Technology

Benefits of Activity Trackers

Can wearing a fitness device actually change your health habits?

By Sonya Collins

In the 2013 film Her, Theodore(Joaquin Phoenix) falls head over heels in love with his computer operating system. After meeting “her,” he never wants to be without her, and his life is changed forever. That’s how New Yorker Marian Rivman feels about her FitBit — the wearable activity tracker that counts her daily steps and the calories she burns and monitors her heart rate. After she’d had it for only one day, she was in love, she says. And since then, her life has certainly changed.

“I want to have a naturally occurring 10,000-step-a-day life,” says Rivman, a semi-retired public relations and marketing consultant who recently celebrated her 70th birthday. “Not that I just go out for a walk, but that I have a life that’s vigorous and active, and in the course of just living, I walk 10,000 steps.”

Ten thousand steps is about five miles, and it’s the generic daily goal that makers of the devices recommend for users. Since Rivman fastened the FitBit onto her wrist in June 2015, she’s met or surpassed that goal every day. She’s lost 12 pounds, and she thinks a little harder before she gives into the temptation of an indulgent snack. “I ask myself, ‘How many steps is that puppy going to cost me?’”

Rivman is among an estimated one in five Americans who owns an activity tracker, also called fitness bands or fitness trackers. Wearable devices — including trackers and smart watches, clothes, and glasses — are expected to comprise a $50 billion industry by 2018. At a time when obesity and sedentary lifestyles are linked to some of the leading causes of death, these little gizmos could be a boon to the nation’s health. But do blinking lights on a wristband light a sufficient flame to get people off the couch and walking five miles a day? For some people, yes. For others, definitely no.

What’s an activity tracker?

FitBit, JawBone, and Nike Fuelband are among the major players on the tracker scene. The functions of these wristbands, bracelets, watches, and clip-ons vary by price. Besides counting steps and calories burned, the gadgets may measure heart rate, skin temperature, sleep, floors climbed, and distance traveled. They can track different workouts, such as yoga, hiking, and weight lifting. Certain models can learn users’ baseline activity level and suggest appropriate personalized goals. They can alert users when they’ve been idle for too long — usually after an hour.

Trackers send data wirelessly to the company’s website or a mobile app where users can access a dashboard that shows their activity and progress. Users can share their data with others and challenge or support others in their activities. Websites or apps often provide food and calorie logging. Some trackers have smart watch features and alert users about incoming calls, texts, and emails. While this feature isn’t related to fitness, it could encourage users to keep wearing the devices.

“The makers are realizing that if there’s a chance for you to take these things off, that’s a chance for you not to put them back on,” says Mitesh Patel, who researches wearable technology in his role as an assistant professor of medicine and of healthcare management at the University of Pennsylvania in Philadelphia.

Super steppers

Fitness trackers can remind users to move, but they can’t make them do it. For some people, the high-tech gizmo tethered to their wrist or clipped to their waistband is motivation enough. In a recent study of older, inactive women, those who received a FitBit increased their weekly physical activity substantially over the course of four months. The women who received pedometers instead made no significant lifestyle changes.

“Several people [in our focus group] said that when they were below their goal, they would walk around their house in circles until they reached the number of steps they were supposed to get,” says Laura Pugliese, manager of innovation research at HITLAB, a healthcare innovation lab in New York City. “One woman was on a daylong road trip, so she walked in place in her seat to make sure she got enough steps.”

Rivman can identify. If it gets close to midnight, when her FitBit resets to zero steps, and Rivman hasn’t logged her 10,000 steps, she goes outside and walks around her Manhattan block until she reaches her goal.

“It does the job of getting you out of your house,” Rivman says, which in retirement, she adds, is easier said than done.

Perhaps that’s why older adults take to the gadgets. In a study of fitness trackers that included adults of all ages, it was the oldest members of the group who stuck with the devices and saw the greatest health benefits. Pugliese, a researcher on the study, suggests that perhaps older people take new technology more seriously, while younger ones take it for granted.

In another study, researchers wanted to know whether it was even reasonable to suggest that seniors use fitness trackers. They gave Nike Fuel bands to a group of adults over 70 for three months. All but a handful kept the trackers on the whole time. The seniors wearing the trackers bumped up their average daily steps over the study period and shrank their waistlines.

Several people [in our focus group] said that when they were below their goal, they would walk around their house in circles until they reached the number of steps they were supposed to get.

“A lot of people think that older adults wouldn’t be interested, but once they are trained how to use the devices, they actually are interested. They just didn’t know this was something that might appeal to them,” says Lisa Cadmus-Bertram, an assistant professor of kinesiology at the University of Wisconsin-Madison, who has conducted fitness tracker studies that included middle-age and older women.

Side-steppers

For every fanatic lapping the living room at a quarter to midnight, there’s another who’s tossed the wristband into a drawer alongside a pile of flip phones. “About half the people that buy a wearable device stop using it within the first couple of months,” says Patel. A PricewaterhouseCoopers report found that only 10 percent of those who own trackers wear them every day.

Some who abandon the trackers do so intentionally. Data don’t lie, and if those daily steps aren’t increasing, wearable devices are a grim reminder of personal failure. When Cadmus-Bertram had a newborn baby, she was wearing an activity tracker that logged her sleep.

“It just made me more tired to see how little sleep I was getting,” she says. “If you don’t have that [data], you can tell yourself that maybe you’re not doing so badly.” While she never abandoned the tracker during daytime hours, Cadmus-Bertram stopped tracking her sleep until she and the new baby were actually getting some.

Others may simply not put it on again after they take it off. “Many devices require daily or weekly charging. Some are not water-resistant. Charging it, taking it off to get in the shower, that’s just another chance for you to forget to put it back on,” Patel says. While most people will turn around and go back home for a forgotten smartphone, fewer will return home for a wearable device. For this reason, Patel argues, smartphones might make better activity trackers than a separate device — particularly for the less motivated.

Simply wearing the thing is, as they say, only half the battle. In Pugliese’s study, activity trackers had virtually no impact on users’ daily activity, except for the most senior participants. Sure, people wore them. But they weren’t moving around any more in the 12th month than they were in the first.

Steps forward

What motivates some people can be meaningless or even discouraging for others. “All some people need for motivation is the device and to know how to use it. But that’s not most people. For other people, the trackers need to be part of something bigger,” says Cadmus-Bertram. Like many researchers, Cadmus-Bertram believes the contraptions could have the power to help set a sedentary culture in motion, but they can’t do it alone.

“You can’t expect an individual who’s not motivated to put on a wearable device and then come back three months later and magically be healthier and more active,” says Patel.

Patel’s research explores strategies that employers, insurers, or healthcare providers can combine with activity trackers in order to make them more beneficial for the people who need them most.

Many studies that show health benefits of activity trackers examine programs that provide users with financial or social incentives to improve their health. When 212 employees of an Australian company participated in a seven-month FitBit program, more than a third stayed with the program the whole time. A quarter of them reduced their risk for type 2 diabetes over the seven-month period. And those at greatest risk for diabetes when the program started used the FitBits the most.

How did the program achieve this level of engagement? Participants got to buy their trackers at a 20 percent discount. About half of the participants were so sold on their FitBits that, when given the chance to buy one more for a family member or friend at the same rate, they jumped at it.

Other studies of workplaces that offer employees gift cards or other perks for reaching specified fitness milestones have yielded positive results, too. Workplaces may be particularly fertile ground for tracker-based wellness programs. Not only can employers offer perks, but those who are motivated by competition or social accountability have their co-workers to fill that role.

Trackers are capitalizing on social motivation strategies. Jawbone, for example, recently launched a feature that allows users to challenge family, friends, or co-workers to a 24-hour, three-day, or weeklong duel. For those who need an extra push, challenging people they know may be more motivating than challenging faceless users of the device through its social media features.

“The stronger the social connections, the more powerful. If you’re competing with somebody you see at work every day, that’s going to be slightly more powerful than somebody you don’t know,” says Patel. “But competing with a stranger on the app is going to be more powerful than just using the tracker alone.”

As for super-steppers like Marian Rivman, social motivation finds them whether they need it or not. “There’s a whole community of FitBitters. You know, strangers,” Rivman says. “They’ll point to mine as I pass them on the street and give me a thumbs-up or a high-five, and I return the gesture.”