A new study published in JAMA Network Open found that the use of wearable devices for health monitoring among children was inconsistent based on social determinants of health (SDoH). The study revealed significant differences in initial participation and amount of time using the wearable device between white and black children. The research highlights the need for further investigation into the relationship between SDoH and the use of wearable devices for health monitoring to ensure that biases are not present in the development of these resources.
The use of wearable devices is expanding in popularity and applicability, with more people using these devices to monitor their health. While these devices have the potential to improve healthcare, researchers continue to question whether biases exist regarding the development of these resources and the resulting data collection. Previous research has noted the structural barriers related to wearable device use among children, and evidence surrounding the long-term use of wearable devices for health monitoring was limited, specifically regarding whether it would yield valid data. This study aims to gather further information about how social determinants of health (SDoH) correlated with patient willingness to engage in the use of wearable devices and related health research.
Methods
Researchers conducted a cohort study that included 10,414 patients, all of whom were between 11 and 13 years old and were at the two-year (Y2) follow-up point in the Adolescent Brain and Cognitive Development (ABCD) Study. This study took place at 21 sites across the US. At the Y2 follow-up, all patients were given the option of wearing Charge HR 2 Fitbit. Devices were provided for a three-week period.
Researchers considered participant retention and total device wear time over 21 days as the primary outcomes. They also noted the associations between the primary endpoints and sociodemographic and socioeconomic indicators.
Results
Among the 10,414 participants, the mean age was 12; 52.3 percent were male, 13.7 percent were Black, 19.7 percent were Hispanic, and 53.9 percent were White. Researchers obtained this information during onboarding and at the Y2 point. The wearable device cohort comprised 71.3 percent of the total population, and the remaining 28.7 percent of participants did not use the devices or share data.
Researchers found that while Black children remained engaged in the study for an average of 16 days, White children usually lasted the entire period. They also noted that pediatric patients from racial and ethnic minority groups wore devices for a significantly shorter period. Among the entire population, the median device wear time was 400.7 hours. However, the median for Black patients fell below 300 hours.
Based on the data collected, researchers concluded that noticeable differences existed between White and Black children in terms of initial participation and amount of time using the wearable device.
Discussion
The study found that wearable device use among children was inconsistent based on social determinants of health (SDoH), specifically patient demographics and socioeconomic factors. The data showed that there were significant differences between White and Black children in terms of initial participation and amount of time using the wearable device. This suggests that there may be biases in the development of these resources and the resulting data collection.
Furthermore, previous research has also indicated that disparities are common within pediatric populations in digital healthcare. Research from April 2022 found that rural-residing, publicly insured pediatric patients from low-income families used telehealth less frequently. As telehealth continues to grow, efforts to increase access and equity are necessary.
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