Using Wearable Devices and Smartphones to Track Physical Activity: Initial Activation, Sustained Use, and Step Counts Across Sociodemographic Characteristics in a National Sample

In Annals of Internal Medicine, Mitesh Patel and colleagues describe rates of initial use of activity trackers, sustained use after 6 months, and step counts across different sociodemographic characteristics from a wellness program offered across the United States. Many large employers are using data collected from wearable devices and smartphones in workplace wellness programs; however, the characteristics of persons who use these devices are poorly understood.

Mean daily step count and sociodemographic characteristics between 2014 and 2015 were obtained from Humana for insured persons with access to HumanaVitality, a nationwide wellness program (n = 4,483,853). Median household income from U.S. census data were linked using zip code. The program used gamification with points and levels; achieving higher levels made points redeemed for gift cards or other prizes more valuable.

This study had 3 main findings. First, activity tracker activation, sustained use, and step counts varied across sociodemographic characteristics. Second, initial activation was low, particularly among older and lower-income persons; however, overall activation rates increased between 2014 and 2015. Third, sustained use and mean step counts were high among those who initially activated their devices, perhaps partly because of the program's use of gamification and incentives, which have been effective approaches in other settings. The authors recommend programs consider ways to better engage older persons and those who may be less able to afford devices, as well as consider testing gamification and incentive strategies to improve device use and physical activity outcomes.