A Device Agnostic Approach to Predict Children's Activity from Consumer Wearable Accelerometer Data: A Proof-of-Concept Study.

INTRODUCTION: This study examined the potential of a device agnostic approach for predicting physical activity from consumer wearable accelerometry compared with a research-grade accelerometry. METHODS: Seventy-five 5- to 12-year-olds (58% male, 63% White) participated in a 60-min protocol. Children wore wrist-placed consumer wearables (Apple Watch Series 7 and Garmin Vivoactive 4) and a research-grade device (ActiGraph GT9X) concurrently with an indirect calorimeter (COSMED K5). Activity intensities (i.e., inactive, light, moderate-to-vigorous physical activity) were estimated via indirect calorimetry (criterion), and the Hildebrand thresholds were applied to the raw accelerometer data from the consumer wearables and research-grade device. Epoch-by-epoch (e.g., weighted sensitivity, specificity) and discrepancy (e.g., mean bias, absolute error) analyses evaluated agreement between accelerometry-derived and criterion estimates. Equivalence testing evaluated the equivalence of estimates produced by the consumer wearables and ActiGraph. RESULTS: Estimates produced by the raw accelerometry data from ActiGraph, Apple, and Garmin produced similar criterion agreement with weighted sensitivity = 68.2% (95% confidence interval (CI), 67.1%-69.3%), 73.0% (95% CI, 71.8%-74.3%), and 66.6% (95% CI, 65.7%-67.5%), respectively, and weighted specificity = 84.4% (95% CI, 83.6%-85.2%), 82.0% (95% CI, 80.6%-83.4%), and 75.3% (95% CI, 74.7%-75.9%), respectively. Apple Watch produced the lowest mean bias (inactive, -4.0 ± 4.5; light activity, 2.1 ± 4.0) and absolute error (inactive, 4.9 ± 3.4; light activity, 3.6 ± 2.7) for inactive and light physical activity minutes. For moderate-to-vigorous physical activity, ActiGraph produced the lowest mean bias (1.0 ± 2.9) and absolute error (2.8 ± 2.4). No ActiGraph and consumer wearable device estimates were statistically significantly equivalent. CONCLUSIONS: Raw accelerometry estimated inactive and light activity from wrist-placed consumer wearables performed similarly to, if not better than, a research-grade device, when compared with indirect calorimetry. This proof-of-concept study highlights the potential of device-agnostic methods for quantifying physical activity intensity via consumer wearables.

Improving Asthma Management in the Elementary School Setting: An Education and Self-management Pilot Project.

PURPOSE: To increase daily asthma symptom self-assessments of elementary school students using Green Means Go, an asthma education and self-assessment program, via a partnership between an elementary school and a school of nursing. METHODS: Over four months, accelerated MSN nursing students provided small group education sessions to teach students and teachers to identify asthma symptoms by Asthma Action Plan (AAP) zones and actions for each zone. To promote continuity of care between school and home, a teacher-parent communication log during yellow zone days was encouraged. RESULTS: Students with asthma (n = 90), teachers (n = 12) and parents (n = 1) participated. Previously no students performed daily self-assessments and at program end, all students accurately identified symptoms, AAP zones, and action steps. A total of 789 symptom self-assessments were recorded. Teachers reported increased asthma knowledge. One parent attended an education session and one home visit was completed. No communication logs were returned. CONCLUSIONS: Partnerships between elementary and nursing schools may be an effective strategy for delivery of health programs to high-risk children with chronic diseases. Self-assessment of symptoms and taking appropriate actions at school are critical components of early asthma intervention, particularly when a school nurse is not always available. Training teachers to follow a child's AAP within school policies is a critical second step. Home visits showed potential as a strategy for engaging parents. PRACTICE IMPLICATIONS: In the current climate of school nurse shortages, management of asthma-related episodes in school can be improved with similar partnerships and programs that promote health education and self-management.