Objective Physical Activity Monitoring for Health-Related Research: A Discussion of Methods, Deployments, and Data Presentations

Objective Physical Activity Monitoring for Health-Related Research: A Discussion of Methods, Deployments, and Data Presentations John M. Schuna Jr., PhD School of Biological and Population Health Sciences Oregon State University, Corvallis OR

What is Objective Physical Activity Monitoring?

What is Objective Physical Activity Monitoring? Measure of physical activity behavior - - not fitness Mechanical and electronic devices are used to characterize physical activity behavior 4-14 day data collection periods are common in free-living Waist and wrist are most common locations to wear devices

Objective Physical Activity Monitors

Pedometers Step counters (electronic or electromechanical) Accelerometers Measure acceleration as a marker of physical activity Predict energy expenditure Also capable of counting steps Multi-sensor devices (wearables) Combine multiple sensor inputs Predict energy expenditure Count steps Predict type of activity Monitor Device Types

Common Devices - Pedometers Device Wear Location Outputs Sensors Cost Yamax SW-200 Waist Steps Spring-lever Step Counter $20.00 Omron HJ-151 Waist Steps, Moderate Steps Piezoelectric Accelerometer $30.00 NL-1000 Waist Steps, Distance, Active Minutes Piezoelectric Accelerometer $54.95

Common Devices - Accelerometers Device Wear Location Outputs Sensors Cost GT9X Link Waist / Wrist Ankle / Thigh Steps, Activity Counts, Raw Accel Accelerometer, magnetometer, gyroscope $275 ActivPAL Thigh Posture, Steps Accelerometer $493 GENEActiv Waist / Wrist Ankle / Thigh Raw Accel Accelerometer $248 6 Axivity Waist / Wrist Ankle / Thigh Raw Accel Accelerometer $141

Device Fitbit Zip / One Jawbone UP3 Common Devices - Wearables Wear Location Waist Wrist Outputs Sensors Cost Steps, Stairs, Distance, Active Minutes, Sleep, Calories Steps, Distance, Active time, Sleep, Calories Accelerometer $50 / $100 Accelerometer $50 Withings Pulse O 2 Wrist Steps, Distance, Calories, HR, O 2 Sats Accelerometer, Infrared O 2 Sensor $100 7 Apple Watch Wrist Steps, HR, Movement Mode, Calories Accelerometer, Photoplethysmograph $300

How Do Modern Objective Physical Activity Monitors Work and What Data Do They Give Us?

Accelerometer Data Waist Wrist

Raw Acceleration Data 2.0 1.8 Steps 1.6 Acceleration (g-force) 1.4 1.2 1.0 0.8 0.6 0.4 0.2 0.0

Raw Acceleration Data 1.0 0.8 0.6 Acceleration (g-force) 0.4 0.2 0.0-0.2-0.4-0.6-0.8-1.0

How Are Objective Physical Activity Monitors Typically Deployed?

Troiano et al. (2008). MSSE; Pahor et al. (2014). JAMA Large Scale Deployments National Health and Nutrition Examination Survey (NHANES) Coronary Artery Risk Development in Young Adults (CARDIA) Reasons for Geographic and Racial Differences in Stroke (REGARDS) Compliance (%) 100 80 60 40 20 0 Males Females 6-11 12-15 16-19 20-59 60+ Lifestyle Interventions and Independent for Elders (LIFE)

Smaller Deployments Minutes 30 20 10 Physical Activity During an After-School Program 7.6 26.9 18.4 2.9 Thousands upon thousands of smaller research applications Pre-school aged children Older adults Old-order Amish 0 20000 15000 10000 5000 0 < 1.5 1.5-2.9 3.0-5.9 6+ 18,425 METs Mean Daily Steps Among Old Order Amish Men 14,196 Women Non-research behavioral interventions and health promotion programs Individualized pedometer-based interventions Worksite health promotion challenges Etc. Schuna et al. (2013). J Sch Health; Bassett et al. (2004). MSSE

Objective Physical Activity Monitoring Tips Identify your target population and the physical activity outcome you want to measure Select measurement tool based upon.. Outcome you want to measure Characteristics of your target population/environment Available resources Validity/reliability evidence Design the measurement protocol How will the device be worn? How long will the protocol last? How will devices be retrieved?

Barreira, Schuna Jr., Tudor-Locke, et al. (2015). IJO G Coefficients 0.9 0.8 0.7 0.6 0.5 0.4 0.3 0.2 0.1 How Many Days of Data Do I Need? 1 0 Reliability of Accelerometer-determined MVPA 7 days to achieve 0.80 reliability 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Number of Days of Monitoring

Objective Physical Activity Monitoring Tips Implementation of the measurement protocol Strategies to increase compliance to the monitoring regimen Planning for device malfunctions and losses Data processing and reduction Data analysis and presentation

How Are Objective Physical Activity Monitoring Data Typically Presented?

Schuna et al. (2013). IJBNPA Objective Monitoring Data Presentations Average per day summaries (means) over the monitoring frame (e.g., 7-days) are most typical Graphical displays Tabular presentations

The WAVE~Ripples for Change: Obesity Prevention in Active Youth The WAVE study USDA 2013-67001-20418

WAVE

WAVE Physical activity monitoring via Fitbit Zip Wireless data capture Integrated system to feed data back into the intervention

CLOUD User s data captured via Bluetooth and stored on Fitbit server. Data retrieved by request. Data, Charts, Progress

Daily/Weekly Data Reports

WAVE Study Health Report John Doe High School

CLOUD User s data captured via Bluetooth and stored on Fitbit server. Data retrieved by request. Data, Charts, Progress

OSU Siew Sun Wong, PhD Melinda Manore, PhD Chris Scaffidi, PhD Kathy Gunter, PhD Evan Hilberg, MS, MPH Rahul Patel, BS Acknowledgments Umass-Amherst Catrine Tudor-Locke, PhD Patty Freedson, PhD John Staudenmayer, PhD Michael Busa, PhD Michael Green, MS LSU - PBRC Bill Johnson, PhD Peter Katzmarzyk, PhD Stephanie Broyles, PhD Emily Mire, MS Syracuse University Tiago Barreira, PhD

References 1. Troiano, R.P, Berrigan, D., Dodd, K.W., et al. (2008). Physical activity in the United States measured by accelerometer. Medicine & Science in Sports & Exercise, 40(1), 181-188. 2. Pahor, M., Guralnik, J. M., Ambrosius, W. T., et al. (2014). Effect of structured physical activity on prevention of major mobility disability in older adults: The LIFE study randomized clinical trial. JAMA, 311(23), 2387-2396. 3. Schuna, J. M., Jr., Lauersdorf, R. L., Behrens, T. K., et al. (2013). An objective assessment of children s physical activity during the Keep It Moving! after-school program. Journal of School Health, 83(2), 105-111. 4. Bassett, D. R., Schneider, P. L., & Huntington, G. E. (2004). Physical activity in an Old Order Amish community. Medicine & Science in Sports & Exercise, 36(1), 79-85. 5. Barreira, T.V., Schuna, J.M., Tudor-Locke, C. (2015). Reliability of accelerometerdetermined physical activity and sedentary behavior in school-aged children: A 12- country study. International Journal of Obesity, 5, S29-S35. 6. Schuna, J. M., Jr., Johnson, W. D., & Tudor-Locke, C. (2013). Adult self-reported and objectively monitored physical activity and sedentary behavior: NHANES 2004-2006. International Journal of Behavioral Nutrition and Physical Activity, 10, 126.