Associations Between Physical Activity Wearable Device Adherence, Health Outcomes, And Psychosocial Indicators Among High School Adolescents From Underserved Populations: A School-based Observational Study

PURPOSE: Wearable device (WD) use offers an opportunity for targeting insufficient physical activity (PA) among high school adolescents from underserved populations. This prospective school-based cohort study investigates whether socio-demographics, health-related outcomes, PA related behavior, and perceptions of neighborhood walkability are associated with wearable device adherence among high school adolescents from racial/ethnic minority groups. METHODS: Data was collected on a convenience sample of adolescents aged 14-18 years enrolled in a high school PE during the school day at the school gymnasium in October, prior to school-based wearable device deployment. Wearable device steps /day activity was downloaded weekly from online platform Fitabase for 6 months of the school year. Adherence (primary outcome) was defined as wearable device use for at least 30-days. Associations between self-reported PA behavior, subscales from the Neighborhood Environment Walkability Scale, health-related outcomes (anthropometrics, resting heart rate (RHR), blood pressure, single leg stance, 6-minute walk test (6-MWT)), and WD adherence were examined. RESULTS: Participants (n = 63) were 56% females, 81% in 9th grade, 73% with free/reduced lunch, 72% African-Americans, 42% Hispanics, 16% reported to be foreign born and 41% reported at least 1 foreign born parent. Of these, 73% (n = 46) synched WD with online platform weekly for at least 1 month and were categorized as WD users. There were no differences in race, ethnicity, birth-country, BMI, BP, and 6-MWT between WD and non-WD cohorts. However, while participants in WD cohort had higher RHR (76 vs. 67 bpm, p = .009), less single leg stance time (57 vs. 59 sec), reported significantly less days a week engaged in 60 minutes of MVPA (2.4 vs 4 days, p.004) and muscle strengthening exercises (3 vs 4.8 days, .004), and less team sport participation (46% vs. 71%, p = .004), participants in non-WD group perceived lower crime-safety (1.8 vs 2.13, p = .023). CONCLUSIONS: Findings suggest that future school-based deployment of wearable device and adherence of WD among racial/ethnic minority adolescents should consider in addition to PA related behavior and health outcomes, the impact of perceptions of neighborhood safety, and other social determinants of health.