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Tech News Briefs – 9/12/22

Apps, Influencing online behavior, Major depression, Neurostimulation, Technology Influence, Treatment


Various recent technology news / studies that may be of interest.

Study examines the impact of fake online reviews on sales
New research exposes the pervasive practice of fake online product reviews

Can you really trust that online product review before you make a purchase decision? New research has found that the practice of faking online product reviews may be more pervasive than you think.

According to researchers from UCLA Anderson School of Management, andthe Marshall School of Business at the University of Southern California (USC), a wide array of product marketers actually purchases fake online reviews through an online marketplace found through social media. As a result, marketers receive many reviews and high-average ratings on e-commerce sites that include Amazon, Walmart and Wayfair, among others.

The study, published in the current issue of the INFORMS journal Marketing Science, offers:

Key Takeaways:

  • There’s a large online marketplace for the selling and buying of fake online reviews.
  • Fake online reviews do contribute to better ratings and sales for product sellers.
  • Most major brands do not engage in the practice of buying fake reviews.
  • Online marketplaces work to regulate online fake reviews, but there is lag time in enforcement.

[Read more]

Noble Introduces Mental Health Technology To Reduce Misdiagnosed And Underserved Patients In Primary Care

Noble is an AI, and objective data-driven mental health app, announced the launch of a new offering for primary care physicians and mental health professionals that provides remotely monitored, preventative, and early intervention support for acute or chronic mental health conditions.

According to the app creators, it consists of four-part remote patient monitoring model combines innovative technology with trained mental health professionals to impact outcomes in a lasting, meaningful way:

  • Assess: Subjective data gathering through client self-reporting and objective data gathering through hair cortisol concentration tests, heart rate variability (HRV), and voice as a digital biomarker.
  • Support: AI-driven care provider dashboard that shares the remotely monitored objective data stream to offer remote insights and real-time alerts to the care provider and team.
  • Motivate: Immediate, AI-driven treatment, protocol-driven and therapeutic interventions based on patient needs.
  • Connect: Human-to-human monitoring and coaching support guided by additional understanding through voice analysis, and AI-supported technology.

[Read more]

Magnus Medical announced today that it received FDA 510(k) clearance for its Saint neuromodulation system. 

The Saint neurostimulation platform is for the treatment of major depressive disorder (MDD). It treats adults who fail to achieve satisfactory improvement from prior antidepressant medications in the current episode.

The individualized, rapid-acting, non-invasive neurostimulation platform demonstrated the potential to be a reproducible, rapid and highly effective treatment for severe, refractory depression in a broader clinical setting. It received FDA breakthrough device designation in October 2021.

Saint combines advanced imaging technologies and personalized targeting and novel stimulation patterns. It uses structural and functional MRI to inform a proprietary algorithm. The algorithm identifies the optimal anatomic target for focused neurostimulation in people with MDD.

Results of a trial published in the American Journal of Psychiatry showed that 79% of people in the active treatment arm entered remission from their depression. That compared to 13% in the sham treatment arm. Magnus said in a news release that the new “individualized” neurostimulation provides a new option for treating depression.

[Read more]

App for serious mental illness starts clinic-training phase

Apps, Bipolar Disorder, Mental Health, Psychosis, Schizophrenia, Serious Mental Illness, Treatment

The Patient-Centered Outcomes Research Institute (PCORI) announced funding ($1.8 million) to bring a mental health smartphone app into real world practice. The app is called FOCUS, which has shown promise as a supportive therapy for people who have serious mental illness such as schizophrenia and bipolar disorder. 

The development team,headed by Dror Ben-Zeev, Ph.D. a professor of psychiatry and behavioral sciences at the University of Washington School of Medicine, have guided the app’s development through early user studies, the most recent of which showed that patients found the digital therapy more engaging than a scheduled trip to the clinic — the far more resource-intensive conventional care.

The next step for FOCUS involves rolling out a system aimed at teaching clinicians how to engage patients to use the app confidently and how to get the most information from patients’ use.

“We demonstrated that FOCUS is clinically potent in several studies, but to move this from academic research to real-world practice, we need an implementation approach that includes digital trainings for clinicians who are not used to mental health apps. This will support their journey as digital health adopters, which is a daunting task for some. We’re creating evergreen materials so any clinician will be able to get FOCUS up and running with their patients quickly,” Ben-Zeev said.

Part of the study is to understand how different clinic staff might need different information upfront about FOCUS to introduce it in a compelling way to their colleagues.

“It could be frontline clinicians or admin support people or team leaders, so we need to ensure that we finely tune the information that helps FOCUS make the greatest impact it can,” Ben-Zeev said.

The FOCUS app has written and video content adapted from in-person, evidence-based interventions. Its treatment domains address:

  • auditory hallucinations (“hearing voices”)
  • mood problems (typically depression and anxiety)
  • sleep
  • social functioning such as social skills training or paranoia
  • medication use (reminders and information to examine counter-therapeutic beliefs that people might have about their medications)

The App is Always Available

The app’s 24/7 availability is a huge advantage for patients who may have mental health needs outside clinic hours and who otherwise might need to wait several weeks or more to address an episode in a clinic environment. 

Moreover, many patients with serious mental illness receive services at community mental health centers. These facilities often are under-resourced and less able to provide continuity of care due to high turnover rates among their staff. FOCUS can provide continuity of care as clinical staffing ebbs and flows, Ben-Zeev said. 

The study will be conducted in collaboration with the adult outpatient programs at community mental health agencies in New Hampshire and Missouri that care for people with serious mental illness: 

Sources:

UW Medicine Newsroom

PCORI News

BRITE Center (Focus Developers)

Study Finds Use of Digital Devices Could Help Improve Memory Skills

Cognition, memory

Contrary to previously expressed concerns that the overuse of technology could result in the breakdown of cognitive abilities and cause “digital dementia”, research, published in Journal of Experimental Psychology: General, showed that digital devices help people to store and remember very important information. This, in turn, frees up their memory to recall additional less important things.

The study used a memory task to be played on a touchscreen digital tablet or computer. The test was undertaken by 158 volunteers aged between 18 and 71.

Participants were shown up to 12 numbered circles on the screen, and had to remember to drag some of these to the left and some to the right. The number of circles that they remembered to drag to the correct side determined their pay at the end of the experiment. One side was designated ‘high value’, meaning that remembering to drag a circle to this side was worth 10 times as much money as remembering to drag a circle to the other ‘low value’ side.

Participants performed this task 16 times. They had to use their own memory to remember on half of the trials and they were allowed to set reminders on the digital device for the other half.

The results found that participants tended to use the digital devices to store the details of the high-value circles. And, when they did so, their memory for those circles was improved by 18%. Their memory for low-value circles was also improved by 27%, even in people who had never set any reminders for low-value circles.

However, results also showed a potential cost to using reminders. When they were taken away, the participants remembered the low-value circles better than the high-value ones, showing that they had entrusted the high-value circles to their devices and then forgotten about them.

According to the authors, “we wanted to explore how storing information in a digital device could influence memory abilities. We found that when people were allowed to use an external memory, the device helped them to remember the information they had saved into it. This was hardly surprising, but we also found that the device improved people’s memory for unsaved information as well.

This was because using the device shifted the way that people used their memory to store high-importance versus low-importance information. When people had to remember by themselves, they used their memory capacity to remember the most important information. But when they could use the device, they saved high-importance information into the device and used their own memory for less important information instead.”

Dupont, D., et al. (2022) Value-based routing of delayed intentions into brain-based vs external memory stores. Journal of Experimental Psychology. doi.org/10.1037/xge0001261

Using Virtual Reality to Address Serious Mental Illness

Psychosis, Schizophrenia, Treatment, Virtual Reality

OxfordVR Earns FDA’s Breakthrough Device Designation for its gameChange Treatment

Published in Lancet Psychiatry an automated virtual reality therapy program to treat agoraphobic avoidance and distress in patients with psychosis: a multicenter, parallel-group, single-blind, randomized, controlled trial in England was granted FDA’s Breakthrough Device Designation.

Oxford VR develops clinically validated, cost-effective, user-centred cognitive treatments for clinical conditions with significant impact on patients and the healthcare system.

Oxford VR’s developers are drawn from the gaming industry. They apply their animation, illustration and programming skills to help ensure the treatments are not only effective, but also engaging and easy to use. Each VR treatment uses high-quality simulations that promote the best clinical experience.

The Study

The clinical study assessed automated virtual reality therapy to treat agoraphobic avoidance and distress in patients with psychosis. It was a parallel-group, single-blind, randomized, controlled trial across nine National Health Service trusts in England. Eligible patients were aged 16 years or older, with a clinical diagnosis of a schizophrenia spectrum disorder or an affective diagnosis with psychotic symptoms, and had self-reported difficulties going outside due to anxiety. Patients were randomly assigned (1:1) to either gameChange VR therapy plus usual care or usual care alone. gameChange VR therapy was provided in approximately six sessions over 6 weeks. Trial assessors were masked to group allocation. Outcomes were assessed at 0, 6 (primary endpoint), and 26 weeks after randomization. The primary outcome was avoidance of, and distress in, everyday situations, assessed using the self-reported Oxford Agoraphobic Avoidance Scale (O-AS).

Results

A total of 346 were enrolled. 231 (67%) patients were men and 111 (32%) were women, 294 (85%) were White, and the mean age was 37·2 years (SD 12·5). 174 patients were randomly assigned to the gameChange VR therapy group and 172 to the usual care alone group. Compared with the usual care alone group, the gameChange VR therapy group had significant reductions in agoraphobic avoidance at 6 weeks.

Reductions in threat cognitions and within-situation defense behaviors mediated treatment outcomes. The greater the severity of anxious fears and avoidance, the greater the treatment benefits. There was no significant difference in the occurrence of serious adverse events between the gameChange VR therapy group (12 events in nine patients) and the usual care alone group (eight events in seven patients; p=0·37).

Automated VR therapy led to significant reductions in anxious avoidance of, and distress in, everyday situations compared with usual care alone. gameChange VR therapy has the potential to increase the provision of effective psychological therapy for psychosis, particularly for patients who find it difficult to leave their home, visit local amenities, or use public transport.

Automated: Therapy is automated using a virtual coach for therapy delivery, standardizing clinical excellence and adherence to protocol with genuine ease of use.
In situ Treatment: In VR we can create powerful simulations of the scenarios in which psychological difficulties occur, providing a safe space to try new behavior.
Learning that translates: Despite a simulated environment, the mind and body behave as if it were real. This means that the lessons learned in VR transfer into everyday life

Sources:

Freeman D, Lambe S, Kabir T, et al. Automated virtual reality therapy to treat agoraphobic avoidance and distress in patients with psychosis (gameChange): a multicentre, parallel-group, single-blind, randomised, controlled trial in England with mediation and moderation analyses. Lancet Psychiatry 2022; 9: 375–88.Published Online. April 5, 2022. https://doi.org/10.1016/ S2215-0366(22)00060-8 

OxfordVR website

GamechangeVR website

AIfred Health Begins North American Clinical Trial of AI-based Clinical Decision Support Tool for MDD

artificial intelligence, Clinical Trial, Major depression

This clinical trial, a world-first in the treatment of mental health using an AI-based clinical decision support tool, was designed with input from US and Canadian regulatory authorities to validate Aifred’s AI platform for use with patients suffering from moderate to severe depression.  

Aifred’s technology was developed using high quality clinical data from clinical trials evaluating therapeutic treatments of depression. Aifred’s software was developed with and for treating physicians (family doctors and psychiatrists) who today have limited tools to personalize the therapeutic choice for patients, leading to what is for many patients a lengthy and painful trial-and-error process. Aifred’s software is intended to support clinical decision making and improve this experience for patients and clinicians alike.

The trial is being conducted at up to 12 U.S. and Canadian centers of excellence for depression treatment including Veterans Affairs (VA) hospitals where Aifred is a VA research partner. Aifred expects to complete enrollment in 2022 and report top-line results in mid 2023. Aifred’s technology placed #1 in North America and #2 in the world in the IBM Watson AI XPRIZE, the goal is to initiate and complete this clinical trial which will provide clinicians across North America with a much-needed clinical tool. 

Aifred’s current patient <> physician clinical decision support tool is accessible on any device, supporting both telehealth and in-person appointments. A patient enters behavioral health information, which is then processed by a clinical algorithm based on best-evidence guidelines. Outputs help the physician understand: where the patient is on the disease cycle, monitor the patient over time, and determine ‘what to do next’ at each stage, e.g. adding psychotherapy or making adjustments to medication.

For additional information about this landmark clinical trial can consult: https://clinicaltrials.gov/ct2/show/NCT04655924  

Source: Aifred Health Website

Video of interviews by XPRIZE Foundation of unscripted comments by medical professionals working with Aifred [Link]

NICE’s Early Value Assessment for Medtech

Anxiety, Apps, children & adolescents, Diagnosis, Early Identification, Emerging technologies, Major depression, Mental Health, Technology Assessment & Evaluation

The explosion in digital health products has left National Health Service commissioners in the UK wondering how they can possibly sift out what works and what provides maximum benefit for the service and for patients.

The Early Value Assessment for Medtech will offer a rapid assessment of digital products, devices and diagnostics for clinical effectiveness and value for money. The goal of this new approach is that the service and patients will be able to benefit sooner.

Early Value Assessment is being designed to draw in the most promising and impactful medical technologies where the evidence base is still emerging, starting with digital products, in areas where there is greatest need.  Whether its empowering patients to better manage their own health and seek clinical advice, reducing admissions and waiting lists or supporting clinicians and other front-line staff to provide better quality care this new program will help to alleviate system pressures as the NHS recovers from the COVID pandemic.

In this accelerated approach, the first two pilot digital health topics will begin their early value assessments this month (June) with a view to publishing findings in October. This is much faster than a full NICE Medtech evaluation meaning benefits will be realized sooner, while companies generate more evidence required for a full NICE evaluation at a later stage.  

The first two pilots are digital apps for depression and anxiety in children and others will quickly follow in adult mental health, early cancer diagnosis, cardiovascular disease and other areas that support elective recovery following the pandemic.

In this ‘fast-track’ approach, NICE is working closely with NHS England and all its system partners to help develop commercial and data collection arrangements to support the technologies that go through early value assessment in adoption and scaling and to make this new program of work deliver on the potential of digital health for patients.

Source: NHS Blog

Rethinking Time Spent on Social Media: Exploring Dissociation

facebook, Normative dissociation, Social Media, Twitter

People sometimes experience daydreaming or become engrossed in reading a page of a book and then realize that their mind was somewhere else, occupied in an unrelated train of thought. In a similar way, many have become completely absorbed in a movie or computer game, resulting in losing track of external stimuli.  These experiences are described as normative dissociation.

Researchers at the University of Washington wondered if people enter a similar state of dissociation when surfing social media, and if that explains why users might feel out of control after spending so much time on their favorite app. (There are multiple types of dissociation including trauma-based dissociation and the everyday dissociation associated with spacing out or focusing intently on a task)

A study presented at the recent CHI Conference on Human Factors in Computing Systems entitled “I Don’t Even Remember What I Read”: How Design Influences Dissociation on Social Media observed how participants interacted with a Twitter-like platform to show that some people are spacing out while they’re scrolling. Researchers also designed intervention strategies that social media platforms could use to help people retain more control over their online experiences. 

The research team designed and built an app called Chirp, which was connected to participants’ Twitter accounts. Through Chirp, users’ likes and tweets appear on the real social media platform, but researchers can control people’s experience, adding new features or quick pop-up notices or surveys. 

Researchers asked 43 Twitter users from across the U.S. to use Chirp for a month. For each session, after three minutes users would see a dialog box asking them to rate on a scale from one to five how much they agreed with this statement: “I am currently using Chirp without really paying attention to what I am doing.” The dialog box continued to pop up every 15 minutes. 

“We used their rating as a way to measure dissociation,” lead author Baughan said. “It captured the experience of being really absorbed and not paying attention to what’s around you, or of scrolling on your phone without paying attention to what you’re doing.”

Over the course of the month, 42% of participants (18 people) agreed or strongly agreed with that statement at least once. After the month, the researchers did in-depth interviews with 11 participants. Seven described experiencing dissociation while using Chirp. 

In addition to receiving the dissociation survey while using Chirp, users experienced different intervention strategies. The researchers divided the strategies into two categories: changes within the app’s design (internal interventions) and broader changes that mimicked the lockout mechanisms and timers that are available to users now (external interventions). Over the course of the month, participants spent one week with no interventions, one week with only internal interventions, one week with only external interventions and one week with both.  

When internal interventions were activated, participants got a “you’re all caught up!” message when they had seen all new tweets. People also had to organize the accounts they followed into lists. 

For external interventions, participants had access to a page that displayed their activity on Chirp for the current session. A dialog box also popped up every 20 minutes asking users if they wanted to continue using Chirp. 

In general, participants liked the changes to the app’s design. The “you’re all caught up!” message together with the lists allowed people to focus on what they cared about. 

The problem with social media platforms, the researchers said, is not that people lack the self-control needed to not get sucked in, but instead that the platforms themselves are not designed to maximize what people value.

“Taking these so-called mindless breaks can be really restorative,” Baughan said. “But social media platforms are designed to keep people scrolling. When we are in a dissociative state, we have a diminished sense of agency, which makes us more vulnerable to those designs and we lose track of time. These platforms need to create an end-of-use experience, so that people can have it fit in their day with their time-management goals.”

Study:
Baugnan A, Zhang MR, Rao R, et al. “I Don’t Even Remember What I Read”: How Design Influences Dissociation on Social Media. CHI ’22: CHI Conference on Human Factors in Computing Systems. April 2022 Article No.: 18, Pages 1–13 https://doi.org/10.1145/3491102.3501899

[Link to slides with audio of presentation at CHI Conference 5/22]

Don’t Blame Social Media for the Decrease In Face-to-Face Interaction.

Emerging technologies, Social displacement theory, Social Media, Social Media Consequences, Social Media Use, TikTok, ,

An new article in Current Opinion in Psychology reviews the best available evidence to debunk the “social displacement hypothesis” that holds that use of mobile and social media is the cause of decreased face-to-face (FtF) interaction. Lead author Jeffrey Hall, PhD has uncovered a worrisome trend: In the United States, Great Britain and Australia, there has been a steady, uniform decline in FtF time that began well before the rise of social media. This new analysis shows the decline continued through the stay-at-home orders and social distancing of the COVID-19 pandemic.

Dr. Hall, a professor of communication studies and director of the Relationships and Technology Lab at the University of Kansas, and his co-author, Dong Liu of Renmin University in China, take on that notion in a new paper titled “Social media use, social displacement, and well-being” 

The ‘social displacement hypothesis’ is probably the most well-known, long-lasting explanation that blames the new technologies (especially texting and social media) for usurping everyone’s time away from person-to-person contact. Hall states that “the best available evidence suggests that it’s just not so.”

Hall took data on FtF time from the U.S. Department of Labor’s annual American Time Use Survey and from similar governmental studies in Australia and Great Britain between 1995 and 2021 and plotted them on a single chart. Interestingly, all three lines decline over time at a similar rate.

According to Hall,  “it’s the case that social media rates of consumption have grown across demographic groups and across the world. Yes, it’s the case that face-to-face time has declined. However, it’s not the case it takes from face-to-face time.”

If the evidence doesn’t support the social displacement theory, then where is the time for increased social media use coming from?

The paper highlights that there has been a transformation of where people are putting their attention. While it is true that TikTok and YouTube are increasingly popular outlets for watching streaming content, Hall suggests social media time is most likely borrowing from time spent watching TV, which, for decades, has been a major place where Americans spend their time. “Social-media time is also borrowing from time at work or doing household chores” Hall said.

Similar Data In 3 Countries

The paper reports a new analysis showing that FtF time has declined across three countries in a similar fashion. “The fact that the UK data track U.S. data so tightly despite using slightly different methods in different years, is surprising,” Hall said. This international trend of reduced time in face-to-face communication may reflect growing rates of loneliness.

Hall’s analysis shows that these trends of declining face-to-face communication existed well before the pandemic, and the pandemic may have exacerbated some of them. When people had some time back because they weren’t commuting to work or able to go out as much, they didn’t turn to face-to-face communication. “What’s discouraging about that,” Hall notes, “is even when people have time, they don’t seem to use it in a way that promotes their social health.” Noting the widespread evidence that FtF socialization is beneficial to well-being, “we’re not on the right path to being able to reclaim that face-to-face time,” said Hall, “at least in these three nations.”

Why is FtF time declining?

“The best available evidence suggests face-to-face is in competition with hours spent at work and commuting,” Hall says. In other words, people who work longer spend more of their leisure time alone. During the pandemic, when people got that time back from commuting, “they still spent it working virtually,” Hall said. “They didn’t spend it socializing with each other.”

And, Hall says, friendship and social media are not enemies: “Social media can be used in many friendship-promoting ways, especially now that many people use messaging programs supported by social media platforms.” As the paper claims, “social people are active both online and offline.”   

“It seems we live in a society that privileges working and media consumption over everything else,” Hall said. “The decline in face-to-face time is a matter of priority and a matter of availability. And we are neither prioritizing face to face time, nor are we available to do so.”

Source: Hall JA, Lui D. Social media use, social displacement, and well-being. Current Opinion in Psychology. Volume 46, August 2022, 101339

Patient influencers’ the new frontier in direct-to-consumer drug marketing

facebook, Snapchat, Social Media, Social Media Consequences, Social Media Influencers, Social Media Use, TikTok

Pharma companies are increasingly partnering with patients to share stories and advocate for brands online. 

It began in 2015, when a celebrity influencer named Kim Kardashian was pregnant and began singing the praises of a new morning sickness drug called Diclegis to her tens of millions followers on Instagram.

In addition to a selfie and picture of the pill bottle, she wrote, “It’s been studied and there’s no increased risk to the baby, I’m so excited and happy with the results.” The Food and Drug Administration swiftly flagged the post for omitting risks, and required Kardashian to remove the post and sent the drug maker a serious warning letter.

But seven years later, so-called patient influencers are alive and well, with pharmaceutical companies increasingly partnering with real-life patients who share their personal stories and advocate for brands online.

A Trend Again?

This trend has drawn the attention of Erin Willis, an associate professor of Advertising, Public Relations and Media Design at CU Boulder. In a new paper, published in the Journal of Medical Internet Research, she calls on the academic community to take a closer look. “This is a growing phenomenon, but there is virtually no research on it and very little regulation,” said Willis, who is interviewing dozens of patient influencers for a new study. “Is it going to help patients be better informed? Or is it going to get patients to ask their doctors for drugs they don’t really need? We just don’t know, because no one has studied it.”

New twist on ‘direct to consumer’ marketing

In one of the first academic papers to date to explore the phenomenon, Willis and co-author Marjorie Delbaere, a professor of marketing at the University of Saskatchewan, framed patient influencers as “the next frontier in direct-to-consumer (DTC) pharmaceutical marketing.”

This controversial form of marketing, which is legal only in the United States and New Zealand, enables drug companies to target consumers directly, rather than through physicians. Since the first DTC ad ran in the 1980s, the ads have exploded, leading patients to ask their doctors about drugs they see on TV or in print. As Willis notes, aproximately 44% who ask their doctor about a drug, get it.

Having learned from the Kardashian incident, many ad agencies now avoid celebrity influencers altogether and instead engage “micro-influencers” like individual patients who share their personal stories and endorsements in condition-specific support groups (diabetes, heart disease, etc.) or those with a niche social media following.

“It’s a lot like what we used to see with doctors and pharmaceutical companies,” said Willis. “Only now it is patients using social media to advocate for disease awareness, and in some cases—pharmaceutical medications.”

A blurring of the lines between ad and opinion

The Federal Trade Commission (FTC) now requires that patient influencers disclose whether they are being paid (influencers use #ad or #sponcon to alert followers). And the FDA has published rules about what can and cannot be said on social posts. But such rules are open to interpretation and hard to enforce, said Willis.

The authors also have concerns that “a blurring of the lines” between ad and opinion could potentially deceive patients.

Unlike other forms of DTC advertising, social media is interactive.

“If an influencer recommends a drug, there is an entire community of voices that get to weigh in on it and support it or share their negative experiences,” said Willis.

Thus far in her interviews of patient influencers, Willis said she has found that only a small number  are paid to post (some get free trips to conferences or are paid to sit on advisory boards). Some aren’t paid at all.

“They all say they are really doing this so that other patients have information and can have a better life,” said Willis. “That is their No. 1 motivation and I think that’s awesome.”

She said she hopes that her work, funded in part by the Arthur W. Page Center for Integrity in Public Communication, and the new research agenda she has launched, will lead to a set of best practices for both patient influencers and the companies they work with.

“There is both value and risk in this growing trend and, like anything, it has the potential to become dangerous if we’re not careful,” Willis said.

Source: Willils E, Delbaere M. Patient Influencers: The Next Frontier in Direct-to-Consumer Pharmaceutical Marketing. JMIR Published on 1.3.2022 in Vol 24, No 3 (2022): March

A Study To Understand The Lack Of Diversity In The Use Of Fitness Trackers.

Uncategorized

As the world continues to become increasingly connected, mobile devices have become ubiquitous. Wearable devices, including fitness trackers provide nearly continuous information on physical activity, heart rate, and sleep. As the use of these monitoring increases, data are increasingly integrated into clinical and research settings. There is emerging evidence that fitness trackers can identify changes in heart rate variability, and other symptoms including the potential to identify COVID-19 prior to a clinical diagnosis.

Unfortunately, an understanding of how digital health technologies can be used for equitable healthcare across diverse communities is needed.  

It seems that most people who use smartwatches and other wearable devices that can track health are white, well-educated, and wealthy. 

Recent research published in Nature’s NPJ Digital Medicine Journal, intentionally included groups that are historically underrepresented in medical research e.g. lower-income groups and racial minority groups. The goal was to find out the reasons for lack of interest or reduced adoption of fitness trackers.

The study was conducted by researchers at the All of Us Research Program, an initiative at the National Institutes of Health aiming to build a health database that’s representative of the United States. As part of the program, the researchers wanted to let program participants send health data directly from Fitbit devices. They found, though, that the demographics of the people who decided to send data were whiter and wealthier than the racial and socioeconomic diversity of the project as a whole.

To figure out why, the team surveyed over 1,000 patients at six Federally Qualified Health Centers, which provide medical care to underserved communities. Around 40 percent of the people who responded identified as Hispanic, 36 percent as non-Hispanic Black or African American, and 15 percent as non-Hispanic white. Two-thirds of the surveys were done in English, and one-third were done in Spanish. Most had a high school education or less.

Over half of the people who responded to the survey said that they’d be interested in a fitness tracker, saying that they’d be interested in things like tracking their steps or heart rate.

Of the group that was interested, 49 percent said that they don’t have a tracker because they’re too expensive. Almost 20 percent said that they don’t know how to use them, and 15 percent said that they don’t know how a tracker could help — but want to learn.

The research team also found that language barriers can dissuade people from using a smartwatch: many Spanish-speaking participants were concerned by the use of “tracker” to describe the devices and thought that their movements would be monitored.

As more and more health features get built into wearable devices, they’re becoming a major tool used both for individual people’s health and for medical research. But if groups like the ones served by Federally Qualified Health Centers are shut out from the products, smartwatches just end up reinforcing existing equity gaps in healthcare and in health research. When groups aren’t represented in studies, results can’t be generalized to those groups, and they miss out on the benefits of new findings.

Source: Hook M, Litwin TR, Munoz F, et al. Wearable fitness tracker use in federally qualified health center patients: strategies to improve the health of all of us using digital health devices. npj Digital Medicine Vol 5, Article number:53 (2022).