Self-reported acceptance of a wearable activity monitor in persons with stroke

BackgroundWearable activity monitors offer clinicians and researchers accessible, scalable, and cost-effective tools for continuous remote monitoring of functional status. These technologies can complement traditional clinical outcome measures by providing detailed, minute-by-minute remotely collected data on a wide array of biometrics that include, as examples, physical activity and heart rate. There is significant potential for the use of these devices in rehabilitation after stroke if individuals will wear and use the devices; however, the acceptance of these devices by persons with stroke is not well understood. ObjectiveIn this study, we investigated the participant-reported acceptance of a commercially available, wrist-worn wearable activity monitor (the Fitbit Inspire 2) for remote monitoring of physical activity and heart rate in persons with stroke. We also assessed relationships between reported acceptance and adherence to wearing the device. MethodsSixty-five participants with stroke wore a Fitbit Inspire 2 for three months, at which point we assessed the acceptance of wearing the device using the Technology Acceptance Questionnaire (TAQ) inclusive of its seven dimensions (Perceived Usefulness (PU), Perceived Ease of Use (PEOU), Equipment Characteristics (EC), Privacy Concern (PC), Perceived Risk (PR), Facilitating Conditions (FC), and Subjective Norm (SN). We then performed Spearmans correlations to assess relationships between acceptance and adherence to device wear, which we calculated as both the percentage of daily wear time and percentage of valid days the device was worn during the three weeks preceding TAQ administration. ResultsMost participants reported generally agreeable responses with high overall total TAQ scores across all seven dimensions that indicated strong acceptance of the device; "Agree" was the median response to 29 of the 31 TAQ statements. Participants generally found the device beneficial for their health, efficient for monitoring, easy to use and don/doff, and unintrusive to daily life. However, participant responses on the TAQ did not show significant positive correlations with measures of actual device wear time (all p>0.05). ConclusionsThis study demonstrates generally high self-reported acceptance of the Fitbit Inspire 2 among persons with stroke. Participants reported general agreement across all seven TAQ dimensions with minimal concerns interpreted as being directly relatable to post-stroke motor impairment (e.g., donning and doffing devices, using the device independently). However, the high self-reported acceptance scores did not correlate positively with measures of real-world device wear. Accordingly, it should not be assumed that persons with stroke will adhere to wearing these devices simply because they report high acceptability.