# Feasibility, Acceptability, and Perspectives Regarding the Use of Activity Tracking Wearable Devices Among Home Health Aides: Mixed Methods Study

## TL;DR

This study explores how home health aides can use wearable activity trackers to improve their health, finding that the devices are feasible and accepted, though challenges remain.

## Contribution

The study provides new insights into the feasibility and acceptability of activity tracking devices among home health aides, a historically underserved group.

## Key findings

- 94% of home health aides wore activity trackers for the full 4-week study period.
- Participants showed increased health awareness and made positive behavior changes based on the data.
- Sleep improvements were challenging due to social and occupational constraints.

## Abstract

Home health aides and attendants (HHAs) provide in-home care to the growing population of older adults who want to age in place. Despite their vital role in patient care, HHAs are an underserved and vulnerable population of health care professionals who often experience poor health themselves. Activity tracking devices offer a promising way to improve HHAs’ health-related awareness and promote health behavior change, particularly regarding physical activity and sleep quality, 2 areas in which the workforce struggles.

This study aimed to understand how feasible it is for HHAs to use activity tracking devices and assess their perceptions of such devices for improving their health. Specifically, we conducted (1) a field study to assess the use, feasibility, and acceptability of these devices among HHAs and (2) a qualitative study to understand HHAs’ perspectives on and reactions to activity trackers on and off the job.

We partnered with the 1199 Service Employees International Union Training and Employment Fund to conduct a field study with home care agency–employed HHAs working in New York City, New York. Participants wore activity tracking devices for 4 weeks that collected data on physical activity and sleep. The HHAs were subsequently interviewed on their experiences with and attitudes toward the devices and asked to reflect on personalized visualizations of their data to prompt them to think aloud. Quantitative data were analyzed using descriptive statistics. Qualitative data were analyzed using grounded theory.

A total of 17 HHAs participated; their mean age was 48.7 (SD 12.2) years, 15 (88%) were women, 11 (65%) identified as Black, 5 (29%) identified as Hispanic or Latinx, and they had worked as HHAs for a mean of 11.7 (SD 7.5) years. In total, 94% (n=16) of the HHAs wore their activity trackers for the full 28-day study period. Participants took a mean of 10,230 (SD 3586) daily steps during the study period and slept for a mean of 6.27 (SD 0.58) hours per night. Overall, 4 key themes emerged: (1) activity tracking devices enhanced participants’ health awareness by providing empirical data for self-reflection; (2) this increased awareness led to positive behavior changes, including setting and achieving health-related goals; (3) HHAs believed that these devices could improve not only their own health but also that of their patients through positive behavior changes; and (4) despite this optimism, participants emphasized that their ability to modify sleep and activity patterns was constrained by social and occupational determinants, with sleep improvements being particularly challenging.

Our findings suggest that appropriately designed personal tracking interventions could offer a promising approach to supporting positive health-related changes in this historically overlooked workforce, potentially improving their well-being and the quality of care they provide to their patients.