Measure It Super Simple (MISS) activity tracker: (re)design of a user-friendly interface and evaluation of experiences in daily life

Figures & data

Figure 1. Schematic overview of the two designs used in this study.

Figure 2. Feedback concepts for battery life, progress to goal, and synchronization status.

Figure 3. Alternative designs for the application.

Figure 4. Overview of data collection during the 2 weeks test period. Abbreviation – 10MWT: 10-meter walking test.

Table 1. Demographics of the included participants of the develop and deliver phase.

Characteristics	Participants shape and wear location (n = 3)	Participants feedback (n = 12)	Participants app (n = 20)
Gender, male, n (%)	2 (66)	6 (50)	10 (50)
Age (year), median (range)	66 (66–74)	71 (66–77)	72.5 (65–89)
Knowledge of technology^a, median, (range)	7 (5.5–8)	7 (0–7)	6 (0–8)
Use of technology, n (%)
Smartphone	2 (66)	4 (33)	15 (75)
Computer	3 (100)	11 (92)	15 (75)
Tablet	2 (66)	6 (50)	8 (40)
Activity tracker	1 (33)	3 (25)	5 (25)

^aParticipant could score their knowledge of technology between zero and ten. Zero representing no knowledge and 10 a lot of knowledge.

Table 2. Main finding of the development and delivery phase.

Characteristic	Main findings	Remarks
Design of the activity tracker	Activity tracker should be round Activity tracker should be worn on one’s pants pocket with a clip Clip should be long enough Clip should be sturdy Clip should be easy to put on	A round shape was technically not possible, therefore a square shape was chosen
Feedback system on the activity tracker	Colour of the hardware should be neutral Battery level on activity tracker Colour of lights on activity tracker is not important Feedback as simple as possible No feedback about synchronization Feedback activation of activity tracker by tapping on tracker	It was technically not possible to activate the activity tracker by tapping, therefore the activity tracker will be activated by shaking
Feedback by an app	Good user-flow is needed Original design was preferred App should work both clicking as well as swiping Additional information screen is needed

Table 3. Demographics of the included participants during the 2-week testing period.

Characteristics	Participants (n = 28)
Gender, male, n (%)	11 (39)
Age (year), median (range)	69 (65–78)
Education, n (%)
Secondary Education	12 (40)
College	14 (50)
University	3 (10)
Living situation, n (%)
Living alone	2 (6)
Living with a partner	23 (81)
Living with partner and child(ren)	4 (13)
Housing situation, n (%)
Single-family dwelling	28 (100)
Hobbies^a, n (%)
Active	48 (47)
Passive	54 (53)
Use of technology, n (%)
Computer	27 (96)
Tablet	24 (86)
Activity tracker	11 (39)
Operating systems smartphone, n (%)
Apple	12 (43)
Android	17 (57)

^aEach participant was asked to name four hobbies, and each activity was categorised as either active or passive. Based on the MET score, a MET score >3 was considered active [38,39].

Table 4. Results of the interviews presented in categories based on a previously developed framework.

Category	Main findings	Quote	Icon
Purchase of the activity tracker	Those who show interest in buying the MISS activity say they want to buy it in a healthcare setting. Expect that the healthcare setting in question will have expertise in activity trackers. The app should also work on a tablet.	“I think I would go to a company which is specialised and has sufficient background knowledge about it [the activity tracker] so I would go to a pharmacy”. Female, 69 years	[40]
Instruction and use	Manual was clear. Help desk provided a reassuring feeling.	“Yes, I think everybody should be able to install it I think, I can’t decide for everyone but, on average, yes”. Female, 67 years “I can imagine that it is easy to have a helpdesk if you can’t figure it out you would want a helpdesk, right?” Male, 75 years	[41]
Characteristics of the activity tracker	Activity tracker was easy to use. Goal setting was clear. Lights on the activity tracker were not of additional value. Step count and active minutes were sufficient as variables. Preference to read data on the app. No problems wearing the activity tracker.	“No, no, I just need step count and active minutes every day and that was sufficient for me”. Female, 76 years	[42]
Correct functioning	Overall, no technical problems. Experiences with the validity of the activity tracker are variable.	“Yes, sometimes it said it was offline then I had to restart it. No, I had no problems with it”. Female, 76 years	[43]
Privacy	No privacy issues. A few participants felt they had to be especially active because they knew someone could see their results.	“A kind of motivation that you would say, wow that lady walked a lot!” Female, 68 years	[44]
Use of the activity tracker	Data was checked multiple times per day. Activity tracker was used to gain insight into physical activity levels. There is added value in sharing their data with healthcare professionals. Participants expect that their healthcare professional will initiate the use of their tracker’s data and that they will integrate this data in their treatment.	“I checked every day how much I did the day before and sometime when I walked or cycled, I checked when I was back how many steps that has contributed”. Male, 73 years “It depends why you are with a physiotherapist, if you are there for your arm or something like that, I think it won’t be added value but maybe for the movement mechanism and your back it might be of added value”. Male, 71 years	[45]
Interest in feedback	Activity tracker provides insight into physical activity level. Participants who were not motivated by the activity trackers said that they would be if they saw that they were not active enough.	“If I didn’t walk enough, I think it might motivate me, but I know now that I am active the whole day”. Female, 76 years	[46]

Table

Variable^a		Considered as critical	References
1	Measurements are valid and reliable	Yes (algorithm)	[10,12,15,19–22]
2	Activity tracker measures step count	Yes (algorithm)	[10,19,20,15,21,23–25]
3	Activity tracker measures burned calories	No	[10,19,21–24,28]
4	Activity tracker measures sleep	No	[10,19,12,15,28–30]
5	Activity tracker measures distance walked	Yes (algorithm)	[10,15,21,30]
6	Activity tracker measures active minutes	Yes (algorithm)	[10,21,30]
7	Activity tracker measures posture	No	[10,22]
8	Activity tracker measure swimming	No	[10,25]
9	Activity tracker measures cycling	Yes (algorithm)	[10,25]
10	Activity tracker measure heartrate	No	[10,19,28,30,31]
11	Activity tracker measures blood pressure	No	[10,28,26,30,31]
12	Activity tracker measures walk speed	No	[10]
13	Activity tracker has option to track food and beverage intake	No	[10,12,23,24,31]
14	Activity trackers provides real-time feedback	Yes	[10]
15	Activity tracker provides feedback in a day overview	Yes	[10,19,23,11]
16	Activity tracker provides feedback in a week overview	Yes	[10]
17	Feedback on the activity tracker itself	Yes	[10,19,23,11,27]
18	Activity tracker is compatible with a smartphone	Yes	[10,27]
19	Activity tracker is compatible with a computer	Yes	[10,27]
20	Feedback is shown on the activity tracker with a maximum of one act	Yes	[10,28]
21	Activity tracker provides positive motivating messages	Yes	[10,12,22–24,28,29,27,13]
22	Activity tracker provides negative messages	No	[10]
23	Text on the activity tracker is readable	Yes	[10,28,29]
24	Buttons on the activity tracker are not too small (operable with one finger without pushing another button)	Yes	[10,15,25,28,29]
25	Possibility to set an individual activity goal	No	[10,12,24,28,29,27,32]
26	Possibility for physical help when installing the activity tracker	No	[10,28,31,13]
27	No problems with logging in (not more than one attempt)	Yes	[10,21,28,29]
28	No problems with synchronizing (not more than one attempt)	Yes	[10,15,21,23,28,29]
29	Data can be shared	Yes	[10,21,22,26,32]
30	The user can decide what data to share and to whom	Yes	[10,21,25,30,27,32]
31	Data is not automatically shared with companies	Yes	[10]
32	A manual is delivered with the activity tracker	Yes	[10,15,28,13]
33	Dutch language is available on the activity tracker and interface	Yes	[10,25]
34	Manual in Dutch language	No	[10,25]
35	Activity tracker should be small (trouser pocket size)	No	[10]
36	Activity tracker can be attached with a clip	No	[10,25]
37	Activity tracker can be worn on trousers, pocket, or bra	No	[10,27,13]
38	Activity tracker can be worn on wrist	No	[10,15,27,13]
39	Activity tracker can be independently put on	Yes	[10,28]
40	Activity tracker is made from comfortable material	Yes	[10,22,28,29]
41	Activity tracker should not be visible	No	[10,19,23,25,28,29,27]
42	Activity tracker should be fashionable	No	[10,22,23,28]
43	Activity tracker can be charged by an electric socket	Yes	[10]
44	Battery life lasts 2 weeks	Yes	[10,19,15]
45	Activity tracker is waterproof	Yes	[10,19,12,15,21,22,28,27]
46	Activity tracker is damage proof (will not break after one fall of 1.5-m height)	Yes	[10,25,13]
47	Activity tracker is compatible with iOS	Yes	[10,23,27]
48	Activity tracker runs on current and new software version of smartphones	Yes	[10]
49	Step count should be visible on the activity tracker	Yes	[10]
50	Interface uses graphs and symbols	No	[10]
51	Activity tracker measures intensity of movements	No	[10,25]
52	Activity tracker measures walking stairs	No	[10,25]
53	Activity tracker shows (on tracker or app) when the battery is almost empty	Yes	[10,25]

^aVariables based on 48 interviews with people with a chronic disease [10] (Chronic obstructive pulmonary disease (COPD), cardiovascular disease, chronic pain, oncology, osteoarthritis, and diabetes mellitus) who received treatment from a physiotherapist. Variables were propounded and confirmed with four experts in wearables.

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Data availability statement

The data that support the findings of this study are available from the corresponding author, upon reasonable request.