by Dr. Sheri Colberg, Ph.D., FACSM
As we all know, it is easy to start out with good intentions to be more active or manage diabetes better, but it’s much more difficult to follow through and stick with such changes so that they become sustainable. We’ve talked recently about using physical activity tracking devices and whether they are motivational. While some studies have recently shown that newer devices like the Fitbit can indeed increase physical activity adherence in people who can certainly benefit from it (1)—like older women who are overweight or obese—the real question is, will using the latest health information technologies for fitness, diet, diabetes, or other health management be motivating enough for most people to continue doing it long-term?
The latest craze in patient care that involves health and fitness apps and tracking devices—that is, use of consumer health information technologies that encourage self-tracking—is attracting entrepreneurs in droves who believe they’ll create the next big app like MyFitnessPal. Use of diet and fitness tracking apps and disease management journals is attracting widespread interest among technology-oriented consumers and the healthcare industry as well. But does this type of tracking lead to long-term behavior change, and will the majority of people who can benefit from doing it actually use these technologies?
Developers of consumer health information technologies for data tracking (such as diet and exercise apps or blood glucose logs) often assume patients have unlimited enthusiasm for tracking their own health data via technology. However, a recent study on this topic reported surprising (and disappointing) findings (2). The authors reported a relatively low adoption of consumer health information technologies like online health apps.
Four major themes arose from the patient interviews in that study (2). Of most importance was likely the fact that self-tracking health data feels like work—and who needs more work, especially when some health care providers trust technologically measured data such as lab reports over patients’ self-tracked data? For others, they already have enough guilt, anxiety, and depression related to having health conditions that require daily management like diabetes without attaching other strong emotions and value judgments to self-tracked data. How do you feel when you don’t reach your goal of 10,000 steps in a day? Does that make you feel worse than you already do when you know you “cheated” on your diet that day?
It’s clear that patients track health data for different purposes, ranging from making sense of measured outcomes to using it to better manage their own health condition to collecting results to report to their doctors. But not everyone is equally motivated by data tracking. Personally, I did it for years with a pen and diabetes logs to learn how my body responds to different foods, exercise levels, medication, and more, but no matter how engaged I am when I start, I can’t get myself to use online trackers for more than a day or two before the data entry feels overwhelming and cumbersome—and I’m generally a self-motivated, ideal patient!
Results such as these suggest that making a public health impact may require that developers of such technologies need to consider broader issues that can creatively overcome these pragmatic and emotional issues, or else they are never likely to reach an audience that is broader than technologically sophisticated early adopters. Novel technologies are likely to be successful only if they clearly reduce patient inconvenience and burden, helping them to accomplish their “illness work” more efficiently and effectively.
What I personally believe will likely result in the highest adoption of the use of health tracking technologies is ease of use—which will likely only occur when all tracked data are entered automatically by devices and not manually entered by the user, who may lose interest quickly in entering all food eaten, activity done, medications taken, and measurement outcomes (like blood glucose levels) on a daily basis long-term. Technologies should also be able to integrate all of these data into a single app or database for easy viewing and interpretation of results and trends. We’re not quite there yet, although we’re rapidly moving in that direction!
As a leading expert on diabetes and exercise, I recently put my extensive knowledge to use in founding a new information web site called Diabetes Motion (www.diabetesmotion.com), the mission of which is to provide practical guidance about blood glucose management to anyone who wants or needs to be active with diabetes as an added variable. Please visit that site and my own (www.shericolberg.com) for more useful information about being active with diabetes.