Assessing an Activity Tracker to Increase Motivation for Physical Activity in T2D

Physical inactivity is a well-documented contributor to premature mortality, cardiovascular disease (CVD), and (T2D). “Adopting healthy habits, such as regular physical activity, good nutrition, weight management, and not smoking, can have powerful effects on risks for CVD, T2D, and complications from these diseases,” says Caroline Rhéaume, MD, PhD. “However, despite overwhelming evidence supporting their benefits, few patients follow recommended healthy lifestyles. The challenge is to find ways to integrate structured and intensive lifestyle interventions and to follow the lifestyle habits of patients over time.”

Testing an Activity Tracker-Based Intervention

Many technologies have been developed to improve physical activity and increase adoption of healthier behaviors, including mobile apps, pedometers, and activity trackers (eg, Fitbit and Jawbone), but some studies report challenges with implementing technology in real-life settings. For a study published in mHealth, Dr. Rhéaume and colleagues evaluated the impact of an activity tracker on physical activity and cardiometabolic risk variables in patients with T2D. They also assessed the feasibility of implementing an activity tracker in a primary care setting.

The study included 30 patients with T2D who were randomly assigned to a control group, which included a physical activity promotion intervention supported by a kinesiologist, or an intervention group that received the same intervention as the control group but added use of an activity tracker (Fitbit). Cardiometabolic risk variables, physical activity, and motivation were assessed at baseline and after 3 months. Satisfaction with, and acceptability of, wearing the activity tracker in the intervention group were also assessed. “This is important research because there is a need to find relatively low-cost interventions that can be scaled to improve health in patients with T2D,” says Dr. Rhéaume.

Motivation & Satisfaction Increase With Activity Tracker Use

The study results showed that physical activity increased in both cohorts, but changes in cardiometabolic risk variables, physical activity, and motivation were greater for the intervention group. “Our most important finding was that the activity tracker could be a potential motivational tool to increase physical activity in patients with T2D,” Dr. Rhéaume says. “We found that 86% of participants in the intervention group were satisfied with their activity tracker use and compliance remained high during the study.” Of note, 75% of participants reported the activity tracker would motivate them to stick to their physical activity program after the intervention ended.

“Our study also showed that use of an activity tracker improves some cardiometabolic risk variables,” says Dr. Rhéaume (Table). “HDL cholesterol significantly increased in the intervention group while it decreased in the control group. Resting systolic and diastolic blood pressure and glycated hemoglobin levels tended to decrease in both groups. In a multivariate regression analysis, we saw significant correlations in pre- and post-intervention groups between average steps per day and changes in waist circumference, BMI, and fat percentage in the intervention group.”

Use of Activity Trackers Feasible in Primary Care Settings

Based on the findings, activity trackers should be viewed as a motivational tool to increase physical activity in patients with T2D while also potentially improving cardiometabolic risk variables. “Since activity trackers are widely available, the technology can be easily applied within the community,” says Dr. Rhéaume. “Implementing activity trackers in primary care settings appears to be feasible. These devices could become an important additional tool for managing chronic diseases like T2D.”

A larger-scale study is needed to assess the effectiveness of activity tracker use on cardiometabolic risk variables and physical activity. “We’re hoping to expand on our study by increasing the number of participants, integrating Fitbit data into electronic medical records, and adding more family medicine units,” Dr. Rhéaume says. “In future research, we also want to explore the potential of using a kinesiologist-led physical activity intervention. Ultimately, we need solutions to align technological tools with electronic medical records to help clinicians implement and optimize structured lifestyle habits in the management of chronic disease.”