Application of N-of-1 Experiments to Test the Efficacy of Inactivity Alert Features in Fitness Trackers to Increase Breaks from Sitting in Older Adults.

BACKGROUND: Frequent breaks from sitting could improve health. Many commercially available fitness trackers deliver vibration alerts that could be used to cue sitting breaks. As a potentially pragmatic approach to promote frequent breaks from sitting, we tested the efficacy of inactivity alerts among obese older adults, a highly sedentary population. METHODS: We conducted 10 sequential N-of-1 (single-case) experimental ABA trials. Participants (mean age = 68, mean BMI = 35) were monitored for a baseline phase ("A1") followed by an intervention phase ("B"). The intervention was then removed and participants were monitored to test an experimental effect (reversal "A2" phase). Total time in the study was limited to 25 days. During the intervention phase ("B"), participants used fitness trackers to stand up or move every time they received an alert (every 15 or 20 minutes of inactivity). Participants wore activPAL devices to measure breaks from sitting each day. Randomization tests were used to determine whether the number of breaks was significantly higher during the "B" phase than the two "A" phases. RESULTS: Breaks were higher by 7.2 breaks per day during the "B" phase compared to the mean of the "A" phases. Seven out of 10 participants had more sitting breaks during the intervention phase which subsequently decreased during the reversal "A2" phase (combined p-value < .05). CONCLUSION: Inactivity alert features within commercially available devices are efficacious for promoting modest improvements in breaks from sitting among older adults with obesity and could be a simple health-promoting strategy in this population.

Acceptability of Fitbit for physical activity tracking within clinical care among men with prostate cancer.

Prior research has not examined the acceptability of commercially available fitness tracking devices in men with prostate cancer, many of whom are at risk for conditions that physical activity could alleviate. We conducted an exploratory 3-week field study to examine acceptability of the Fitbit Zip and attitudes towards integrating fitness tracking into clinical care among men with prostate cancer. Twenty-six men used the Fitbit Zip for a one-week baseline phase followed by a 2-week optional use phase and then completed in-depth interviews. Interview data was analyzed using inductive thematic analysis. Participants found the device comfortable and easy to wear. Barriers to use included health and technology difficulties. Participants expressed value in sharing Fitbit data with their health care team. Findings support the use of easy to use and simple fitness trackers among men with prostate cancer and there could be opportunities to integrate fitness tracker data into clinical care.

Removal of industry-sponsored formula sample packs from the hospital: does it make a difference?

BACKGROUND: Most US hospitals distribute industry-sponsored formula sample packs. No research has examined outcomes associated with sample pack removal as part of a hospital intervention to eliminate sample distribution postpartum. OBJECTIVE: To examine prospectively hospital-based and breastfeeding outcomes associated with removal of industry-sponsored formula sample packs from the hospital. METHODS: We enrolled mothers postpartum at Cooper University Hospital, an urban New Jersey hospital, in 2009-2010. For the first 6 months, all women received industry-sponsored formula samples packs (control group); for the next 6 months, all postpartum women received hospital-sponsored bags with no formula at source (intervention group). Research assistants blinded to the design called subjects weekly for 10 weeks to determine feeding practices. RESULTS: We enrolled 527 breastfeeding women (284 control; 243 intervention). At 10 weeks postpartum, 82% of control and 36% of intervention women (P < .001) reported receiving formula in the "diaper discharge bag." Kaplan-Meyer curves for any breastfeeding showed the intervention was associated with increased breastfeeding (P = .03); however, exclusive breastfeeding was not significantly different between intervention and controls (P = .46). In post hoc analysis, receiving no take-home formula in bottles from the hospital was associated with increased exclusive breastfeeding in control (P = .02) and intervention (P = .03) groups at 10 weeks. CONCLUSION: Although the hospital-branded replacement contained no formula at source, many women reported receiving bottles of formula from the hospital. Change in practice to remove industry-sponsored formula sample packs was associated with increased breastfeeding over 10 weeks, but the intervention may have had a greater impact had it not been contaminated.