JMIR Publications

ABSTRACT

Background:

Children with cancer are at risk for reduced physical activity. Gaining insight into physical activity using smartwatches could improve understanding of individual potential during treatment, support early recognition of aberrant physical activity and enable tailored support.

Objective:

This study aims to explore the feasibility, barriers and facilitators of long-term physical activity tracking using a smartwatch during childhood cancer treatment.

Methods:

In this prospective study, 30 children (8-18 years) under active cancer treatment were included in 2 phases. During phase 1, 15 children wore a smartwatch daily for 12 consecutive weeks and in-depth interviews were conducted to identify key considerations used to optimize wearability. In phase 2, another 15 children wore the smartwatch and feasibility was evaluated (set at 60.0% of children wearing it for at least 75.0% of the study time). Semi-structured interviews were conducted at weeks 1, 3, 6 and 12 and thematically analyzed to identify barriers and facilitators. An iterative process of alternating data collection and analysis allowed for ongoing method refinement and deepening thematic analysis during the study period.

Results:

Key considerations for improvement identified in phase 1 led to refinements in phase 2, including: enhanced engagement, regular prompts, customized plans, personalized setup and improved aesthetics and comfort. In phase 2, 46.2% adhered to wearing the smartwatch for at least 75.0% of the study period. Four main themes for (not) wearing were identified during phase 2: Burden and resilience, Motivational drivers and perception, Insight and evaluation and User experience and functionality. Feasibility was influenced by the child’s physical state and perceived burden. Motivation, perceived value and expectations played crucial roles in sustaining adherence while also the balance between positive reinforcement and potential confrontation affected long-term use. User experience including attractiveness, comfort and usability impacted acceptance.

Conclusions:

Real-time and long-term physical activity tracking using a smartwatch in children during treatment for cancer was not feasible in our cohort. A personalized approach, incorporating individual preferences and physical condition, is essential to support adherence.