayed group . Conclusions This study demonstrated the feasibility of a behavioral intervention , supported by the use of a wearable device , to promote physical activity among people with knee OA . Trial Registration Clinical Trials.gov NCT02313506 ; https:// clinical trials.gov/ct2/show/NCT02313506 ( Archived by WebCite at http://www.webcitation.org/6r4P3Bub0 Background The office workplace is a key setting in which to address excessive sitting time and inadequate physical activity . One major influence on workplace sitting is the organizational environment . However , the impact of organizational-level strategies on individual level activity change is unknown . Further , the emergence of sophisticated , consumer-targeted wearable activity trackers that facilitate real-time self-monitoring of activity , may be a useful adjunct to support organizational-level strategies , but to date have received little evaluation in this workplace setting . Objective The aim of this study is to evaluate the feasibility , acceptability , and effectiveness of organizational-level strategies with or without an activity tracker on sitting , st and ing , and stepping in office workers in the short ( 3 months , primary aim ) and long-term ( 12 months , secondary aim ) . Methods This study is a pilot , cluster-r and omized trial ( with work teams as the unit of clustering ) of two interventions in office workers : organizational-level support strategies ( eg , visible management support , emails ) or organizational-level strategies plus the use of a waist-worn activity tracker ( the LUMOback ) that enables self-monitoring of sitting , st and ing , and stepping time and enables users to set sitting and posture alerts . The key intervention message is to ‘ St and Up , Sit Less , and Move More . ’ Intervention elements will be implemented from within the organization by the Head of Workplace Wellbeing . Participants will be recruited via email and enrolled face-to-face . Assessment s will occur at baseline , 3 , and 12 months . Time spent sitting , sitting in prolonged ( ≥30 minute ) bouts , st and ing , and stepping during work hours and across the day will be measured with activPAL3 activity monitors ( 7 days , 24 hours/day protocol ) , with total sitting time and sitting time during work hours the primary outcomes . Web-based question naires , LUMOback recorded data , telephone interviews , and focus groups will measure the feasibility and acceptability of both interventions and potential predictors of behavior change . Results Baseline and follow-up data collection has finished . Results are expected in 2016 . Conclusions This pilot , cluster-r and omized trial will evaluate the feasibility , acceptability , and effectiveness of two interventions targeting reductions in sitting and increases in st and ing and stepping in office workers . Few studies have evaluated these intervention strategies and this study has the potential to contribute both short and long-term findings Background Mobile technologies have great potential to promote an active lifestyle in lower educated working young adults , an under research ed target group at a high risk of low activity levels . Objective The objective of our study was to examine the effect and process evaluation of the newly developed evidence - and theory-based smartphone app “ Active Coach ” on the objective ly measured total daily physical activity ; self-reported , context -specific physical activity ; and self-reported psychosocial variables among lower educated working young adults . Methods We recruited 130 lower educated working young adults in this 2-group cluster r and omized controlled trial and assessed outcomes at baseline , posttest ( baseline+9 weeks ) , and follow-up ( posttest+3 months ) . Intervention participants ( n=60 ) used the Active Coach app ( for 9 weeks ) combined with a Fitbit activity tracker . Personal goals , practical tips , and educational facts were provided to encourage physical activity . The control group received print-based generic physical activity information . Both groups wore accelerometers for objective measurement of physical activity , and individual interviews were conducted to assess the psychosocial variables and context -specific physical activity . Furthermore , intervention participants were asked process evaluation questions and generalized linear mixed models and descriptive statistics were applied . Results No significant intervention effects were found for objective ly measured physical activity , self-reported physical activity , and self-reported psychosocial variables ( all P>.05 ) . Intervention participants evaluated the Active Coach app and the combined use with the Fitbit wearable as self-explanatory ( 36/51 , 70.6 % ) , user friendly ( 40/51 , 78.4 % ) , and interesting ( 34/51 , 66.7 % ) . Throughout the intervention , we observed a decrease in the frequency of viewing graphical displays in the app ( P<.001 ) ; reading the tips , facts , and goals ( P<.05 ) ; and wearing the Fitbit wearable ( P<.001 ) . Few intervention participants found the tips and facts motivating ( 10/41 , 24.4 % ) , used them to be physically active ( 8/41 , 19.6 % ) , and thought they were tailored to their lifestyle ( 7/41 , 17.1 % ) . Conclusions The lack of significant intervention effects might be due to low continuous user engagement . Advice or feedback that was not perceived as adequately tailored and the difficulty to compete with many popular commercial apps on young people ’s smartphones may be responsible for a decrease in the engagement . A st and -alone app does not seem sufficient to promote an active lifestyle among lower educated working young adults ; therefore , multicomponent interventions ( using both technological and human support ) , as well as context -specific sensing to provide tailored advice , might be needed in this population . Trial Registration Clinical Trials.gov NCT02948803 ; https:// clinical trials.gov/ct2/show/ results /NCT02948803 ( Archived by WebCite at http://www.webcitation.org/71OPFwaoA BACKGROUND An activity tracker combined with a smartphone application ( smartcare ) may help people track and receive feedback on their own activities . However , activity trackers themselves generally fail to drive long-term sustained engagement for a majority of users . One potential strategy for increasing the effectiveness of smartcare is through the use of incentives . The purpose of this pilot r and omized trial is to test the feasibility of our intervention and to assess the extent to which smartcare with or without financial incentives can increase physical activity levels and reduce weight over a 12-week period . METHODS / DESIGN This study employs a three-arm , open-label r and omized controlled trial design : control ( st and ard basic education ) , smartcare , and smartcare plus financial incentives .  Male university students with body mass index ≥ 27 are enrolled . Our primary and secondary endpoints are the amount of weight loss and the level of physical activity respectively . The weight loss goal is 3 % of baseline at week 4 , 5 % at week 8 , and 7 % at week 12 . The daily physical activity goal was individualized according to the participants ' weight . Process incentives are accumulated when participants met daily physical activity goals , and outcome incentives are provided when they met weight reduction goals . DISCUSSION Given the global increase in physical inactivity and obesity , there is a growing need for effective , scalable , and affordable health promotion strategies . Our proof-of-concept study will provide the evidence for the combination of rising health promotion technology of activity trackers and smartphone applications with the modern concept of behavioral economics using financial incentives INTRODUCTION Direct-to-consumer mHealth devices are a potential asset to behavioral research but rarely tested as intervention tools . This trial examined the accelerometer-based Fitbit tracker and website as a low-touch physical activity intervention . The purpose of this study is to evaluate , within an RCT , the feasibility and preliminary efficacy of integrating the Fitbit tracker and website into a physical activity intervention for postmenopausal women . METHODS Fifty-one inactive , postmenopausal women with BMI ≥25.0 were r and omized to a 16-week web-based self-monitoring intervention ( n=25 ) or comparison group ( n=26 ) . The Web-Based Tracking Group received a Fitbit , instructional session , and follow-up call at 4 weeks . The comparison group received a st and ard pedometer . All were asked to perform 150 minutes/week of moderate to vigorous physical activity ( MVPA ) . Physical activity outcomes were measured by the ActiGraph GT3X+ accelerometer . RESULTS Data were collected and analyzed in 2013 - 2014 . Participants were aged 60 ( SD=7 ) years with BMI of 29.2 ( 3.5 ) kg/m(2 ) . Relative to baseline , the Web-Based Tracking Group increased MVPA by 62 ( 108 ) minutes/week ( p<0.01 ) ; 10-minute MVPA bouts by 38 ( 83 ) minutes/week ( p=0.008 ) ; and steps by 789 ( 1,979 ) ( p=0.01 ) , compared to non-significant increases in the Pedometer Group ( between-group p=0.11 , 0.28 , and 0.30 , respectively ) . The Web-Based Tracking Group wore the tracker on 95 % of intervention days ; 96 % reported liking the website and 100 % liked the tracker . CONCLUSIONS The Fitbit was well accepted in this sample of women and associated with increased physical activity at 16 weeks . Leveraging direct-to-consumer mHealth technologies aligned with behavior change theories can strengthen physical activity interventions Background Physical activity ( PA ) reduces pain and improves functioning in people with knee osteoarthritis ( OA ) , but few people with the condition meet recommended PA guidelines . Successful intervention strategies to increase PA include goal setting , action planning , self-monitoring , and follow-up feedback from a healthcare professional . Recently developed consumer wearable activity trackers allow users to set activity goals , self-monitor daily goal -progress , and provide feedback on goal attainment . It is hypothesized that a multi-component physiotherapist-led intervention that includes a short ( 40-min ) education module , guided goal - setting and action planning , the use of a wristb and activity tracker , and weekly follow-up phone calls will lead to increased PA outcomes . Methods / design Thirty-six participants will be recruited from the community for a two-group pilot r and omized controlled trial with a stepped-wedge design using an intention-to-treat analysis . Computer-generated block r and omization will be performed using varying block sizes and a 1:1 allocation ratio . The 4-week intervention will be delivered immediately ( immediate-intervention group ) or after a 5-week delay ( delayed-intervention group ) . Outcome measures of pain and disability ( Knee Injury and OA Outcome Score ) , disease self-management ability ( Partners in Health Scale ) , and objective bouted moderate-to-vigorous PA and sedentary time ( BodyMedia SenseWear Mini Armb and ) will be collected at baseline ( week 0 ) and two follow-ups ( weeks 5 and 10 ) , for a total study duration of 11 weeks . Feasibility data relating to process , re source , management , and scientific elements of the trial will be collected . Outcome measure and feasibility data will be summarized , and an estimate of intervention efficacy will be obtained by regression model with planned comparisons . The trial began recruiting in February 2015 . To date , 34 subjects have been recruited . Discussion This study will evaluate the feasibility and preliminary efficacy of a novel intervention to promote  PA in people living with knee OA . The results will provide valuable information to inform a larger r and omized trial to assess intervention effectiveness . Trial registration Clinical Trials.gov Identifier : NCT02313506 ( registration date 8 December 2014 ) . First participant r and omized 20 February 2015 Background Although many wearable devices for monitoring and tracking physical activity are available to consumers , relatively few research studies have been conducted to determine their efficacy in promoting health . Methods In this article , data on the use of consumer wearable devices in promoting healthy behaviors  are summarized based upon bibliographic search es in PubMed and Psychology and Behavioral Sciences Collection with relevant search terms through September 2016 . Results A total of 274 articles were identified in the bibliographic search es . By screening abstract s or full-text articles , six pre/post test trials and seven r and omized controlled trials were identified . In initial trials , consumer wearable devices have been shown to increase physical activity and help users lose weight . However , the number of studies completed to date is small and limited by small sample sizes , short study duration s , and uncertain generalizability of the findings . Conclusions Future studies should utilize r and omized controlled trial research design s , larger sample sizes , and longer study periods to better establish the efficacy of wearable devices in promoting physical activity . Additional research is needed to determine the feasibility and effectiveness of wearable devices in promoting physical activity and weight loss in community setting s including communities affected by health disparities . Studies focusing on children and adolescents are also needed BACKGROUND As wearable sensors/devices become increasingly popular to promote physical activity ( PA ) , research is needed to examine how and which components of these devices people use to increase their PA levels . AIMS ( 1 ) To assess usability and level of engagement with the Fitbit One and daily SMS-based prompts in a 6-week PA intervention , and ( 2 ) to examine whether use/ level of engagement with specific intervention components were associated with PA change . METHODS Data were analyzed from a r and omized controlled trial that compared ( 1 ) a wearable sensor/ device ( Fitbit One ) plus SMS-based PA prompts , and ( 2 ) Fitbit One only , among overweight/ obese adults ( N = 67 ) . We calculated average scores from Likert-type response items that assessed usability and level of engagement with device features ( e.g. , tracker , website , mobile app , and SMS-based prompts ) , and assessed whether such factors were associated with change in steps/day ( using Actigraph GT3X+ ) . RESULTS Participants reported the Fitbit One was easy to use and the tracker helped to be more active . Those who used the Fitbit mobile app ( 36 % ) vs. those who did not ( 64 % ) had an increase in steps at 6-week follow-up , even after adjusting for previous web/app use : + 545 steps/ day ( SE = 265 ) vs. -28 steps/ day ( SE = 242 ) ( p = .04 ) . CONCLUSIONS Level of engagement with the Fitbit One , particularly the mobile app , was associated with increased steps . Mobile apps can instantly display summaries of PA performance and could optimize self-regulation to activate change . More research is needed to determine whether such modalities might be cost-effective in future intervention research and practice BACKGROUND Studies have shown self-monitoring can modify health behaviors , including physical activity ( PA ) . This study tested the utility of a wearable sensor/device ( Fitbit ( ® ) One ™ ; Fitbit Inc. , San Francisco , CA ) and short message service ( SMS ) text-messaging prompts to  increase PA  in overweight and obese adults . MATERIAL S AND METHODS Sixty-seven adults wore a Fitbit One tracker for 6 weeks ; half were r and omized to also receive three daily SMS-based PA prompts . The Fitbit One consisted of a wearable tracker for instant feedback on performance and a Web site/mobile application ( app ) for detailed summaries . Outcome measures were objective ly measured steps and minutes of PA by intensity using two accelerometers : Actigraph ™ ( Pensacola , FL ) GT3X+ ( primary measure ) at baseline and Week 6 and Fitbit One ( secondary measure ) at baseline and Weeks 1 , 2 , 3 , 4 , 5 , and 6 . RESULTS Mixed-model repeated- measures analysis of primary measures indicated a significant within-group increase of + 4.3 ( st and ard error [SE]=2.0 ) min/week of moderate- to vigorous-intensity PA ( MVPA ) at 6-week follow-up ( p=0.04 ) in the comparison group ( Fitbit only ) , but no study group differences across PA levels . Secondary measures indicated the SMS text-messaging effect lasted for only 1 week : the intervention group increased by + 1,266 steps ( SE=491 ; p=0.01 ) , + 17.8 min/week MVPA ( SE=8.5 ; p=0.04 ) , and + 38.3 min/week total PA ( SE=15.9 ; p=0.02 ) compared with no changes in the comparison group , and these between-group differences were significant for steps ( p=0.01 ) , fairly/very active minutes ( p<0.01 ) , and total active minutes ( p=0.02 ) . CONCLUSIONS These data suggest that the Fitbit One achieved a small increase in MVPA at follow-up and that the SMS-based PA prompts were insufficient in increasing PA beyond 1 week . Future studies can test this intervention in those requiring less help and /or test strategies to increase participants ' engagement levels Background Many adults are insufficiently physically active , have prolonged sedentary behaviour and report poor sleep . These behaviours can be improved by interventions that include education , goal setting , self-monitoring , and feedback strategies . Few interventions have explicitly targeted these behaviours simultaneously or examined the relative efficacy of different self-monitoring methods . Methods / Design This study aims to compare the efficacy of two self-monitoring methods in an app-based multi-behaviour intervention to improve objective ly measured physical activity , sedentary , and sleep behaviours , in a 9 week 2–arm r and omised trial . Participants will be adults ( n = 64 ) who report being physically inactive , sitting > 8 h/day and frequent insufficient sleep ( ≥14 days out of last 30 ) . The “ Balanced ” intervention is delivered via a smartphone ‘ app ’ , and includes education material s ( guidelines , strategies to promote change in behaviour ) , goal setting , self-monitoring and feedback support . Participants will be r and omly allocated to either a device-entered or user-entered self-monitoring method . The device-entered group will be provided with a activity tracker to self-monitor behaviours . The user-entered group will recall and manually record behaviours . Assessment s will be conducted at 0 , 3 , 6 , and 9 weeks . Physical activity , sedentary behaviour and sleep-wake behaviours will be measured using the wrist worn Geneactiv accelerometer . Linear mixed models will be used to examine differences between groups and over time using an alpha of 0.01 . Discussion This study will evaluate an app-based multi-behavioural intervention to improve physical activity , sedentary behaviour and sleep ; and the relative efficacy of two different approaches to self-monitoring these behaviours . Outcomes will provide information to inform future interventions and self-monitoring targeting these behaviours . Trial registration ACTRN12615000182594 ( Australian New Zeal and Clinical Trials Registry . Registry URL : www.anzctr.org.au ; registered prospect ively on 25 February 2015 ) Background As adults age , their physical activity decreases and sedentary behavior increases , leading to increased risk of negative health outcomes .  Wearable electronic activity monitors have shown promise for delivering effective behavior change techniques . However , little is known about the feasibility and acceptability of non-Fitbit wearables ( Fitbit , Inc , San Francisco , California ) combined with telephone counseling among adults aged more than 55 years . Objective The purpose of our study was to determine the feasibility , acceptability , and effect on physical activity of an intervention combining a wearable physical activity monitor , tablet device , and telephone counseling  among adults aged 55 - 79 years . Methods Adults ( N=40 , aged 55 - 79 years , body mass index=25 - 35 , < 60 min of activity per week ) were r and omized to receive a 12-week intervention or to a wait list control . Intervention participants received a Jawbone Up24 monitor , a tablet with the Jawbone Up app installed , and brief weekly telephone counseling . Participants set daily and weekly step goals and used the monitor ’s idle alert to notify them when they were sedentary for more than 1 h. Interventionists provided brief counseling once per week by telephone .  Feasibility was measured using observation and study records , and acceptability was measured by self-report using vali date d items . Physical activity and sedentary time were measured using ActivPAL monitors following st and ard protocol s. Body composition was measured using dual-energy x-ray absorptiometry scans , and fitness was measured using a 6-min walk test . Results Participants were 61.48 years old ( SD 5.60 ) , 85 % ( 34/40 ) female , 65 % ( 26/40 ) white .  Average activity monitor wear time was 81.85 ( SD 3.73 ) of 90 days . Of the 20 Up24 monitors , 5 were reported broken and 1 lost . No related adverse events were reported . Acceptability items were rated at least 4 on a scale of 1 - 5 . Effect sizes for most outcomes were small , including stepping time per day ( d=0.35 ) , steps per day ( d=0.26 ) , sitting time per day ( d=0.21 ) , body fat ( d=0.17 ) , and weight ( d=0.33 ) . Conclusions The intervention was feasible and acceptable in this population . Effect sizes were similar to the sizes found using other wearable electronic activity monitors , indicating that when combined with telephone counseling , wearable activity monitors are a potentially effective tool for increasing physical activity and decreasing sedentary behavior . Trial registration Clinical trials.gov NCT01869348 ; https:// clinical trials.gov/ct2/show/NCT01869348 ( Archived by WebCite at http://www.webcitation.org/6odlIolqy BACKGROUND Physical activity is positively associated with survival and quality of life among breast cancer survivors . Despite these benefits , the majority of breast cancer survivors are insufficiently active . The potential health benefits of reducing sedentary behaviour ( sitting time ) in this population have not been extensively investigated . The ACTIVATE Trial will evaluate the efficacy of an intervention that combines wearable technology ( the Garmin Vivofit2 ® ) with traditional behavioural change approaches to increase physical activity and reduce sedentary behaviour performed by breast cancer survivors . METHODS / DESIGN This r and omised controlled trial includes inactive , postmenopausal women diagnosed with stage I-III breast cancer who have completed their primary treatment . Participants are r and omly assigned to the primary intervention group ( Garmin Vivofit2 ® ; behavioural feedback and goal setting session ; and , five telephone-delivered health coaching sessions ) or to the wait-list control group . The primary intervention is delivered over a 12-week period . The second 12-week period comprises a maintenance phase for the primary intervention group , and an abridged intervention ( Garmin Vivofit2 ® only ) for the wait-list control group . Moderate- to vigorous-intensity physical activity ( MVPA ) and sedentary behaviour are assessed by accelerometry at baseline ( T1 ) , end of intervention ( T2 ) , and end of maintenance phase ( T3 ) . DISCUSSION The ACTIVATE Trial is one of the first studies to incorporate wearable technology into an intervention for cancer survivors . If the use of wearable technology ( in combination with behaviour change strategies , or alone ) proves efficacious , it may become an inexpensive and sustainable addition to the health promotion strategies available to health care providers in the cancer survivorship context . TRIAL REGISTRATION ACTRN12616000175471 Background The benefits of physical activity are well documented , but scalable programs to promote activity are needed . Interventions that assign tailored and dynamically adjusting goals could effect significant increases in physical activity but have not yet been implemented at scale . Objective Our aim was to examine the effectiveness of an open access , Internet-based walking program that assigns daily step goals tailored to each participant . Methods A two-arm , pragmatic r and omized controlled trial compared the intervention to no treatment .  Participants were recruited from a workplace setting and r and omized to a no-treatment control ( n=133 ) or to treatment ( n=132 ) . Treatment participants received a free wireless activity tracker and enrolled in the walking program , Walkadoo .  Assessment s were fully automated : activity tracker recorded primary outcomes ( steps ) without intervention by the participant or investigators . The two arms were compared on change in steps per day from baseline to follow-up ( after 6 weeks of treatment ) using a two-tailed independent sample s t test . Results Participants ( N=265 ) were 66.0 % ( 175/265 ) female with an average age of 39.9 years . Over half of the participants ( 142/265 , 53.6 % ) were sedentary ( < 5000 steps/day ) and 44.9 % ( 119/265 ) were low to somewhat active ( 5000 - 9999 steps/day ) . The intervention group significantly increased their steps by 970 steps/day over control ( P<.001 ) , with treatment effects observed in sedentary ( P=.04 ) and low-to-somewhat active ( P=.004 ) participants alike . Conclusions The program is effective in increasing daily steps .  Participants benefited from the program regardless of their initial activity level . A tailored , adaptive approach using wireless activity trackers is realistically implementable and scalable . Trial Registration Clinical trials.gov NCT02229409 , https:// clinical trials.gov/ct2/show/NCT02229409 ( Archived by WebCite at http://www.webcitation.org/6eiWCvBYe This study examined the use of activity trackers alone or combined with weekly communication through email to improve activity and body composition over one academic year in medical students . This r and omized clinical trial conducted at the New York Institute of Technology from July 7 , 2016 through June 4 , 2017 enrolled 120 medical students . The first group ( Fitbit-Plus ) wore activity trackers and received weekly emails offering fitness challenges and lifestyle modification challenges . The second group ( Fitbit-Only ) received only activity trackers and did not receive weekly emails . The third group ( Control ) was asked not to purchase an activity tracker of any kind throughout the study . All groups had a body composition analysis prior to the start of the academic year and at the end of the first academic year . Outcome measures included step count and body composition ( body fat percentage and lean body mass ) . The results showed the overall mean daily steps were greater in the Fitbit-Plus group than the Fitbit-Only group for the academic year ( 7429 ± 2833 vs. 6483 ± 2359 ) with only months April and May showing a significant difference between the groups ( p = 0.011 ; p = 0.044 ) . Body fat percentage decreased in the Fitbit-Plus overweight women ( 2.1 ± 1.6 % ) lean body mass increased in the Fitbit-Plus group in overweight men ( 2.4 ± 4.6 lbs . ) . A subsequent finding of this study showed improved body composition in a small sub-group of over-weight students . Weekly behavioral challenges combined with an activity tracker  increased step count in medical students compared to an activity tracker alone . Clinical trials.gov Identifier : NCT02778009 BACKGROUND Activity tracking devices can reinforce physical fitness and may be beneficial to resident physicians . To date , their use has not been evaluated . OBJECTIVE To determine if use of an activity tracking device increases residents ' activity  , measured as steps per day . METHODS A prospect i ve , crossover study involved residents at 1 academic hospital system . Participants were weighed and completed a baseline survey . All participants were asked to wear an activity tracking device for 8 weeks . Residents were blinded to feedback from the device on activity level during the first 4 weeks . During the second 4-week period , participants were given access to data on activity level and were invited to join a voluntary activity tracking group . RESULTS Of 104 residents invited to participate , 86 enrolled . The majority of participants were female and did not have experience using activity trackers . Almost half ( 49 % , 51 of 104 ) had a body mass index greater than 25 kg/m2 . The median steps per day of all participants during the blinded period was 7260 . This increased to 8266 steps per day during the unblinded period . Surgical residents recorded significantly more steps than nonsurgical specialties ( 7938 versus 6724 , P = .018 ) . The 26 residents who joined the voluntary activity tracking group registered higher median steps per day , and wore their activity tracker more consistently . CONCLUSIONS Providing residents with activity trackers , increasing feedback , and providing comparisons to peers may enhance residents '  physical activity levels Background : Site‐based cardiac rehabilitation  ( CR ) provides supervised exercise , education and motivation for patients . Graduates of CR have improved exercise tolerance . However , when participation in CR ceases , adherence to regular physical activity often declines , consequently leading to worsening risk factors and clinical events . Therefore , the purpose of this pilot study was to evaluate if a mHealth program could sustain the fitness and physical activity levels gained during CR . Methods and Results : A 12‐week mHealth program was implemented using physical activity trackers and health coaching .  Twenty‐five patients were r and omized into mHealth or usual care after completing CR . The combination of a 4.7 ± 13.8 % increase in the mHealth and a 8.5 ± 11.5 % decrease in the usual care group result ed in a difference between groups ( P ≤ .05 ) for absolute peak VO2 . Usual care decreased the amount of moderate‐low physical activity minutes per week ( 117 ± 78 vs 50 ± 53 ; P < .05 ) as well as moderate‐high ( 111 ± 87 vs 65 ± 64 ; P < .05 ) . mHealth increased moderate‐high physical activity ( 138 ± 113 vs 159 ± 156 ; NS ) . The divergent changes between mHealth and usual care in moderate‐high physical activity minutes/week result ed in a difference between groups ( 21 ± 103 vs – 46 ± 36 ; P < .05 ) . Conclusions : A 12‐week mHealth program of physical activity trackers and health coaching following CR graduation can sustain the gains in peak VO2 and physical activity achieved by site‐based CR Background Ageing is associated with a decrease in physical activity . This decrease particularly occurs during specific transitional life stages . Especially during adolescence and young adulthood a steep decrease in physical activity is observed . Inactive people are often not aware of their inactivity . Providing feedback on the actual physical activity level by an activity monitor can increase awareness and may in combination with an individually tailored physical activity advice stimulate a physically active lifestyle . Methods In a r and omized controlled trial the effectiveness of providing an activity monitor in combination with a personal physical activity advice through the Internet will be examined . Outcome measures are level of physical activity , determinants of physical activity , quality of life , empowerment , aerobic fitness and body composition .  Participants are relatively inactive adolescents and young adults who are measured at baseline , after 3 months intervention and 5 months after the end of the intervention . In addition , facilitating and hindering factors for implementation of the intervention will be investigated . Discussion The use of a personal activity monitor in combination with web-based assisted individually tailored health promotion offers a good opportunity to work interactively with large groups of adolescents and young adults and provide them with advice based on their actual activity level . It has great potential to motivate people to change their behaviour and to our knowledge has not been evaluated before Background Regular physical activity reduces the risk of cardiovascular events , but most ischemic heart disease ( IHD ) patients do not obtain enough . Methods and Results ACTIVE REWARD ( A Clinical Trial Investigating Effects of a R and omized Evaluation of Wearable Activity Trackers with Financial Rewards ) was a 24‐week home‐based , remotely monitored , r and omized trial with a 16‐week intervention ( 8‐week ramp‐up incentive phase and 8‐week maintenance incentive phase ) and an 8‐week follow‐up . Patients used wearable devices to track step counts and establish a baseline . Patients in control received no other interventions . Patients in the incentive arm received personalized step goals and daily feedback for all 24 weeks . In the ramp‐up incentive phase , daily step goals increased weekly by 15 % from baseline with a maximum of 10 000 steps and then remained fixed . Each week , $ 14 was allocated to a virtual account ; $ 2 could be lost per day for not achieving step goals . The primary outcome was change in mean daily steps from baseline to the maintenance incentive phase . Ischemic heart disease patients had a mean ( SD ) age of 60 ( 11 ) years and 70 % were male . Compared with control , patients in the incentive arm had a significantly greater increase in mean daily steps from baseline during ramp‐up ( 1388 versus 385 ; adjusted difference , 1061 [ 95 % confidence interval , 386–1736 ] ; P<0.01 ) , maintenance ( 1501 versus 264 ; adjusted difference , 1368 [ 95 % confidence interval , 571–2164 ] ; P<0.001 ) , and follow‐up ( 1066 versus 92 ; adjusted difference , 1154 [ 95 % confidence interval , 282–2027 ] ; P<0.01 ) . Conclusions Loss‐framed financial incentives with personalized goal setting significantly increased physical activity among ischemic heart disease patients using wearable devices during the 16‐week intervention , and effects were sustained during the 8‐week follow‐up . Clinical Trial Registration URL : https://www . clinical trials.gov . Unique identifier : NCT02531022 AIMS Despite the known benefits , 60 % of individuals with diabetes do not engage in regular physical activity ( PA ) . This pilot study tested the effects of a counseling intervention using continuous glucose monitoring system ( CGMS ) feedback on PA self-efficacy , PA levels , and physiological variables . METHODS Adults ( N=52 ) with type 2 diabetes ( non-insulin requiring , inactive ) were r and omized to intervention ( n=27 ) or control ( n=25 ) groups . Both groups received 90min of diabetes education with a follow-up phone call 4 weeks later . The intervention group also received counseling derived from self-efficacy theory . This intervention included feedback on each participant 's CGMS graph and used role model CGMS graphs to clearly depict glucose reductions in response to PA . Outcomes were assessed at baseline and 8 weeks . RESULTS Participants receiving the intervention had higher self-efficacy scores than the control group for sticking to activity/resisting relapse at 8 weeks ( p<0.05 ) , indicating more confidence in maintaining a PA program . Intervention group participants light/sedentary activity minutes decreased significantly ( p<0.05 ) , moderate activity minutes increased significantly ( p<0.05 ) , and , HbA1c and BMI decreased significantly ( p<0.05 ) . CONCLUSIONS These data suggest that PA counseling interventions using CGMS feedback for individuals with type 2 diabetes may improve PA levels and reduce risk factors for diabetes-related complications
CONCLUSIONS Utilizing a consumer-based wearable activity tracker as either the primary component of an intervention or as part of a broader physical activity intervention has the potential to increase physical activity participation .
BACKGROUND The range of benefits associated with regular physical activity participation is irrefutable .
Despite the well-known benefits , physical inactivity remains one of the major contributing factors to ill-health throughout industrialized countries .
Traditional lifestyle interventions such as group education or telephone counseling are effective at increasing physical activity participation ; however , physical activity levels tend to decline over time .
Consumer-based wearable activity trackers that allow users to objective ly monitor activity levels are now widely available and may offer an alternative method for assisting individuals to remain physically active .
OBJECTIVE This review aim ed to determine the effects of interventions utilizing consumer-based wearable activity trackers on physical activity participation and sedentary behavior when compared with interventions that do not utilize activity tracker feedback .