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New Wearables Study Misses the Point on mHealth

A 2010 study recently published in JAMA concluded that wearables aren't helping people lose weight. Aside from being outdated, it overlooked the value of patient engagement.

By Eric Wicklund

- In real estate, timing and location matter. The same can be said for mHealth.

A study recently reported in the Journal of the American Medical Association and conducted at the University of Pittsburgh reportedly concluded that wearable monitors did not help people lose weight. In fact, the 18-month study of some 471 overweight people found that those equipped with a wearable actually lost less weight than those not using the device.

The news, understandably, caused quite a stir in consumer-facing mHealth circles. “Study Finds Fitbit Might Impede Weight Loss,” one online magazine exclaimed. “Activity Trackers May Undermine Weight Loss Efforts,” another reported.

Except, that’s not altogether true.

For one, the study was launched in 2010 and completed in 2012, and used BodyMedia’s Fit tracker armband. Today, BodyMedia is long since gone, as is its armband, and activity trackers have for the most part migrated from the upper arm down to the wrist, or into smartphones and even smart clothing (The aforementioned Fitbit, in fact, launched as a clip-on device in 2008 and only became wrist-borne with the 2013 launch of the Flex).

READ MORE: Fitbit's mHealth Quest: Making Doctors Care About Health and Wellness

“One of the biggest drawbacks to the Fit is that it’s not particularly comfortable,” one analyst pointed out in a 2013 review of the armband (perhaps signaling a sign of things to come for the company). “(U)sually, I was aware I was wearing it. Several times during the day I’d move it slightly on my arm, to give a break to the particular place the sensors were touching. When I took it off, I knew it was off and I felt a bit more relaxed.”

When surveyed about the armband, less than half of the study participants reported that it was comfortable, while one-quarter disagreed or strongly disagreed with the statement “The armband was comfortable to wear.”

What that study didn’t take into account – and what the wearables industry is grappling with now – is the comfort factor, which ultimately leads to consumer engagement. If a device isn’t comfortable or fashionable, it probably won’t be worn for long. And then all bets are off.

Second, researchers introduced the armband to study participants long after they’d begun a pretty effective weight-loss regimen that included diet and exercise advice and counseling sessions. Also added to the program were online education resources, text messages, even phone-based counseling.

In other words, the participants were doing fine in the program already, so adding a somewhat-intrusive armband really didn’t make much of a difference.

READ MORE: Cleveland Clinic: mHealth Wearables Aren't Reliable for Heart Rate

Noted mHealth think tanks like Partners Healthcare’s Center for Connected Health, the University of Southern California’s Center for Body Computing and the Wireless Life Sciences Alliance have long studied how to improve patient engagement in mHealth and telehealth, whether it be through devices or digital health programs delivered online or via mobile devices. Time and time again they have pointed out that mHealth programs fail when they’re intrusive, uncomfortable or don’t keep the user’s interest beyond an initial honeymoon period.

It has also been proven that wearables won’t do the job on their own, a point made by the study’s lead researcher, John Jakicic.

“Our findings show that adding them to behavioral counseling that includes physical activity and reduced calorie intake does not improve weight loss or physical activity engagement,” he reported. “Therefore, within this context, these devices should not be relied upon as tools for weight management in place of effective behavioral counseling for physical activity and diet."

In talking to The Atlantic, Jakicic further wondered if the armbands “might give people a false sense of security, so they don’t pay attention to key behaviors that they otherwise might pay attention to. They’re relying on the device too much.”

In other words, the wearable has to integrated, and it has to bring something to the table that can’t be found anywhere else. Researchers at PricewaterhouseCoopers came to that same conclusion in their May 2016 report, “The Wearable Life 2.0: Connected Living in a Wearable World.”

READ MORE: Do Doctors, Patients Take mHealth Seriously?

“For consumers to commit to wearables for the long term, a device should not only be attractive and comfortable, but should also reach beyond data delivery to provide knowledge and benefits unavailable elsewhere,” the report noted.

If anything the University of Pittsburgh study points out that we’ve come a long way in mHealth wearables in just six years. And the reaction to that study today indicates that we still have a ways to go.

Dig Deeper:

Fitbit Makes a Play for mHealth Engagement

Using Wearables to Empower the Patient

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