Health trackers could be valuable if they measured more data
Steps, calories, heart rate, blood pressure, sleep, menstrual cycle: Today there are all sorts of ways to measure, track, analyze, and judge your body’s functioning. According to a survey from earlier this year, 34% of adults reported using mobile health apps, primarily for monitoring heart rate and exercise; 27% said they use fitness wearables. And more of these products are coming down the pipe: Rumors that Apple may add a sleep-tracking app to the Apple Watch continue to spread, and the wearables industry is estimated to grow by 20% each year for the next half-decade.
“I have found in my research that people are really curious to know more about themselves,” says Jordan Etkin, PhD, an associate professor at Duke University who studies goals and motivation. “I think they do believe that through knowing about themselves, they can improve and become better and optimize.”
Despite the very real consumer interest, today’s tracking technologies often fall short. Some popular apps and devices have come under fire for accuracy issues. Class action lawsuits were filed in 2015 and 2016 against Fitbit, with customers claiming inaccuracies in heart rate monitoring and sleep tracking. Research has also shown that many activity trackers, including Garmin vivofit and Jawbone UP24, tend to underestimate how much energy users expend. In a 2018 scientific review of mobile health apps, researchers found that out of the thousands of existing health apps, only 22 had been systematically reviewed and “the body of evidence of effectiveness was of very low quality.”
“Changing human behavior is really hard.”
Beyond measurement issues — and privacy concerns — constant wellness monitoring can have other unintended drawbacks. Incessant tracking and measuring of activities like sleeping or walking can lead to a less pleasurable experience while performing these tasks, according to a 2016 study, since the pursuit feels like work. Sleep tracking apps have even resulted in a rise of user self-diagnosed sleep disorders, like insomnia, based on app data — and not based on how they actually felt based on the quality of sleep, per a 2017 study.
“Changing human behavior is really hard,” says Dr. Oyungerel Byambasuren, a research assistant at Bond University in Australia and the lead researcher on the study examining the efficacy of health apps. “If you’re used to eating things which are not particularly good for you and doing certain unhealthy behaviors… it’s really hard to change set ways in people’s daily lives because we run on autopilot for evolutionary reasons — to save energy to make better decisions.”
In a 2013 study, Byambasuren found that one of the apps which best served users was a diabetes management app called Glucose Buddy, which tracks more variables than just caloric intake, including blood sugar, insulin, and medication. However, Byambasuren also found that when the business of selling an app interferes with the quality of the product, users can get the short end of the stick. Because many wellness apps are free, Byambasuren says, they don’t track as many variables as a paid version. For instance, the Glucose Buddy app was subsequently purchased by another company since Byambasuren studied it and now offers fewer free features. “Any good app getting bought by larger companies and becoming more for-profit makes it hard for health care professionals to suggest it to patients,” he says.
Devices and apps which measure more information, such as steps, sweat rate, and heart rate will provide a more accurate reading of calorie burn. Additional sensors will also improve results. “If you can wear a device on the ankle and the wrist, that will be better than just a wrist,” says Alexander Montoye, PhD, an assistant professor at Alma College. “It seems totally impractical, but the sensor technology is getting small enough now where you can embed it into clothing. You could embed a sensor in your shoe or your sock and that would be a much better step detection system than something on your wrist.”
Montoye is confident wearables’ accuracy will improve if there were “more sensing technologies, either in terms of the number and location of sensors or the types of physiological variables we’re collecting overall.”