Electronic Activity Monitors Could be Helpful in Clinical, Public Health, Rehabilitation Settings

In a recent report, researchers found electronic activity monitors may represent a medium by which clinical behavioral interventions could be translated for widespread use in clinical, public health and rehabilitation settings.

“Electronic activity monitors are very popular, but there is little empirical research on their effectiveness. Our hope in performing this content analysis was to provide some insight to researchers and consumers about how closely these monitors adhere to standard practices in behavioral activity intervention,” Elizabeth Lyons, PhD, MPH, assistant professor in the department of nutrition and metabolism at the University of Texas Medical Branch at Galveston, told O&P Business News. “Our results demonstrate that these monitors do hold quite a bit of promise… It will be interesting to see if integrating electronic activity monitors into interventions can produce more sustained increases in activity than standard procedures.”

Comparisons of activity monitors

Researchers identified 13 electronic activity monitors that measured lifestyle physical activity and provided feedback through a computer or mobile app. Three trained coders tested each activity monitor for 1 week. Researchers based coding on a hierarchical list of 93 behavior change techniques, while findings from meta-analysis and meta-regression in the research literature were used to base further coding of potentially effective techniques and adherence to theory-based recommendations.

Elizabeth Lyons, PhD, MPH


According to study results, all monitors provided tools for self-monitoring, feedback and environmental change, and the most prevalent techniques were goal-setting and emphasizing discrepancy between current and goal behavior. Researchers found more than half of the systems included review of behavioral goals, social support, social comparison, prompts/cues, rewards and a focus on past success. Of the techniques identified from the research literature as potentially effective, the monitors studied included a range of five to 10 of 14 total techniques and most of the monitors included goal-setting, self-monitoring and feedback content that closely matched recommendations from social cognitive theory.

“Essentially, we were looking to see how many evidence-based behavior change techniques were used and how they were used. These monitors show a lot of promise as relatively inexpensive ways to implement behavior change interventions, but we do not know much about how similar their content already is to the typical clinical interventions we implement,” Lyons said. “Some important techniques, such as specific action planning and problem solving, were rare. When they were present, most of the techniques were implemented in ways that adhered to recommendations from health behavior theory.”


Lyons and colleagues are using the results from this study to develop a program that combines using electronic activity monitors with counseling to provide behavior change techniques not available in the monitors. This future research will continue to involve numerous electronic activity monitors so the researchers can continue to apply evidence-based behavior change techniques to each type. Future research also may include participants choosing which activity monitor they use during the study.

“I think a big take-home message from our testing process is that regardless of the number or quality of behavior change techniques, whether or not a monitor works for an individual is likely mostly due to individual preference,” Lyons said. “I have found that I care a lot about the usability and aesthetics of the apps, but many other people care more about whether their friends also have the monitor — so that they can chat and compete, whether the monitor is waterproof or has specific functions like heart rate, etc. Validity is a big issue as well. Some of the monitors have reputations for being more or less valid than others. We are currently testing several of them to determine their validity compared to direct observation of steps.” — by Casey Tingle

For more information:
Lyons EJ. J Med Internet Res. 2014;doi:10.2196/jmir.3469.

Disclosure: Lyons has no relevant financial disclosures.

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