The magazine of the UW School of Public Health

Download full issue PDF. Spring/Summer 2015
Volume 32, Number 1

Inside this issue


Individual Fitness Tracking Turns Social

Activity-tracking technology is drawing users and designers together. What does this mean for data analysis and population health?

By Deborah Gardner

Activity-tracking technology is drawing users and designers together. What does this mean for data analysis and population health? 

“I like to play basketball with the governor,” says a Silver Lake Elementary student on camera. In the same video on the Snohomish County Health Leadership Coalition website, Governor Jay Inslee sinks a layup. Inslee has a major height advantage over the fifth-grade players, but the kids have what may be a different advantage—they’re each wearing a sleek activity-measuring wrist device called the Sqord PowerPod.

Through the Coalition’s Gear Up & Go! initiative, the device is available to every fifth-grader in Snohomish County schools to encourage movement, play, and a lifelong love of being active. Thousands of fifth-graders in over 100 schools participate. Students upload data to laptops and tablets at schools, libraries, and community organizations, accumulating virtual currency to adorn an avatar with Seahawks garb or other fashions. If the devices are trendy among the fifth-grade set, they’re inclusively so; the program is free and optional, with parent or guardian permission.

The goals of Gear Up & Go! align nicely with Inslee’s Healthiest Next Generation Initiative, but interest in individual activity monitoring raises questions about access, data, and privacy. Will data-generating tools advance population health or increase disparities? What are the implications of targeting technology to children?

At school, something unexpected happened. Silver Lake PE teachers had assumed athletic kids would be the most active, but a teacher told Gear Up & Go! Program Manager Carly Kaufman about a student who unexpectedly scored high points. The girl proudly told Kaufman she’d found creative ways to be active: running in place, walking the dog, doing laundry—anything to keep moving. This was no anomaly. The same story unfolded around the county. The kids teachers expected would be less active became top scorers.

Could technology reverse childhood’s activity decline? “There is a greater long-term potential if you can build habits at a young age,” said Dr. Allen Cheadle, Director of the Center for Community Health and Evaluation at Group Health Research Institute. “Targeting fifth-grade was strategic because activity starts to decline when kids enter middle school.”

As one of the program’s evaluators, along with the Northwest Center for Public Health Practice, Cheadle’s team is analyzing the PowerPod data. It’s pretty Big Data—a row for every 15 minutes for every child. The device is not research-grade and is worn on the wrist, so the team plans to study its accuracy.

Even with limitations, activity-monitoring data are more accurate than self-reported data. “Measuring outcomes requires having good metrics, and activity self-reports from kids are particularly inaccurate,” Cheadle explained. With accelerometers offering greater precision, he foresees a steep increase in use of activity-monitoring data. Researchers are studying the best ways to wear monitoring devices and interpret the data. Cheadle hopes to understand the association between device-wearing and higher activity levels. The researchers found kids were more active with PowerPods than without them.

Sqord PowerPodThe PowerPod doesn’t collect sensitive data such as location—a particular privacy concern for children—and data is used for research only. Reassured by this, all Snohomish school districts joined the public-private collaboration.
Teacher and student enthusiasm for the program is infectious. “School climate and the social aspect have an enormous impact, which builds camaraderie and community engagement,” said Kaufman. For example, after Snohomish County’s Oso landslide, students and the Coalition, along with United Way of Snohomish County, turned students’ virtual points into real dollars to aid the relief effort.

Kids are not the only ones using individual activity monitoring together. Adult fitness data monitoring is turning social too, explains Russell Benaroya, CEO and co-founder of EveryMove, a Seattle-based network encouraging users of various activity-monitoring devices and apps to inspire one another and to use and share their own data.

Similarly, California-based Quantified Self Labs connects technology creators and users for tracking health metrics and developing improvements. In 50 cities on five continents, enthusiasts use another social network——to gather in Quantified Self Meetup groups for show-and-tell, presentations, and hands-on work. A 2014 Quantified Self Public Health Symposium brought together policy makers, technology users, tech companies, and public health researchers.

It makes sense that individual monitoring has become collaborative, said Quantified Self co-founder Gary Wolf. “People are interested in themselves and always have been, but there’s also a cultural piece.” He sees Quantified Self as a cultural movement for data and health literacy.

The cultural shift is not universal. For kids or adults, technology—even with a social or cultural component—won’t change population health without concurrent environmental changes. “Behavior change alone won’t get people to adopt an active lifestyle and eat more nutritious food if the environment doesn’t support those behaviors. It’s difficult for people to thrive in an unhealthy environment, no matter what tools they have,” said Glen Duncan, Associate Professor of Epidemiology at the University of Washington.

A device won’t help someone who has nowhere to walk or play, Duncan warns, stressing that technology can’t compensate for inequitable environments or socioeconomic disparities. Large-scale, personalized activity data may help reveal whom the technology does not help, and why.

Growing privacy concerns—even for adults—leave some people hesitant about fitness monitoring. A January 2015 Federal Trade Commission report warned that “unauthorized access to data collected by fitness and other devices that track consumers’ location over time could endanger consumers’ physical safety.”

However, technology use is thriving. With Gear Up & Go!, Coleman Greene, CEO of Sqord Inc., sees an opportunity; instead of blaming technology for sedentary behavior, why not embrace it to help kids move? Russell Benaroya envisions a future that integrates personal technology with health care and rewards people for tracking activity. “The future self is quantified—but humanized.”

Photos: Snohomish County Health Leadership Coalition and Sqord, Inc.