374) Acceptability and Effects of Using Wearable Activity Trackers for Chronic Pain Management among Older African American Adults

Abstract

Wearable activity trackers can help people with chronic musculoskeletal pain set and achieve goals for increasing daily walking as a pain self-management strategy. Yet older adults from vulnerable populations may face obstacles to using trackers that should be considered in intervention design. In a sample of 51 African American adults with chronic musculoskeletal pain ages 60-85 in an economically disadvantaged community, we evaluated the acceptability of the Fitbit ZipTM and three alternative modes of reporting daily steps. Our randomized design (28 in intervention group, 23 controls) also allowed us to assess whether using a Fitbit was associated with improvements in PROMIS pain interference and walking frequency, assessed during telephone surveys at baseline and eight weeks. Intervention participants wore a Fitbit for six weeks, and reported daily step counts via text messages, automated telephone calls, and syncing (two weeks each). Acceptability was measured by participant-identified facilitators, challenges, and satisfaction; and feasibility by the proportion of expected days in which step-counts were reported. More than 90% of participants reported that Fitbits were easy to use, but some experienced technical or dexterity-related difficulties with Fitbits and/or with reporting steps. Text reporting yielded 79% adherence, vs. 68% each for automated calls and automatic syncing. Participants’ preferences for reporting mode varied. Intervention participants did not show greater improvement in pain interference than controls. While 75% of intervention group participants reported that the Fitbit motivated them to walk more, pre-post change in walking frequency was not significantly different between intervention and control groups. With attention to specific needs and tailored support, wearable activity trackers and mHealth reporting for chronic pain self-care are feasible for use by vulnerable older adults. Future research should test how the effects of activity trackers on pain-related outcomes can be enhanced by incorporating behavior change strategies and training in evidence-based cognitive-behavioral techniques. Funding: This study was supported by a grant from the National Institutes of Health, P30 AG015281, and the Michigan Center for Urban African American Aging Research and by grants from the National Institute on Aging [K01 AG050706-01A1 to MRJ]; UM OAIC Pepper Center 2017 Pilot Grant (Janevic, PI).