Investigating the impact of Fitness Trackers on the outcomes of a weight management intervention delivered within a cardiovascular disease prevention context.
Authors:   , Reed Weronika 
Published: October 2024

Cardiovascular disease (CVD) is a significant cause of death and disability, especially in deprived areas. Most English Local Authorities provide harder-to-reach populations with weight management interventions to reduce obesity, a risk factor for CVD. This study examined whether the use of Fitness Trackers (FT) impacted the outcomes of such interventions using the Healthy Hearts (HH) weight management programme. Two theoretical frameworks were used as a backdrop to this research: the Theory of Planned Behaviour (TPB) and the Capability, Opportunity, Motivation, Behaviour framework (COM-B). This research had four main objectives. First, it evaluated the effectiveness of adding FTs to the HH intervention, comparing outcomes with and without FTs. Second, it studied psychological factors linked to weight loss and assessed whether these varied over time and across study conditions. Third, it examined whether psychological factors could predict HH intervention outcomes. Lastly, it explored the experiences of service users and health professionals involved in the HH weight management programme utilising FTs. A scoping review of seven studies looking at the use of FTs in weight management was initially conducted to provide a broader context and position the current research. The review partially supported the use of FTs to achieve better weight outcomes and identified some research gaps, which are subsequently addressed in the current study. Using mixed methods within a pragmatic framework, 57 participants who were taking part in the HH intervention were randomly assigned to either the FT or control group. They completed questionnaires at three time points: baseline (wave 1), after the 10-week intervention (wave 2), and at six months (wave 3). Data from the HH programme and FTs were also analysed. Additionally, nine FT users and four health professionals were interviewed. Overall, the results show that those wearing FTs had more favourable weightrelated results when compared with the control group. The FT group experienced significant reductions in weight, waist circumference, and BMI at wave 3 and achieved greater weight loss at wave 2. FT users also showed better Physical Activity (PA) outcomes and more positive changes in psychological well-being than non-FT users, including reduced anxiety and depression scores. Furthermore, FT users attended 1.72 more HH sessions than those without FTs. While associations between attitudes, anxiety, and pre-post-intervention weight changes were observed, these factors did not predict the differences in weight loss. FT data revealed that those who recorded more steps and physical activities had better weight outcomes overall. In general, service users and health professionals reported positive experiences with the use of FTs in weight management interventions, particularly in terms of motivation and self-monitoring of PA and other behaviours involved in weight management. They also identified some drawbacks and barriers related to FT use (e.g., personal or technical). While many participants used FTs effectively, these devices were not suitable for everyone. When considered collectively, the results have significant implications. It is recommended that FTs should be provided as weight management intervention tools as they could positively impact self-monitoring of PA, programme attendance and outcomes. Nevertheless, more research is needed to identify the user groups that could most benefit from these tools. Practical recommendations for FT implementation are also provided. If offering FTs to individuals from harder-to-reach backgrounds at increased risk of CVD can improve intervention outcomes, these devices should be considered cost-effective in the long run. They can also serve as additional resources for addressing health disparities when provided to individuals with limited financial means.