Associations Among Wearable Activity Tracker Use, Exercise Motivation, and Physical Activity in a Cohort of Cancer Survivors: Secondary Data Analysis of the Health Information National Trends Survey

Abstract

Background Cancer survivors who meet physical activity (PA) recommendations (≥150 minutes of moderate-to-vigorous physical activity [MVPA] per week) experience better health outcomes. With the growing availability of wearable activity trackers (WATs), it may be easier to track PA. However, it is unknown what motivates survivors to use these devices. Objective The aim of this study is to investigate the associations among motivations for exercise, previous WAT use for tracking a health goal or activity, and meeting the recommended amount of PA among a cohort of cancer survivors. Methods Data on WAT users who reported having a previous cancer diagnosis were analyzed from the National Cancer Institute’s Health Information National Trends Survey 5 Cycle 3. All survivors with complete information on demographics, exercise motivations (internal guilt, external pressure, physical appearance, and exercise enjoyment), previous WAT use (yes or no), and minutes of MVPA per week (N=608) were included. Multivariate logistic regression models were used to test these associations. A separate cluster analysis was conducted to identify the profiles of exercise motivation that were associated with reporting WAT use. Results The mean age of the cohort was 66.9 years (SD 12.1). The majority were non-Hispanic White (473/608, 78.8%) and female (322/608, 54.9%), and skin cancer was the most commonly reported diagnosed cancer (154/608, 27.8%). Survivors who reported using WATs to track a health goal or activity were 1.6 times more likely to meet MVPA recommendations than those who did not use WATs (odds ratio [OR] 1.65, 95% CI 1.03-2.65; P=.04). When exercise motivations were assessed independently, survivors who reported not feeling any internal guilt as an exercise motivation were 73% less likely to report having used a WAT than those who felt any internal guilt (OR 0.27, 95% CI 0.14-0.54; P<.001). A total of 3 distinct motivational profiles emerged from the cluster analysis. WAT users had an increased probability of membership in profile 3, which was characterized as being strongly motivated to exercise by internal guilt, physical appearance, and exercise enjoyment (OR 4.5, 95% CI 2.1-9.7; P<.001). Conclusions Among this cohort, survivors who reported using WATs to track a health goal or activity were significantly more likely to report meeting PA recommendations. Survivors who reported feeling internal guilt as an exercise motivation were significantly more likely to report using WATs to track a health goal or activity. When examining clusters of motivation, survivors who reported previous WAT use were more likely to report being motivated to exercise by a mix of intrinsic and extrinsic motivations, including internal guilt, exercise enjoyment, and physical appearance. Given the health benefits of PA for cancer survivors, technology-focused interventions that use WATs and target exercise motivation may aid in cancer survivors meeting the level of recommended PA.

Physical activity maintenance among young adult cancer survivors in an mHealth intervention: Twelve‐month outcomes from the IMPACT randomized controlled trial

“…All participants had ongoing access to an activity tracker and companion app that facilitated use of behavioral strategies (e.g., self‐monitoring of behavior, goal setting) throughout the trial period, and YACS have reported that goals help them maintain PA behaviors 55 . Further, cancer survivors who use activity trackers to monitor activity or a health goal are more likely report meeting PA recommendations 56 . Among YACS, lack of social support has been identified as a key barrier to PA adherence, while accountability to others is a facilitator 55 .…”

“… 55 Further, cancer survivors who use activity trackers to monitor activity or a health goal are more likely report meeting PA recommendations. 56 Among YACS, lack of social support has been identified as a key barrier to PA adherence, while accountability to others is a facilitator. 55 It is possible that the Facebook group was sufficient for some participants in both groups to enhance social support and accountability.…”

Association Between Wearable Device Use and Levels of Physical Activity Among Older Adults in the US: Evidence From the 2019-2020 Health Information National Trends Survey

“…The intensity of WD use may play a role in promoting positive health changes. Previous works examining the role of wearable healthcare devices in facilitating physical activity have mainly focused on the association between ever-users vs. non-users of WD and physical activity engagement [ 28 , 44 ]. These studies indicated that simply using wearable devices may promote physical activity among adults.…”

Comparing the Effectiveness of a Wearable Activity Tracker in Addition to Counseling and Counseling Only to Reinforce Leisure-Time Physical Activity among Breast Cancer Patients: A Randomized Controlled Trial

“…Fifth, there were 9 patients who had missing items on the primary end points and were omitted in the analysis, but the proportion of patient with missing and the baseline self-reported LTPA were similar between intervention and control. Sixth, while WAT could be used for individualized PA intervention regardless of type of cancer or treatment [ 69 ], the individual PA counseling should be performed considering cancer- and cancer treatment-related factors. However, the study included only patients who were scheduled to receive RT for breast cancer at a single center, which may limit the generalizability of the findings.…”