Fitbit and Fitabase Technology: Tracking and Evaluating Youth Physical Activity

Introduction

With the health of today's youth a national priority, professionals from a variety of disciplines need tools they can use to accurately assess activity patterns in various populations and to motivate behavior change in individuals. Historically, researchers have used accelerometers, which are wearable devices that estimate a user's step count and energy expenditure. Although accelerometers have been shown to be valid and reliable in multiple research settings, there is a need for more feasible and inexpensive options for monitoring physical activity in the general population (Gusmer, Bosch, Watkins, Ostrem, & Dengel, 2014). Because of technological advances, wearable activity tracking devices, such as the Fitbit, are now commercially available and increasingly have proved to be reliable, primarily in relation to step counting (Mackinlay, 2013; Mammen et al., 2012). Additionally, the Fitbit uploads data wirelessly to a web-based database and provides direct feedback from the device to the user (Gusmer et al., 2014), greatly increasing feasibility and participant interface. This article describes how wearable technology is being used to enhance the 4-H healthful living program WeCook: Fun with Food and Fitness (WeCook), the rationales for use, and recommendations for future implementation.

Program Design

Given the health risks of obesity and the economic burden caused by obesity-related complications, there is a critical need to reshape youths' environments and behaviors. Extension and 4-H programs provide key opportunities for encouraging healthful habits during out-of-school time. With poor eating habits, lack of food preparation skills, and physical inactivity on the rise, WeCook addressed these issues through a 12-week program that engaged at-risk fourth- and fifth-grade youths in a comprehensive, multifaceted approach to improving health. Throughout the program, youths attended two 60-min sessions per week. One session was dedicated to teaching food preparation skills and the importance of balanced nutrition using U.S. Department of Agriculture guidelines, and the other session focused on increasing physical activity through interactive games.

Preprogram and postprogram surveys were administered to youths and their parents/caregivers. Additionally, each youth wore a Fitbit Charge for 1 week near the beginning and again near the end of the program to track physical activity. The 1-week time frame was selected in part due to the estimated battery life of the devices. Individual Fitbit data automatically synced to the WeCook Fitabase account, an online research platform. Fitabase was used for collecting, aggregating, analyzing, and exporting the data while maintaining participant confidentiality. Table 1 provides a brief overview of Fitbit and Fitabase setup, distribution, and implementation.

Rationale for Use

An increase in daily physical activity has been shown to improve a number of health outcomes. Keeping this in mind, accurate measurement of physical activity is essential for understanding how it contributes to chronic disease prevention. Objective methods of assessment, such as those achieved through the use of wearable activity tracking devices, have become standard for evaluating physical activity levels (Mammen et al., 2012). This section outlines the rationales behind selecting the Fitbit and Fitabase technologies for the WeCook program.

Fitbit Rationale

• A number of studies have shown that Fitbit technology is valid and reliable for measuring steps in healthy populations, making it a feasible and comparatively inexpensive evaluation tool (Gusmer et al., 2014; Mackinlay, 2013; Mammen et al., 2012; Takacs et al., 2014).
• Participants are able to view their individual data on both the wearable device and the online dashboard, creating the potential for greater buy-in among youths.
• Fitbit.com has a comprehensive privacy policy that meets confidentiality standards.
• The Fitbit Charge was chosen for the following reasons (Fitbit, n.d.):
• It tracks minute-by-minute steps and sleep automatically.
• The watch and display can be customized depending on what is being tracked.
• It has a battery life of 7–10 days.
• Data sync wirelessly and automatically.
• Fitbit has gained popularity among consumers, leading to the potential for greater acceptance by youths as compared to their acceptance of other research tools.

Fitabase Rationale

• Data gathered from multiple devices automatically sync to the Fitabase dashboard. The dashboard can then be used for viewing all data reported since the preceding sync (Fitabase, 2015).
• Spreadsheet exports of reported data can be created for a custom date range and can be retrieved in day-, hour-, and minute-level intervals (Fitabase, 2015).
• Fitabase.com has a comprehensive privacy policy that meets confidentiality standards.

Recommendations for Implementation

As part of a complimentary evaluation method, each WeCook youth participant was given a Fitbit Charge to wear for 1 week near the beginning and again near the end of the program. Fitabase was then used for collecting, aggregating, and analyzing the Fitbit data. Recommendations for successfully incorporating these technologies into other healthful living programs are as follows:

• Select a wearable device that fits the program goals, keeping in mind that Fitbit devices are thought to be most accurate in the area of step counting.
• Contact Fitbit.com to determine whether the program qualifies for a research/educational project device discount.
• Contact Fitabase.com to set up an account and receive new user training.
• Develop systems for participant identification numbers, device assignments, programming and distribution of devices, and rules/care guidelines.
• Allow time for each participant to interface with his or her individual Fitbit.com dashboard to assess current level of physical activity and set personal goals for improvement.

Summary

Being physically active from a young age is one of the most important steps to lifelong health. Extension educators have a unique ability to work with school-aged youths at both the individual and community levels (Sheehy & Dharod, 2008), providing ideal settings for both evaluating physical activity levels and influencing behavior change. With activity tracking technology becoming more prevalent and reliable, Extension educators may want to consider incorporating these user-friendly devices and online platforms into healthful living programs.

Acknowledgments

This project is supported by Children, Youth, and Families at Risk, a funding program through the U.S. Department of Agriculture National Institute of Food and Agriculture, for developing and delivering educational programs that equip limited-resource families and youths who are at-risk for not meeting basic human needs with the skills they need to lead positive, productive, contributing lives. Grant number 2014-41520-22207.

References

Fitabase. (2015). What is Fitabase? Retrieved from www.fitabase.com

Fitbit Charge. (n.d.). Fitbit, Inc. Retrieved from http://www.fitbit.com/charge

Gusmer, R. J., Bosch, T. A., Watkins, A. N., Ostrem, J. D., & Dengel, D. R. (2014). Comparison of Fitbit Ultra to ActiGraph GT1M for assessment of physical activity in young adults during treadmill walking. The Open Sports Medicine Journal, 8, 11–15.

Mackinlay, M. (2013). Phases of accuracy diagnosis: (In)visibility of system status in the Fitbit. Intersect: The Stanford Journal of Science, Technology and Society, 6(2), 2–9.

Mammen, G., Gardiner, S., Senthinathan, A., McClemont, L., Stone, M., & Faulkner, G. (2012). Is this bit fit? Measuring the quality of the FitBit step-counter. Health & Fitness Journal of Canada, 5(4), 30–39.

Sheehy, A., & Dharod, J. (2008). The difference between physical activity and nutrition attitudes and behaviors among Maine high school students. Journal of Extension, 46(6), Article 6RIB5. Available at: https://www.joe.org/joe/2008december/rb5.php

Takacs, J., Pollock, C. L., Guenther, J. R., Bahar, M., Napier, C., & Hunt, M. A. (2014). Validation of the Fitbit One activity monitor device during treadmill walking. Journal of Science and Medicine in Sport, 17(5), 496–500.