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|Issue 102||October 2015|
The report is a product of the VA/HSR&D Evidence Synthesis Program.
The Impact of Wearable Motion Sensing Technologies on Physical Activity
Activity devices (wearable motion sensing technologies like those in Fitbit, Jawbone, and Apple Watch, among several others) have demonstrated a small significant effect for increasing physical activity and for weight loss, according to the evidence found in a recent Evidence Synthesis Program (ESP) report. The systematic review, conducted by the ESP Center at the Durham Veterans Affairs Medical Center, found and examined 14 clinical trials on the use of accelerometers to record physical activity.
While regular physical activity is associated with a wide range of mental and physical health benefits, a large proportion of adults, including military Veterans, are insufficiently active. Less than 50% of Veterans report engaging in physical activity at a level to promote health. Comparisons also show disparities among Veterans Affairs (VA) users and non-users, with higher rates of physical inactivity (20%) observed among Veterans using VA services. This is a significant concern for VHA clinicians, managers, and policymakers given that low aerobic fitness, stemming from inactivity, is associated with increased healthcare costs.
Although pedometers are a cost-effective tool, they are increasingly being replaced by accelerometers. Accelerometers offer the advantage of assessing all accelerative movements, in all directions, in addition to the ambulation data collected by a pedometer, and can be calibrated to detect differences in intensity. Data from accelerometers also allow for intervention content to be tailored. The VA National Center for Health Promotion and Disease Prevention (NCP) nominated this project after a process that included a preliminary review of published peer-reviewed literature and consultation with investigators, VA and non-VA experts, and key stakeholders. The goal of this report, as defined by NCP, is to assess whether VA should invest in accelerometers and other wearable activity devices as a tool to motivate Veterans to be more physically active.
While the NCP was also interested in patient satisfaction with these devices, none of the included studies reported on this outcome. Neither did any study examine the integration of physical activity data from wearable accelerometers into the patient's medical records to facilitate ongoing primary care and chronic disease management.
The report authors conclude that while accelerometers have proven to be a valid and reliable means of tracking step counts and activity levels, their effectiveness as an agent of behavior change has been less clear. Nearly all studies assessed in this report used multiple behavioral enhancements (e.g., goal setting, exercise training, nutrition counseling) alongside accelerometers to promote behavior change. Also, the study authors did not identify any head-to-head studies of accelerometers versus pedometers. Thus, they note it is also unclear whether accelerometers offer additional advantages over cheaper pedometers as a means of self-monitoring physical activity. The small positive effects produced by interventions that include accelerometers may not result in a clinically significant impact on physical activity or weight loss; however, the small sample sizes with moderate to high heterogeneity in the current studies in this review limit the conclusions that may be drawn. Larger, well-designed randomized controlled trials are needed that can shed light on such issues as whether accelerometers outperform traditional pedometers, how activity device features may enhance adherence and outcomes, and the effects on long-term outcomes.
View the full report — **VA Intranet only**:
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A Cyberseminar session on this ESP Report will be held on Thursday, January 14, 2016 at 12:00pm (ET). To register, go to the HSR&D Cyberseminar web page.
Please feel free to forward this information to others!
ESP is currently soliciting review topics from the broader VA community. Nominations will be accepted electronically using the online Topic Submission Form. If your topic is selected for a synthesis, you will be contacted by an ESP Center to refine the questions and determine a timeline for the report.
This Management e-Brief is provided to inform you about recent HSR&D findings that may be of interest. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs. If you have any questions or comments about this Brief, please email CIDER. The Center for Information Dissemination and Education Resources (CIDER) is a VA HSR&D Resource Center charged with disseminating important HSR&D findings and information to policy makers, managers, clinicians, and researchers working to improve the health and care of Veterans.
This report is a product of VA/HSR&D's Quality Enhancement Research Initiative's (QUERI) Evidence-Based Synthesis Program (ESP), which was established to provide timely and accurate synthesis of targeted healthcare topics of particular importance to VA managers and policymakers – and to disseminate these reports throughout VA.
See all reports online.