JMIR Publications

ABSTRACT

Background:

Digital health interventions targeting behaviour change have been shown to be promising in adults and adolescents, but less attention has been given to younger children. The proliferation of wearables such as smartwatches and activity trackers that support the collection and reflection of personal health data highlights an opportunity to consider novel approaches to supporting health in young children (5-11 years).

Objective:

This systematic review aimed to investigate how smartwatches and activity trackers have been used for child health interventions (for children aged 5-11 years), specifically: (1) identify the population characteristics of those being targeted in health-related smartwatch and activity tracker interventions; (2) describe the characteristics of the devices being used; and (3) report the feasibility and acceptability of using these devices trackers for health-related applications with children.

Methods:

We searched 10 databases (CINAHL, Embase, ACM Library, IEEE, Cochrane library, PsychINFO, Web of Science, PubMed, SCOPUS, Medline) to identify relevant literature in March 2023. The inclusion criteria for studies were as follows: (1) peer-reviewed or empirical studies; (2) published in English; (3) the research involved a child aged 5-11 years; and (4) the research involved a child using a smartwatch for health-related purposes/applications (physical, mental or social). Two researchers independently double screened papers to assess eligibility. One researcher extracted data relating to the three aims and synthesised the results using narrative and thematic synthesis.

Results:

The database searches identified 4772 papers, of which 15 papers were included in this review. Three papers refer to the same intervention. Nine commercial devices were identified across the studies, mostly used to target improvements in physical activity (n=10). Other applications included using smartwatches to deliver just-in-time interventions for emotional regulation and asthma management. User feedback was positive overall demonstrating the acceptability and feasibility of using these devices with children. However, the studies often lacked a child focus, with three studies not gathering any user feedback from children, only their parents, and eight studies used devices designed for adults, not children. Further, many studies delivered minimal data feedback on the smartwatch or activity tracker, instead relying on a partner application running on a linked parental smartphone with greater functionality.

Conclusions:

Smartwatch and activity tracker interventions with children aged 5-11 years remain limited. Research primarily focuses on using these devices to increase physical activity, with few studies exploring their use for other health applications. The devices are often used in collaboration with children’s parents and have limited data feedback and functionality that supports children’s independent engagement with the data the trackers collect. Future research should engage in more child-centred methods and intervention design including the exploration of novel smartwatch and activity tracker designs via participatory design approaches