title: Use of the Fitbit to Measure Adherence to a Physical Activity Intervention Among Overweight or Obese, Postmenopausal Women: Self-Monitoring Trajectory During 16 Weeks.
abstract: 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 objectively 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 randomized 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 updated 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.
  
  
  BACKGROUND
  Clinicaltrials.gov NCT01837147; http://clinicaltrials.gov/ct2/show/NCT01837147 (Archived by WebCite at http://www.webcitation.org/6d0VeQpvB).
authors.affiliation: Department of Kinesiology, University of Wisconsin - Madison, Madison, WI, United States. cadmusbertra@wisc.edu.
authors.forename: Lisa
authors.identifier: http://orcid.org/0000-0003-4835-2817
authors.initials: L
authors.lastname: Cadmus-Bertram
authors.forename: Bess H
authors.identifier: http://orcid.org/0000-0002-9440-924X
authors.initials: BH
authors.lastname: Marcus
authors.forename: Ruth E
authors.identifier: http://orcid.org/0000-0002-5795-2331
authors.initials: RE
authors.lastname: Patterson
authors.forename: Barbara A
authors.identifier: http://orcid.org/0000-0003-0499-1289
authors.initials: BA
authors.lastname: Parker
authors.forename: Brittany L
authors.identifier: http://orcid.org/0000-0002-5910-6577
authors.initials: BL
authors.lastname: Morey
keywords: Internet; exercise; health behavior; health promotion; mHealth; motor activity; physical activity; technology; women