Jennifer J. Zwetsloot

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: Several studies support the impact of Information Communication Technology-based interventions to promote physical activity among youth [9, 10]. Despite all the studies suggesting benefits of using technology to promote healthy lifestyles among youth, little is known on how technology can be used by the entire family to encourage healthy behavior that can be sustained over long period of time. Previous studies showed that children and youth rely and are dependent upon decisions and values of their caregivers when it comes to having a healthy lifestyle [11,12]. Thus, the exploration of behavior and attitudes of the entire family are needed. Objective: To explore how the use of physical activity tracking devices (FitBit Zip™) by families in rural communities influence a) participation in physical activity; and b) perception of physical activity. Methods: Eleven families with one to three children of different ages took part in semi-structured group interviews following two weeks of using physical activity tracking devices (FitBit Zip™) as a family. The participants were asked to discuss their experience using the FitBit Zip™ as a family, motivation to be physically active, changes in their pattern of participation in those activities, level of engagement by different family members, and competitiveness with or support of each other. All interviews were voice recorded with the participants’ permission and later transcribed verbatim using pseudonyms. To analyze the data the primary investigator (IS) used open, axial, selective coding techniques. Results: Two themes appeared from the data. Changes in physical activities as a result of using FitBit Zip™ as a family was either absent (lack of interest, already active lifestyle) or minimal (small, naturally occurring changes into everyday life or expanding participation in the activities they were already involved with). However, the participants reported change in attitude and perception of physical activities and healthy lifestyle. As a result of using physical activity tracking devices, the family members reported an increased awareness of their activity level and accountability for being inactive, introduced more conversations about active lifestyle and healthy lifestyle, and changed their view of physical activity to more positive one. Conclusions: While the participation in physical activities as a result of using physical activity tracking devices (FitBit Zip™) by families in rural communities was not significantly changed, the attitude toward participating in physical activity was altered. Considering long term changes in lifestyle, the change in the attitude might have more important impact than the change in the immediate behavior.

BACKGROUND Several studies support the impact of information communication technology–based interventions to promote physical activity among youth. However, little is known on how technology can be used by the entire family to encourage healthy behavior. Previous studies showed that children and youth rely and are dependent upon the decisions and values of their caregivers when it comes to having a healthy lifestyle. Thus, the exploration of behavior and attitudes of the entire family is needed. OBJECTIVE The study aimed to explore (1) perceptions of how the use of physical activity tracking devices (Fitbit Zip) by families in rural communities influence their patterns of participation in physical activity, (2) how attitudes toward physical activity change as a result of using physical activity tracking devices as a family, and (3) what factors influence participation in physical activity among families in rural communities. METHODS A total of 11 families with 1 to 3 children of different ages (7-13 years) took part in semistructured group interviews following 2 weeks of using physical activity tracking devices (Fitbit Zip) as a family. The participants were asked to discuss their experience using the Fitbit Zip as a family, the motivation to be physically active, the changes in their pattern of participation in those activities, the level of engagement by different family members, and the factors that affected their participation. All interviews were voice-recorded with the participants’ permission and later transcribed verbatim using pseudonyms. To analyze the data, the principal investigator (IS) used open, axial, and selective coding techniques. RESULTS A total of 3 themes and several subthemes appeared from the data. The families in rural communities reported no or minimal changes in physical activities as a result of using physical activity tracking devices (Fitbit Zip) because of a lack of interest or an already active lifestyle. However, the attitude toward physical activity was altered. The family members reported an increased awareness of their activity level, introduced more conversations about active and healthy lifestyles, and changed their view of physical activity to a more positive one. The participants described the changes they were able to make and the constraining factors that stopped them from making further changes in their lifestyle. CONCLUSIONS Technology might serve as a facilitator to participation in physical activity among families. Technology can motivate the change in attitude toward active recreation. As long-term changes in lifestyle require internal motivation, the change in the attitude might have a more long-lasting impact than the change in the immediate behavior. More longitudinal studies are needed to further explore long-term change in both behavior and attitude toward physical activity. Additional exploration of constraints to participation in physical activity among families is also an important area of exploration.

Athletes and the elderly are two populations that are at an increased risk of dehydration related illness or injury. The purpose of this study was to evaluate the validity of an acoustic method to detect changes in the hydration status of athletes undergoing acute dehydration and rehydration. The presence or absence of dehydration in elderly individuals throughout the day and between days, was also examined. The assessment of water balance was conducted by measuring speed of ultrasound in the calf muscles using a through transmission method. 82 male and female collegiate athletes and 20 elderly individuals were assessed. Results revealed an average change in ultrasound velocity of 1.1 m/s per 1% of body weight lost. This demonstrates that ultrasound velocity in muscle may potentially serve as a measure of body hydration status during acute dehydration and as a diagnostic tool in the elderly. However, the ultrasound velocity measurement method used in this study is highly dependent on the positioning of the probe: even slight variation in the acoustic path results in significant changes in the measured values, which may result in unacceptable error. A solution to this problem is proposed and discussed. [NIH2R44AG042990]