New View on Fitness Tracker Wearables Finds Prompts, Philanthropy, Personality Keys to Engagement

Digital Coaches, Social Networks and Charitable Giving

Researchers found study participants were motivated by digital coaching using text message prompts sent at pre-determined times to encourage daily step goals. The digital coaching correlated with increased activity—whether tied to personal goals or altruistic goals—and encouraged daily activity with higher step counts of 7,389 average daily steps compared to only 5,924 steps without the prompts and messages. The participants also received support from the app's social network, with individual users acting as cheerleaders that supplemented the digital coaches. The number of Friends, Likes and Comments were strong predictors of greater activity, according to researchers.

Researchers also designed the study with the hypothesis that users would maintain daily activity if the rewards were not just tied to personal goals but were also connected to charitable giving. The app synched with VSP's Eyes of Hope® initiative, where study participants accrued points based on reaching daily step goals. Once a certain number of points were achieved, the user triggered the donation of a comprehensive eye exam and pair of glasses to an individual in need among four demographics: school-age children, seniors, veterans or individuals affected by homelessness. Participants who reported being motivated by charitable giving had higher activity levels throughout the study—averaging 700 additional daily steps per degree of charitable motivation.

"One in every five Americans wears a health tracker but there was no research that took a look at what motivates engagement, until now," said Leslie Saxon, MD, founder and executive director of the USC CBC who led the research effort. "Since the average study participant fell into a group considered overweight—which can lead to increasing health issues such as diabetes and heart disease—it was illuminating to find digital coaching via the app and an altruistic connection helped these participants maintain their engagement or even increase their activity in some areas."

Diversity and Personality Dominate Unique Study Cohort

The 12-week study was conducted among 284 USC beneficiary employees who provided a diverse cohort for researchers in the single-center longitudinal observational study. Participants, all of whom were daily prescription eyeglass wearers, ranged in age from 18 to 79. The cohort also represented a wide variety of racial backgrounds (36 percent Caucasian; 10 percent African American; 27 percent Latino; 20 percent Asian American; two percent Native Hawaiian or Pacific Islander; four percent Other) and a uniquely large representation of women (61 percent vs. 39 percent men) compared to other wearable fitness tracker research. When it came to health status, the group had an average mean body mass index (BMI) of 28, which falls into the category of being overweight (between 18.5- 24.9 is considered normal weight and over 30 is considered obese).  

In addition to the digital coaching, social networks and philanthropic connection providing increased engagement, researchers found older age participants—63 percent were over age 40—along with higher life satisfaction scores also predicted higher activity levels and were factors in consistent engagement. On the Satisfaction with Life scale, those who demonstrated higher emotional stability, extraversion, openness, agreeableness and conscientiousness were more likely to exercise regularly.

"While we cannot say we've cracked the code for long-term motivation of physical activity, we still learned a tremendous amount: digital prompts, social support, philanthropy, older age, and life satisfaction created the most impact in motivating our participants," said Glenn Fox, PhD, Head of Design, Strategy and Outreach at the USC Performance Science Institute, who was part of the team to create the study design and conduct the analysis of the participants. "We now know these are all keys to increased engagement with fitness trackers and deserve further investigation."

Biometric Sensor Seamlessly Embedded in Eyeglasses Eased Use

Saxon also acknowledged the seamlessness of having a sensor built into a form factor participants wore every day—prescription eyeglasses—was a key motivator for participants. Referencing the ease of not having to remember to put on a separate wearable, the fashionable and comfortable eyewear design, and the simple charging mechanism, participants embraced these aspects of the Level smart glasses as an ideal wearable for activity tracking.

"In many ways, the Level prototype combines all the unique capabilities of VSP Global, including eyewear design and manufacturing, eye care, optics, technology and charitable giving," said Jay Sales, co-director of VSP's innovation lab, The Shop. "Partnering with the USC Center for Body Computing gave this project a degree of academic rigor and multidisciplinary input that was needed to truly understand this platform. Our team can now take these critical learnings and apply them to future iterations of Level."

Gloria Chiu, OD, FAAO, FSLS, who led the study's eye care team for the USC Roski Eye Institute, stated, "Refractive errors and uncorrectable vision impairment are positively associated with poor self-assessed health and poor psychological health in some populations."  

As part of his recent research finding visual impairment and blindness prevalence will double in the U.S. by 2050 due to uncorrected refractive errors, Rohit Varma, MD, MPH, dean of the Keck School of Medicine of USC and director of the USC Roski Eye Institute, said, "If we can address uncorrected vision impairment and encourage healthier behavior through the use of digital tools such as the Level smart glasses, this is the future we envision and want to encourage.

"This study is another data point that USC's research partnerships with innovators such as VSP Global are helping to identify novel ways we can create a new era in health care by empowering patients," added Varma.

Juniper Research has identified Smart Glasses as the highest growth sector of the consumer wearables segment over the next five years, reaching 11 percent of the overall wearables market by 2021. This is during a time when categories such as smartwatches and fitness wearables have begun to slow.

About the USC Center for Body Computing

Founded in 2006 as one of the nation's first academically-based digital health innovation centers, the USC CBC functions as an interdisciplinary brain trust and innovation center within the Keck Medicine of USC medical enterprise. Member organizations are provided inter-disciplinary research and design support gathering experts in medicine, business, engineering and entertainment to better navigate the complex and evolving world of wireless and wearable healthcare.

About NEJM Catalyst

Launched in 2015 as part of the New England Journal of Medicine Group, NEJM Catalyst, brings health care executives, clinical leaders, and clinicians together to share innovative ideas and practical applications for enhancing the value of health care delivery which is in a period of historic transition. NEJM Catalyst helps forecast improvements to the management and strategy of health care — offering a trusted source of needed information just as the Journal offers a trusted source of information on the art and of science of medicine.

Watch the videos:

USC Study Participants receive their Level Frames

VSP Global's The Shop on collaborating with USC

Learn more about the USC Center for Body Computing: uscbodycomputing.org

Learn more about VSP Global: vspglobal.com

Learn more about VSP Global's The Shop: vspglobal.com/cms/about-us/innovation

SOURCE USC Center for Body Computing

Related Links

https://www.uscbodycomputing.org