by Reymart Patrick B. Yabut, RN MSN St.

Renato Cabug Jr. , RN MSN St.

Darlene G. Cardinal, RN MSN St.

Andrea Maui Ganotisi, RN MSN St.

Sarra Lee Libiano, RN MSN St.

Roison Andro Narvaez MSN RN CMCS CLDP LGBH PhD St.

Citation: Yabut, R. P. B., Cabug, Jr., R., Ganotisi, A. M., Libiano, S. L., & Narvaez, R. A. (2024). Effectiveness of activity trackers on physical activities: An integrative review. Canadian Journal of Nursing Informatics, 19(2).  https://cjni.net/journal/?p=13108

Abstract

Background Individuals nowadays are fond of using handheld technology in their daily lives. Thus, people often resort to using wearable trackers to self-monitor their physical activities.

Objective To assess the effectiveness of wearable activity trackers with a specific emphasis on monitoring an individual’s health.

Design An integrative review.

Results Twelve studies were selected and assessed according to the specified criteria.  

Conclusion The utilization of wearable activity trackers and applications can have a significant impact on an individual’s physical activities. However, it is important to acknowledge that human behaviour still plays a crucial role in promoting one’s physical activities.

What is already known about this topic

1. Wearable activity trackers have become increasingly popular due to their ability to provide insights on activity.

2. Using wearable activity trackers can suggest that there is a modest short-term increase in physical activity while utilizing it.

3. Activity trackers are useful tools for individuals looking to monitor and improve their physical activity levels, health, and overall well-being.

What this review adds

1. Activity trackers and apps can affect one’s physical activities, however, several human factors must be taken into consideration, particularly the person’s psychological and physical factors.

2. Activity trackers may affect the person’s conscious exercise behaviour by observing and monitoring his or her activity data, thus helping to further increase the activity of the person using it.

Background

Wearable activity trackers have become ubiquitous, providing consumers with the means to closely monitor their physical activity levels. Moreover, the availability of smartphones and apps has enabled users to access a range of tracking and motivation tools, facilitating better management of their personal health (Lyons et al., 2014). The prevalence of wearable activity trackers has skyrocketed in the past decade, with these consumer devices serving as tools for individuals to track their own physical activity (Kirk et al., 2018). As mobile devices and wearables are often used by users, they can regularly monitor and record various contextual information, including environmental and user data, through sensors such as motion, magnetic field, light, temperature, and heart rate (Nguyen & Tran, 2023). This integration of sensors allows for a comprehensive understanding of one’s physical activity patterns and environment, providing valuable insights for improving overall health and wellness.

The data that is frequently measured comprises of essential indicators like temperature, respiratory rate,  heart rate, and blood pressure along with posture, physical movements and blood oxygen saturation that are monitored through the utilization of equipment such as heart rate monitors, electrocardiograms (ECG), ballistocardiograms (BCG), and other similar devices (Wu and Luo, 2019). The undeniable advantages linked to consistent physical activity cannot be ignored. Despite being well aware of these benefits, physical inactivity continues to be a significant contributor to poor health in industrialized nations. Despite the effectiveness of traditional methods such as group education and telephone counseling in promoting physical activity, a decline in activity levels has been observed over the years (Brickwood et al., 2019).

Consumer wearable activity trackers are now readily accessible and offer users the ability to objectively track their activity levels. These devices may serve as an alternative approach to assist individuals in maintaining their physical activity (Brickwood et al., 2019). Wearable activity trackers have proven to be successful in enhancing mindful exercise habits, such as increasing daily steps and engaging in weekly moderate to vigorous physical activity. However, they have shown limited effectiveness in altering habitual behaviours like light physical activity and sedentary behaviour (Li et al. 2021).

Despite the increasing prevalence of activity trackers, there is limited substantiation to support their effectiveness in enhancing health outcomes. The integration of smart technology will undoubtedly facilitate health improvement; however, it often necessitates modifying behaviour and acquiring new proficiencies, which can pose challenges for sustained utilization (Sandham et. Al., 2023). Human behaviour  is shaped by a combination of internal factors such as psychological and physical capabilities, motivation, and external factors such as social and physical opportunities. It is widely known that altering human behaviour can be a challenging task (Michie et al., 2011.) Additionally, it has been demonstrated that wearable activity trackers are linked to better physiological outcomes, such as a lower BMI (Bravata et al., 2007).

It has been demonstrated that this wearable tracking technology is legitimate and trustworthy for accurate and dependable feedback and for changing people’s behaviour to become more physically active (Cheatham et al., 2018). Because physical activity has been found to have antidepressant (Kandola et al., 2019) and anxiolytic effects (Stubbs et al., 2017), regular physical activity can have a profound influence on mental well-being and can effectively mitigate symptoms associated with mental health issues. Mental health experts occasionally suggest incorporating exercise into the treatment plan for specific mental disorders, as it diminishes the body’s vulnerability to the detrimental impacts of anxiety (Stubbs, 2018).

Numerous studies exist on various platforms that examine or analyze the efficacy of activity trackers and apps in relation to one’s physical activities. But the goal of this research is to bring these studies together and offer a more focused and thorough examination of whether these applications and activity trackers actually affect people’s engagement with physical activities.

Aims and Objectives

The purpose and goals of this research are to (1) determine the effectiveness of activity apps and trackers to improve one’s physical activities, and (2) to identify different platforms and equipment that are known to be accurate in measuring data on physical activities.

This study aims to evaluate the impact of activity apps and trackers on an individual’s physical activity, as well as to determine the benefits of utilizing these activity trackers and apps for short and long-term effects on people’s physical condition. The outcome of this study suggests that there are ample benefits when utilizing these activity trackers and apps, particularly on one’s physical status and condition. 

Method

Design

An integrative review of the available literature and diverse methodologies can play a great role in evidence-based practice (Whittemore & Knafl, 2005). Extractions have been developed to enhance data collection, the clinical subject that is being examined is clearly identified by articulating the effectiveness of activity trackers and apps as the topic being explored. Thus, this integrative review included multiple published studies that provided information on the effects of activity trackers and apps on physical activities.

Search Strategy

The review was conducted from July to September 2023. The researchers utilized several research databases including Google Scholar, Elsevier, PubMed and CINAHL, to search for relevant articles and studies. Keywords used were “Activity Trackers and Apps on Physical Activities”. The initial search yielded 360 articles based on the article titles. From the initial findings, 130 were screened for the first review based on abstracts. A total of 25 were deemed eligible for further analysis and review.  Overall, there were 12 articles selected to be in the review that met all the criteria for both exclusion and inclusion. A PRISMA diagram (Figure 1) illustrates the search process.

Figure 1.

PRISMA Flow Diagram of Search for Evidence of the Effectiveness of Activity Trackers and Apps on Physical Activity

Inclusion and Exclusion Criteria

Final reviews were limited to the subsets of accumulated studies that focused on the effectiveness of activity trackers and apps on physical activities. Table 1 displays the inclusion and exclusion criteria. There were just 12 publications available for researchers to use in this study after accounting for these inclusion and exclusion criteria.

Table 1.

Inclusion and Exclusion Criteria

Data Evaluation/ Quality Appraisal

The researchers independently and manually analyzed each study using the Level of Evidence (LOE) model by Melnyk & Fineout-Overholt (2022). As shown in Table 2, the researchers classified the studies in accordance with their methodological quality, validity and usefulness to the user. In this integrative review, database sources suitable for the inclusion criteria were added. Each study should discuss the effectiveness and usefulness of activity trackers and applications on physical activities. By using Sparbel and Anderson’s example (2000), the following information was collected: first author, year of publication, the design used, sample size and participants, methods of instruments used, the aim, findings, type of activity and app used, level of evidence (LOE) and analysis of the study that was reviewed. The researchers sought assistance and guidance with their integrative review from our professor in nursing informatics.

Table 2.

Melnyk & Fineout-Overholt (2022) Level of Evidence

Results

Table 3 outlines the 12 studies that met the inclusion criteria for effectiveness of activity tracking devices and applications in physical activities.

Table 3.

Summary of Final 12 Studies selected on the Effectiveness of Activity Trackers and Apps

Characteristics of Included Studies

The following countries produced publications: Singapore (n=1), China (n=1), Australia (n=1), Hong Kong (n=1), and the United States of America (n=8). The time frame for publication was from 2008 to 2023. There were differences between the study designs of the following: two systematic reviews, one case control study, one cohort study, three qualitative studies, four randomized control trials, and one descriptive studies. The tally for the levels of evidence (LOE) are the following: LOE I (n=1); LOE II (n=4); LOE IV (n=2), LOE V (n=1), LOE VI (n=4).

In comparison, a study conducted by Ehn et al. (2008) and Brickwood et al. (2022) showed that wearing activity trackers can have a great impact on one’s physical activities. While the study by Brickwood showed that activity trackers are a great tool in assisting health professionals in providing support and monitoring for their patients, it is somewhat correlated with the study conducted by Ehn because seniors have been motivated to do their activities of daily living with the use of these monitoring devices. Most of the studies conducted stated that using these activity trackers and apps might increase one’s physical activities, but still human factors must be taken into account, considering the motivational and behavioral drive to do these kinds of physical activities. The study conducted by Zahrt et al. (2023) stated that participants perceived their activities as more adequate while wearing these activity trackers. As for the accuracy, the study of Xie et al. (2018) determined that wearable trackers have a high accuracy in detecting activity, thus participants tended to exert more effort because they can accurately check the calories that they are currently burning while doing the physical activities. Same with the study conducted by Germini et al. (2022) while the study focuses more on the type and brand of activity trackers, it clearly supports that these trackers can accurately monitor one’s heart rate and step counts.

Discussion

Twelve studies were reviewed and synthesized and are included in this integrative review. With the emerging rise of handheld devices and gadgets nowadays, people tend to overlook the importance of promoting exercise and avoiding a sedentary lifestyle. This oversight may lead to various diseases, including cardiovascular disease, obesity, and certain cancers such as colon, breast, and uterine cancers. This study aims to disseminate knowledge on the benefits and major contributing factors that may provide an alternative method to help individuals maintain their physical activity levels. Furthermore, this study seeks to better understand and analyze wearable activity trackers that are freely accessible to people through technology, with the aim of potentially changing people’s behaviours to become more physically active.

The integration of activity trackers in consumer wearables can prove to be a beneficial and consistent means of monitoring and aiding healthcare professionals, given the fleeting impact of physical activity. The effectiveness of wearable activity trackers may show positive results; including, they may increase the physical activity of some people who use them. A study conducted by Cheatham et al. (2018) suggested that short-term weight loss interventions (up to six months) utilizing activity trackers may prove to be a superior alternative to conventional weight loss programs for middle-aged or older adults. However, it is important to note that young individuals may not experience the same advantages from utilizing such technology. Moreover, Ehn et al. (2018) showed that activity trackers can prove to be beneficial in promoting and facilitating physical activity among elderly individuals. Nevertheless, there is great potential to enhance the range of solutions available for a wider demographic of senior citizens. Enhancements can be made in terms of reliability, usability, and content that supports the implementation of effective behavioral change techniques aimed at promoting physical activity among older adults.

The integration of activity trackers along with cash incentives or donations has been linked to an increase in physical activity (Finklestein et al., 2016). Over a six-month period, cash incentives were found to be an efficient way to encourage light to vigorous physical activity on a weekly basis. Six months after the incentives were removed, this impact did not, however, continue. Over a 12-month period, the activity tracker—whether it included philanthropic incentives—was successful in halting the slight decline in weekly light to extreme physical activity that the control group had seen. Nevertheless, whether incentives were present or not, there was no proof of better health outcomes. This calls into doubt the devices’ overall effectiveness in improving health. It is important to keep in mind that, even though other incentive schemes might result in higher step counts and better health outcomes, they would most likely need to be kept in place for a longer amount of time to prevent any potential decrease in physical activity brought on by their removal.

According to Ferguson et. al. (2022) many age groups and demographics have demonstrated the benefits of wearable activity monitors in promoting moderate weight loss and physical exercise. The clinical significance of these benefits is noteworthy, and the effects appear to be long-lasting for at least six months. The evidence is strong enough to support the use of wearable activity trackers as an additional tool in physical activity programs, even though the influence on other physiological and psychosocial outcomes may be negligible. Additionally, an internet-based adaptive walking and activity tracking program has been found to be effective in increasing daily step count, regardless of initial activity level. The use of wireless activity trackers in a tailored and adaptive approach is both practical and scalable.

The use of an activity tracker and app intervention has been found to boost physical activity levels in entire families over a short period of time (Schoeppe et al., 2020). By implementing an online-based physical activity program that targets and involves whole families, significant improvements in physical activity levels among children and parents can be achieved. This scalable intervention holds promise for enhancing family and population health. With the help of these activity trackers, families may benefit if this equipment is utilized simultaneously by all family members to promote physical activities. The current market is saturated with wearable activity trackers designed for consumers, allowing them to effectively monitor their activity levels (Brickwood et al., 2019). These devices present a promising option for individuals who aim to sustain their physical activity. Moreover, incorporating these consumer-based trackers into interventions or larger physical activity programs could potentially boost overall physical activity levels.

Numerous wearable devices, including Fitbit, Garmin, Apple Watch, and Nike Band, are now available to measure physical activity; nevertheless, consensus is required regarding how these devices compare in terms of acceptance and accuracy. A study conducted by Germini et al. (2022) demonstrated 14 distinct results, which can be categorized into the following: the number of specific activities (including steps), the time spent on each activity, the intensity of physical activity (including energy expenditure), heart rate, distance traveled, and speed, were used to assess the accuracy of these wearable devices. The researchers were unable to conduct a meta-analysis of the data due to the notable clinical heterogeneity. The most often assessed metrics were energy expenditure, heart rate, and step count. The Fitbit Charge (or Fitbit Charge HR) had a percent inaccuracy of 30 for step counting across all brands, which is indicative of an inaccurate device. Data accessibility and usage duration have a major role in determining acceptability. Approximately 75% of the data are available for Fitbit Charge HR, Fitbit Flex 2, and Garmin Vivofit. The wear times of the Nike FuelBand and the GENEActiv are 89%. This indicates that the Apple Watch’s heart rate readings and the Fitbit Charge and Fitbit Charge HR models’ step counts have been shown to be fairly accurate. It was found that none of the evaluated devices could accurately measure energy use (calories). It is important to try to lessen study heterogeneity so that the results will be more accurate and generalized among test subjects.

In relation to the study by Germini et al. (2022), Xie et al. (2018) stated that consumer devices have the capability to accurately track heart rate, steps taken, distance covered, and sleep duration, making them valuable tools for monitoring one’s health. However, when it comes to measuring energy consumption, their accuracy is limited due to insufficient energy absorption metrics. It is worth noting that health trackers from various brands exhibit different metrics and are influenced by the user’s activity level. This implies that manufacturers of health trackers should strive to enhance their algorithms to provide consistent and reliable readings across different operating conditions.

Relatedly, according to Wong et al. (2021), walking has attracted the attention of researchers in recent years, partly because of its health, environmental, economic, and social benefits for individuals and society. The promotion of walking has been observed frequently around the world. Additionally, the contribution of wearable fitness trackers and smartphone pedometer applications on walking motivation has been confirmed in a series of recent studies.

Wearable trackers can impact a person’s physical activity, but human factors such as health behaviours are key to promoting physical activity. A study conducted by Kim et al. (2018) stated that the use of wearable activity trackers as a behaviour change strategy in elementary school interventions may not be successful in promoting physical activity in this specific context. The claim was made that the use of these devices to encourage students’ physical activity had no effect in the current study. According to Karapanos et al. (2016), activity trackers are not only useful as “tools” to modify behaviour: they provide us with fresh social interactions, ways to increase our self-worth, and the option to integrate them into daily life activities and grow closer to our ideal selves. On the other hand, a study by Li et al. (2021) indicated that wearable activity trackers have proven to be successful in enhancing conscious exercise habits, such as daily steps and medium-term physical activity. However, they have shown limited effectiveness in altering ingrained behaviours like light physical activity and sedentary behavior. As added by Zahrt et al. (2023), activity adequacy mindsets, whether intentionally chosen or prompted by trackers, can impact behavior, mood, and health apart from actual physical activity. Promoting one’s attitude towards physical activity rather than depending on the use of these activity trackers is still a significant factor in enhancing one’s daily physical activities. Although these trackers might help initially, in the long term, human factors still play a big role in promoting one’s physical activities.

To conclude, 21st-century devices have rapidly emerged worldwide, aiding humans in various aspects of daily life, including cooking, transportation, healthcare, and more. They are also being integrated into promoting physical activities. However, human factors such as personal drive and perseverance still play a significant role in determining whether a person will achieve better outcomes in physical activities.

Implication For Practice

Activity trackers and apps are widely used around the world, but they still have both positive and negative impacts on one’s effectiveness in physical activities. While they can monitor a users’ pertinent data such as heart rate, number of steps, calories burned, and oxygen saturation, human factors continue to play a significant role in one’s physical activities. These factors can either enhance or diminish the positive effects of activity trackers and apps, depending on the individual’s motivation and commitment to consistent physical activity.

Nurses are dedicated to helping patients maintain their fitness and health. Therefore, we can monitor their physical activity and assess the extent to which activity trackers and apps assist them in maintaining their physical health. The role of nursing informatics in current practice is vital in providing efficient and quality service and healthcare to our patients in need. With the aid of these technological advances, nurses will become more effective in caring for their patients. Similarly, by utilizing such technology, if patients can monitor their live data while engaging in physical activities, they may be more inclined to adopt active lifestyles rather than resorting to sedentary lifestyles.

Limitations and Recommendations

The studies used in this review mostly came from first world countries leaving a gap in data from third worlds and developing countries.  The study did not cover behavioural changes and habit formation, integration with behavioural interventions, or long-term adherence and engagement. Research studies on activity trackers can cover a wide range of topics, from their effectiveness in promoting physical activity to their impact on health outcomes such as efficacy on increasing activity levels, comparison of different tracker types (wristbands, smartwatch, phone apps), impact on health outcomes, user experience and acceptance.

Conclusion

Activity trackers and apps may help in monitoring pertinent details such as heart rate, and SP02 levels of an individual, but human factors must still be considered in promoting physical activities. The human drive is still an important factor that people must focus on. The equipment may help in monitoring but without human drive, it will still be useless for some people. Physical inactivity is still one of the main causes of health issues, despite the widespread use of wearable activity trackers, which allow users to precisely and efficiently measure their levels of physical activity. These applications and devices may help in monitoring and measuring the heart rate, however different human factors must still be considered when promoting physical activities. Namely, the human drive is quintessential in maintaining one’s health and is what pushes people to stay consistent with their fitness. These different kinds of applications and devices are just a utility for physical activities, but it is still the responsibility of each person whether to engage in these kinds of activities. The different studies used in this research, although providing much insight, are limited to first world countries and have not disclosed some data on the samples used. Specifically, the brand of activity trackers or applications used for these studies as well as whether these are free or paid, must be considered in future research. Overall, these instruments have proven to serve their purpose and with commercialization, have been more widespread than ever. It must be established that it is still the choice of the individual but that the presence of these appliances is still helpful in their fitness journey.

References 

Bravata, D. M., Smith-Spangler, C., Sundaram, V., Gienger, A. L., Lin, N., Lewis, R., Stave, C. D., Olkin, I., & Sirard, J. R. (2007). Using pedometers to increase physical activity and improve health: a systematic review. JAMA, 298(19), 2296–2304. https://doi.org/10.1001/jama.298.19.2296

Brickwood, K. J., Watson, G., O’Brien, J., & Williams, A. D. (2019). Consumer-based wearable activity trackers increase physical activity participation: Systematic review and meta-analysis. JMIR mHealth and uHealth, 7(4), e11819. https://doi.org/10.2196/11819

Cheatham, S. W., Stull, K. R., Fantigrassi, M., & Motel, I. (2018). The efficacy of wearable activity tracking technology as part of a weight loss program: A systematic review. Journal of Sports Medicine and Physical Fitness, 58(4). https://doi.org/10.23736/s0022-4707.17.07437-0

Creaser, A.V., Clemes, S.A., Bingham, D.D. & Costa, S. (2023). Applying the COM-B model to understand wearable activity tracker use in children and adolescents. Journal of Public Health, 31, 2103–2114. https://doi.org/10.1007/s10389-022-01763-7

Davergne, T., Meidinger, P., Dechartres, A., & Gossec, L. (2023). The effectiveness of digital apps providing personalized exercise videos: Systematic review with meta-analysis. Journal of Medical Internet Research, 25, e45207. https://www.jmir.org/2023/1/e45207

Ehn, M., Eriksson, L. C., Åkerberg, N., & Johansson, A. (2018). Activity monitors as support for older persons’ physical activity in daily life: Qualitative study of the users’ experiences. JMIR Mhealth Uhealth, 6(2):e34. https://doi.org/10.2196/mhealth.8345

Ferguson, T., Olds, T., Curtis, R., Blake, H., Crozier, A. J., Dankiw, K., Dumuid, D., Kasai, D., O’Connor, E., Virgara, R., & Maher, C. (2022). Effectiveness of wearable activity trackers to increase physical activity and improve health: A systematic review of systematic reviews and meta-analyses. The Lancet Digital Health, 4(8), e615-e626. https://doi.org/10.1016/s2589-7500(22)00111-x

Finkelstein, E. A., Haaland, B., Bilger, M., Sahasranaman, A., Sloan, R. A., Nang, E. E. K., & Evenson, K. R. (2016). Effectiveness of activity trackers with and without incentives to increase physical activity (TRIPPA): a randomized controlled trial. Lancet Diabetes & Endocrinology, 4(12), 983–995. https://doi.org/10.1016/s2213-8587(16)30284-4

Germini, F., Noronha, N., Borg Debono, V., Abraham Philip, B., Pete, D., Navarro, T., Keepanasseril, A., Parpia, S., de Wit, K., & Iorio, A. (2022). Accuracy and acceptability of wrist-wearable activity-tracking devices: Systematic review of the literature. Journal of Medical Internet Research, 24(1), e30791. https://doi.org/10.2196/30791

Kandola, A., Ashdown-Franks, G., Hendrikse, J., Sabiston, C. M., & Stubbs, B. (2019). Physical activity and depression: Towards understanding the antidepressant mechanisms of physical activity. Neuroscience and biobehavioral reviews, 107, 525–539. https://doi.org/10.1016/j.neubiorev.2019.09.040

Karapanos, E., Gouveia, R., Hassenzahl, M., & Forlizzi, J. (2016). Wellbeing in the Making: Peoples’ Experiences with Wearable Activity Trackers. Psychology of Well-being, 6(1), 4. https://doi.org/10.1186/s13612-016-0042-6

Kim, Y., Lumpkin, A., Lochbaum, M., Stegemeier, S., & Kitten, K. (2018). Promoting physical activity using a wearable activity tracker in college students: A cluster randomized controlled trial. Journal of Sports Sciences, 36(16), 1889-1896. https://doi.org/10.1080/02640414.2018.1423886

Kirk, M., Amiri, M., Pirbaglou, M., & Ritvo, P. (2018). Wearable technology and physical activity behavior change in adults with chronic cardiometabolic disease: A systematic Review and Meta-Analysis. American Journal of Health Promotion, 33(5), 778–791. https://doi.org/10.1177/0890117118816278

Li, C., Chen, X., & Bi, X. (2021). Wearable activity trackers for promoting physical activity: A systematic meta-analytic review. International Journal of Medical Informatics, 152, 104487. https://doi:10.1016/j.ijmedinf.2021.104487

Lyons, E. J., Lewis, Z. H., Mayrsohn, B. G., & Rowland, J. L. (2014). Behavior change techniques implemented in electronic lifestyle activity monitors: a systematic content analysis. Journal of Medical Internet Research, 16(8), e192. https://doi.org/10.2196/jmir.3469

McCormack, G. R., Petersen, J., Ghoneim, D., Blackstaffe, A., Naish, C., & Doyle-Baker, P. K. (2022). Effectiveness of an 8-week physical activity intervention involving wearable activity trackers and an eHealth app: Mixed methods study. JMIR Formative Research, 6(5), e37348. https://doi.org/10.2196/37348

Melnyk, B. M. & Fineout-Overholt, E. (2022). Evidence-based practice in nursing & healthcare: A guide to best practice. (5^th ed.). Wolters Kluwer Health.

Michie, S., van Stralen, M. M., & West, R. (2011). The behaviour change wheel: A new method for characterising and designing behaviour change interventions. Implementation Science, 6, 42. https://doi.org/10.1186/1748-5908-6-42

Monteiro-Guerra, F., Signorelli, G. R., Rivera-Romero, O., Dorronzoro-Zubiete, E., & Caulfield, B. (2020). Breast cancer survivors’ perspectives on motivational and personalization strategies in mobile app-based physical activity coaching interventions: Qualitative study. JMIR mHealth and uHealth, 8(9), e18867. https://doi.org/10.2196/18867

Nguyen, Q. T., & Tran, M. T. (2017) Human Motion Characteristics Recognition with Recurrent Neural Network and Convolutional Neural Network. Master’s Thesis. Researchgate. https://doi.org/10.13140/RG.2.2.28341.55521

Poirier, J., Bennett, W. L., Jerome, G. J., Shah, N. G., Lazo, M., Yeh, H. C., Clark, J. M., & Cobb, N. K. (2016). Effectiveness of an activity tracker- and internet-based adaptive walking program for adults: A randomized controlled trial. Journal of Medical Internet Research, 18(2), e34. https://doi.org/10.2196/jmir.5295

Ryan, D. J., Ross, M. H., Simmich, J., Ng, N., Burton, N. W., Gilson, N., Pavey, T., Brown, W. J. & Gomersall, S. R. (2023). TRACK & ACT: A pragmatic randomized controlled trial exploring the comparative effectiveness of pedometers and activity trackers for changing physical activity and sedentary behavior in inactive individuals. Journal of Activity, Sedentary and Sleep Behaviors, 2, article 12. https://doi.org/10.1186/s44167-023-00018-4

Roberts, A. L., Potts, H. W., Koutoukidis, D. A., Smith, L., & Fisher, A. (2019). Breast, prostate, and colorectal cancer survivors’ experiences of using publicly available physical activity mobile apps: Qualitative study. JMIR mHealth and uHealth, 7(1), e10918. https://doi.org/10.2196/10918

Sandham M., Reed K., Cowperthwait L., Dawson A., & Jarden R. (2023). Expensive ornaments or essential technology? A qualitative metasynthesis to identify lessons from user experiences of wearable devices and smart technology in health care. Mayo Clinic Proceedings: Digital Health. 1(3), 311-333. https://doi.org/10.1016/j.mcpdig.2023.05.006

Schoeppe, S., Salmon, J., Williams, S. L., Power, D., Alley, S., Rebar, A. L., Hayman, M., Duncan, M. J., & Vandelanotte, C. (2020). Effects of an activity tracker and app intervention to increase physical activity in whole families—The Step It Up Family feasibility study. International Journal of Environmental Research and Public Health, 17(20), 7655. https://doi.org/10.3390/ijerph17207655

Seifert, A., Schlomann, A., Rietz, C., & Schelling, H. R. (2017). The use of mobile devices for physical activity tracking in older adults’ everyday life. Digital Health, 3, 205520761774008. https://doi.org/10.1177/2055207617740088

Sparbel, K. J., & Anderson, M. A. (2000). A continuity of care integrated literature review, Part 2: Methodological issues. Journal of Nursing Scholarship. 32(2), 131–135. https://doi.org/10.1111/j.1547-5069.2000.00131.x

Stubbs, B., Davy Vancampfort, Rosenbaum, S., et al. (2017). An examination of the anxiolytic effects of exercise for people with anxiety and stress-related disorders: A meta-analysis. Psychiatry Research, 249,102–108. https://doi.org/10.1016/j.psychres.2016.12.020

Stubbs, B., & Rosenbaum, S. (2018). Exercise-based interventions for mental illness: Physical activity as part of clinical treatment. Elsevier. https://doi.org/10.1016/c2016-0-03784-1

Whittemore, R., & Knafl, K. (2005). The integrative review: Updated methodology. Journal of Advanced Nursing, 52(5), 546-553. https://doi.org/10.1111/j.1365-2648.2005.03621.x

Wong, R., Yang, L., & Szeto, W. (2021). Wearable fitness trackers and smartphone pedometer apps: Their effect on transport mode choice in a transit-oriented city. Travel Behaviour and Society, 22, 244–251. https://doi.org/10.1016/j.tbs.2020.10.006

Wu, M., & Luo, J. (2019). Wearable technology applications in healthcare: A literature review. Online Journal of Nursing Informatics, 23(3). https://www.himss.org/resources/wearable-te chnology-applications-healthcare-literature-review

Xie, J., Wen, D., Liang, L., Jia, Y., Gao, L., & Lei, J. (2018). Evaluating the validity of current mainstream wearable devices in fitness tracking under various physical activities: Comparative study. JMIR Mhealth and Uhealth, 6(4), e94. https://doi.org/10.2196/mhealth.9754

Zahrt, O. H., Evans, K. M., Murnane, E. L., Santoro, E., Baiocchi, M., Landay, J. A., Delp, S. L., & Crum, A. J. (2023). Effects of wearable fitness trackers and activity adequacy mindsets on affect, behavior, and health: Longitudinal randomized controlled trial. Journal of Medical Internet Research, 25, e40529. https://doi.org/10.2196/40529

Author Notes

Reymart Patrick B. Yabut, RN, MSN St.  https://orcid.org/0009-0007-7410-2471

Renato Jr Cabug, RN  MSN St. https://orcid.org/0009-0008-2570-5708

Darlene G. Cardinal, RN MSN St. https://orcid.org/0009-0004-4973-2648

Andrea Maui Ganotisi, RN  MSN St. https://orcid.org/0009-0006-6771-2354

Sarra Lee Libiano, RN    MSN St. https://orcid.org/0009-0008-6904-5422 

Roison Andro Narvaez, MSN RN? CMCS CLDP LGBH PhD St.

https://orcid.org/0000-0001-7555-5420 

Correspondence concerning this article should be addressed to Roison Andro Narvaez, St. Paul University Philippines, Mabini Street, Tuguegarao, Cagayan Philippines, RNarvaez@spup.edu.ph