Usability and Impacts of Wearables for Cardiometabolic Health Promotion

Purpose: A systematic literature review was conducted to describe features of wearables used for monitoring cardiometabolic health and identify usability and impacts of using wearables on cardiometabolic health indicators.

Background/significance: Cardiometabolic disorders (CMDs) represent a cluster of interrelated risk factors, including elevated blood glucose, obesity, hypertension, and dyslipidemia. CMDs are the leading causes of mortality and a significant public health burden in the United States and worldwide.1 With advances in wireless technology, wearable devices (e.g., smartwatches, wristbands) have become popular for monitoring healthy behaviors and risk factors. Approximately 30 % of US adults use wearable devices.2 It is important for nurses and nurse informaticists to understand how these wearables might be utilized in health promotion strategies, particularly with populations at risk for CMDs.

Methods: The wearables were limited to having sensors for blood pressure (BP), heart rate (HR), electrocardiogram (ECG), glucose, and cholesterol, which have been known as the American Heart Association’s cardiovascular risk indicators. A systematic search was performed through PubMed, CINAHL, Academic Search Complete, and Science and Technology Collection databases, using keywords related to the selected CMD risk indicators and wearable(s). We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included studies: 1) were published from 2016 to 2021 in English, 2) focused on wearables external to the body, and 3) examined wearable use by individuals in daily life (not by healthcare providers). We excluded protocol, technical, and non-empirical studies. The search yielded 572 studies; after the abstract screening, 53 articles were selected and critically reviewed regarding wearables' features, usability, and impacts on the cardiometabolic health indicators.

Results: The types of wearables used in the reviewed studies were smartwatches (45.3%), patches (34%), chest straps (22.6%), wristbands (13.2%), and others (9.4%). HR (58.5%), ECG (26.4%), and glucose (28.3%) were the predominant indicators captured. No studies tracked BP and cholesterol. Additional features of the wearables included physical activity, respiration, sleep, diet, and symptoms monitoring. Various usability measurements were used across studies by assessing user satisfaction, monitoring satisfaction, ease of use, comfort, wearability, attractiveness, privacy, etc. Most usability studies reported positive outcomes. Monitoring HR or ECG via wearables was effective in detecting atrial fibrillation, stress response, and myocardial infarction. Glucose monitoring wearables were supportive for reducing time-in-hypoglycemia or hyperglycemia, emotional, and behavioral burden in patients with diabetes.

Conclusions/implications: Wearables have great potential for individuals to easily self-monitor cardiometabolic health. Wearables will enable nurses and nurse informaticists to track data and develop health-promoting interventions for people at risk for CMDs.

Learning outcomes: The audience will be able to identify various capabilities, usability, and impacts of wearables for individuals and nurses/nurse informaticists to monitor cardiometabolic health.

References
1) National Center for Chronic Disease Prevention and Health Promotion (2021). Health and economic costs of chronic diseases. https://www.cdc.gov/chronicdis...
2)    Chandrasekaran, R., Katthula, V., & Moustakas, E. (2020). Patterns of Use and Key Predictors for the Use of Wearable Health Care Devices by US Adults: Insights from a National Survey. Journal of medical Internet research, 22(10), e22443. https://doi.org/10.2196/22443