title: Feasibility and Acceptability of a Wearable Technology Physical Activity Intervention With Telephone Counseling for Mid-Aged and Older Adults: A Randomized Controlled Pilot Trial.
abstract: 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 randomized 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 validated items. Physical activity and sedentary time were measured using ActivPAL monitors following standard protocols. 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.
  
  
  BACKGROUND
  Clinicaltrials.gov NCT01869348; https://clinicaltrials.gov/ct2/show/NCT01869348 (Archived by WebCite at http://www.webcitation.org/6odlIolqy).
authors.affiliation: Department of Nutrition and Metabolism, The University of Texas Medical Branch, Galveston, TX, United States.|Sealy Center on Aging, The University of Texas Medical Branch, Galveston, TX, United States.|Division of Rehabilitation Sciences, The University of Texas Medical Branch, Galveston, TX, United States.
authors.forename: Elizabeth J
authors.identifier: http://orcid.org/0000-0003-1695-2236
authors.initials: EJ
authors.lastname: Lyons
authors.affiliation: Sealy Center on Aging, The University of Texas Medical Branch, Galveston, TX, United States.|Division of Rehabilitation Sciences, The University of Texas Medical Branch, Galveston, TX, United States.
authors.forename: Maria C
authors.identifier: http://orcid.org/0000-0002-4069-3089
authors.initials: MC
authors.lastname: Swartz
authors.affiliation: Division of Rehabilitation Sciences, The University of Texas Medical Branch, Galveston, TX, United States.|BeachBody, LLC, Santa Monica, CA, United States.
authors.forename: Zakkoyya H
authors.identifier: http://orcid.org/0000-0001-8645-6495
authors.initials: ZH
authors.lastname: Lewis
authors.affiliation: Sealy Center on Aging, The University of Texas Medical Branch, Galveston, TX, United States.
authors.forename: Eloisa
authors.identifier: http://orcid.org/0000-0002-6191-6528
authors.initials: E
authors.lastname: Martinez
authors.affiliation: Department of Preventive Medicine and Community Health, The University of Texas Medical Branch, Galveston, TX, United States.
authors.forename: Kristofer
authors.identifier: http://orcid.org/0000-0002-5442-9326
authors.initials: K
authors.lastname: Jennings
keywords: health behavior; mobile health; physical activity; self-control; technology