When is a Fitbit like a New Year’s resolution?

Wearable devices like the Fitbit and Apple Watch are all the rage in the fight against obesity. Yet their failure to encourage meaningful reflection on the data often relegates them to the waste bin of good intentions, alongside failed diets and household budgets.

The tendency to stop using them is of heightened concern in low-socioeconomic communities, where the rates of obesity, diabetes, and heart disease exceed the national average.

Herman Saksomo

Herman Saksomo, MS’14, PhD’20
Photo by Liz Linder Photography

To find out why doctoral candidate Herman Saksono participated in an interdisciplinary team of Northeastern researchers to conduct a two-month study of 14 low-income families. He presented his findings earlier this month at an international conference on Human-Computer Interaction in Glasgow, Scotland.

“Our goal was to understand their experience and why those conditions reduce the likelihood of continued physical activity,” said Saksono, a PhD student who is combining computer science with Personal Health Informatics.

The combination of computer science, health science, and psychology is essential in the quest to harness the power of technology to promote healthy behavior, according to Andrea Parker, assistant professor and director of Northeastern’s Wellness Technology Lab. Parker is Saksono’s PhD advisor and principal investigator on the National Science Foundation grant that funded the study.

“Addressing these issues requires a variety of experts,” says Parker, who has a joint appointment in Bouvé and the Khoury College of Computer Sciences. “The work couldn’t happen without all of us.”

In addition to Parker, the research team includes Carmen Castaneda-Sceppa (public health and exercise science), Jessica Hoffman (school psychology and child development), Magy Seif El-Nasr (computer science and game design), and Vivien Morris (The Mattapan Food and Fitness Coalition).

Numbers aren’t enough

The problem with current wearable devices, according to Saksono, is that they only provide users with raw data.

“We found that people talk about the numbers—how many steps they took that day—but the fitness trackers don’t encourage them to reflect on what those numbers mean in the larger sense,” he said. We need to design these devices better so they encourage people to think about what the data means for their health.”

Andrea G. Parker

Andrea G. Parker, PhD, director of NU’s Wellness Technology Lab
Photo by Brooks Canaday

Saksono noted people in low-income communities face significant barriers to sustained exercise such as the need to work multiple jobs, the cost of exercise programs, and safety concerns about traffic and crime.

To overcome these barriers, he said the wearable devices need to encourage families to discuss how they can make physical activity more sustainable. This includes identifying activities they find rewarding and people who will encourage their activities. In addition, he says the devices need to include games and challenges that keep users engaged in their commitment.

As part of his PhD thesis, he is developing an app called Storywell that requires users to reach the physical activity goals set on their device in order to unlock the next chapter in a story.

“Simple goal setting—I will walk 7,000 steps today—is not enough,” he said.

A broader approach

Saksono also found that for many families, focusing exclusively on the health benefits of exercise is not enough to change behavior. Extensive interviews with study participants showed that the parents who were most likely to sustain interest in their children’s physical activity are those who have personal or family experience with serious health problems.

But he also found that many parents in low-income neighborhoods are more focused more on their children’s education than on their health, often because they see education as the ticket to life in a safer neighborhood.

“Many of these families have more pressing life goals than increasing their physical activity,” said Parker. “In addition to visualizations of their activity levels, health apps should convey that positive behaviors like exercise can have major education-related benefits, such as improved executive functioning and school performance.”

Saksono, who is from Indonesia, was accepted to Northeastern in 2012 on a Fulbright Scholarship. After completing his masters in computer science in 2014, he was accepted as a PhD student under the guidance of Parker.

“I have long been interested in using technology to help people make their lives better,” he says. “When I met Andrea, I sharpened my focus to helping vulnerable populations. It’s another form of activism.”

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