JMIR Publications

ABSTRACT

Background:

Many Veterans who served in the Gulf experience Gulf War Illness (GWI). Veterans with GWI often have difficult-to-treat symptoms, contributing to decreased function, increased mental health needs, and poor quality of life. The Veterans Affairs (VA) War Related Illness and Injury Study Center (WRIISC) in VA New Jersey (NJ) developed a 26-week virtual health coaching intervention to address symptoms and to promote health and wellness for Veterans with GWI. A consumer-grade smartwatch was provided to each participant as part of an activity monitoring program to complement the health coaching intervention.

Objective:

To assess feasibility and acceptability of an activity monitoring program for Veterans with GWI.

Methods:

Twenty-four Veterans participating in the health coaching intervention were invited to enroll in the activity monitoring program. Participants attended a virtual orientation to set up the smartwatch; verbal consent to connect to a HIPAA-compliant platform to share data was obtained. Program feasibility was assessed by evaluating wear time percentage and rate of program completion. Acceptability was assessed by asking two questions in a monthly survey and by eliciting participant perspectives about using the smartwatch through a check-in call at the mid-point of the program. Quantitative data were analyzed descriptively, and qualitative data were analyzed using a coding scheme adapted from Sekhon et al.’s Theoretical Framework for Acceptability (TFA).

Results:

Twenty Veterans agreed to participate in the program (mean age=49; 35% female, 94% non-Hispanic white; 50% first-time smartwatch users). Twelve (60%) participants wore the watch for 26 weeks. Median wear time percentage was >80% for 25 weeks. Most (60%) participants reported that using the wearable helped them achieve their wellness goals, and the majority (80%) of participants would recommend using the smartwatch for activity monitoring to other Veterans. Synthesis of qualitative data also revealed acceptability of wearing the smartwatch for activity monitoring. There was one adverse event reported (i.e., minor skin irritation from the watch band that resolved after switching to a hypoallergenic watch band.

Conclusions:

Findings suggest program feasibility and acceptability of pairing a smartwatch with a health coaching intervention for Veterans with GWI. Since there is no known activity monitoring program for Veterans with GWI, evaluating feasibility and acceptability is critical to future implementation of any activity monitoring program for this population. Using a smartwatch for activity monitoring can inform the design of personalized interventions that target symptoms, as well as provide signals to whether treatments are efficacious. This may be particularly applicable for individuals with chronic conditions, since the smartwatch can serve as a cognitive aid to reduce tracking burden, create accountability, increase awareness of how behavior can affect health, and prompt discussions with care team. The growing availability and use of wearables present an opportunity to develop programs that support self-management of symptoms and chronic conditions. Clinical Trial: N/A