Fitbits for Assessment of Physical Activity and Sleep in Pediatric Pain: Feasibility, Acceptability, and Perspectives (Preprint)

BACKGROUND Consumer-grade wearables, such as Fitbits, are a promising, cost-effective methodology for objectively assessing sleep and physical activity in youth with pain. OBJECTIVE The current study investigated the acceptability and feasibility of implementing Fitbits for youth with acute and chronic pain in and out of hospital settings while maintaining data security and patient confidentiality. METHODS We investigated participant experience of Fitbit usage over three to four weeks for a sample of youth with acute pain undergoing surgical procedures (N=34, mean age=14.46, SD=3.70, 47.06% female) and a sample of youth with chronic pain enrolled in an intensive interdisciplinary pain treatment program (N=28, mean age=15.00, SD=2.33, 17.86% female). We assessed the acceptability of Fitbit usage through survey items probing comfortability (0=extremely uncomfortable to 10=extremely comfortable), perceived burdensomeness (0=not burdensome at all to 10=extremely burdensome), and open-ended issues or concerns. Feasibility was assessed by tracking the daily compliant wear of the Fitbit device, which was operationalized as more than 600 minutes of daily wear time. We created an automated data pipeline to ensure data security, patient confidentiality, and quality. RESULTS Acceptability findings revealed high levels of reported comfort (acute pain: M=8.56, SD=1.43; chronic pain: M=8.27, SD=1.69) and low levels of perceived burdensomeness (acute: M=0.68, SD=1.17; chronic: M=1.15, SD=1.38) related to Fitbit wearing in both samples. Transient concerns of mild wrist irritation and sleep discomfort were occasionally reported across both samples (15.79% of participants). Feasibility findings indicated high feasibility (acute: median compliance rate of 86.67%; chronic: median compliance rate of 96.65%) for the study duration in both samples. CONCLUSIONS These findings support using Fitbits as an acceptable and feasible method of objective data collection regarding sleep and physical activity for youth with pain. Findings also highlight the logistics of implementing consumer-grade wearable devices throughout all stages of the clinical research process.