Wearable Activity Monitors: Effective Tools Or Shiny Toys?

by Nicole Witham

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“6 floors today. I definitely climbed more than that. Let’s see, once in the morning, a couple flights in the afternoon, then...oh. Well, I did walk to the coffee maker more than usual today. That must count, right?” That is my internal dialogue after wearing my physical activity monitor for the day and noticing my sub-par activity.

With the holiday season behind us, more of us are wearing these sparkling new activity monitors gifted to us. All of these track activity in some way. The most advanced wearable devices have even more functions – to track steps taken, hours slept, calories expended, and minutes of vigorous activity performed. The critical objective of any activity monitor is to help the consumer become more conscious of his or her physical activity, or lack thereof, with the hope that this personal awareness will motivate the wearer to positively change, or maintain, health behavior.

So, do activity monitors actually do that? Are these devices helping their wearers make better health choices, such as taking a quick afternoon walk? Or will the monitors be tossed to the side and forgotten about a few weeks after they were unwrapped? We don’t quite know. The jury is still out on the effectiveness of activity monitors for changing health behavior, specifically physical activity.

Research demonstrates that at the root of an effective behavior change program are a few crucial tools. The program should incorporate self-monitoring, social support, and specific goal-setting. There should also be a self-efficacy promoting element to the program. Self-efficacy, that “You can do it!” attitude that fitness instructors typically exude, has demonstrated itself as a predictor of adoption and maintenance of physical activity behavior. No one should expect wearable devices and the websites and apps they are connected to to work if they fail to incorporate these behavior change techniques (BCTs).

It turns out that many of the popular activity monitors do use the exact techniques that have proven themselves in previous research. The most prevalent BCTs used are self-monitoring and goal-setting with some using social support and social comparison to encourage the wearers to increase their physical activity by linking up with others. Additionally, reward mechanisms, such as awarding badges for goals met and encouraging reflections on past success, are used by some of the monitor to reinforce self-efficacy.

While it is good to know that popular activity monitors use many evidence-based techniques to encourage behavior change, there are a few BCTs underrepresented by these wearable devices. Action-planning, as in generating a step-by-step plan on how to achieve a goal, is not often found in activity monitoring applications. Problem-solving assistance is also lacking, but crucial when implementing behavior change. These techniques involve an individualized feedback approach that many activity monitors are not currently equipped to handle.

Despite these limitations, wearable activity monitors have demonstrated potential in recent intervention studies aimed at reducing sedentary behavior. Further research with larger sample sizes and longer follow-up periods is necessary to determine how useful activity monitors are at increasing physical activity in a more general population over a sustained period of time.

I personally know how easy it is to remove my activity monitor and forget about it for a few days (or weeks). However, when I am wearing my monitor regularly, I appreciate the feedback it gives me - even on the days that my most active moments are when I am walking to the coffee maker.