Behavioral economics, wearable devices, and cooperative games: results from a population-based intervention to increase physical activity

Background: Health care literature supports the development of accessible interventions that integrate behavioral economics, wearable devices, principles of evidence-based behavior change, and community support. However, there are limited real-world examples of large scale, population-based, member-driven reward platforms. Subsequently, a paucity of outcome data exists and health economic effects remain largely theoretical. To complicate matters, an emerging area of research is defining the role of Superusers, the small percentage of unusually engaged digital health participants who may influence other members. Objective: The objective of this preliminary study is to analyze descriptive data from GOODcoins, a self-guided, free-to-consumer engagement and rewards platform incentivizing walking, running and cycling. Registered members accessed the GOODcoins platform through PCs, tablets or mobile devices, and had the opportunity to sync wearables to track activity. Following registration, members were encouraged to join gamified group challenges and compare their progress with that of others. As members met challenge targets, they were rewarded with GOODcoins, which could be redeemed for planet- or people-friendly products. Methods: Outcome data were obtained from the GOODcoins custom SQL database. The reporting period was December 1, 2014 to May 1, 2015. Descriptive self-report data were analyzed using MySQL and MS Excel. Results: The study period includes data from 1298 users who were connected to an exercise tracking device. Females consisted of 52.6% (n=683) of the study population, 33.7% (n=438) were between the ages of 20-29, and 24.8% (n=322) were between the ages of 30-39. 77.5% (n=1006) of connected and active members met daily-recommended physical activity guidelines of 30 minutes, with a total daily average activity of 107 minutes (95% CI 90, 124). Of all connected and active users, 96.1% (n=1248) listed walking as their primary activity. For members who exchanged GOODcoins, the mean balance was 4,000 (95% CI 3850, 4150) at time of redemption, and 50.4% (n=61) of exchanges were for fitness or outdoor products, while 4.1% (n=5) were for food-related items. Participants were most likely to complete challenges when rewards were between 201-300 GOODcoins. Conclusions: The purpose of this study is to form a baseline for future research. Overall, results indicate that challenges and incentives may be effective for connected and active members, and may play a role in achieving daily-recommended activity guidelines. Registrants were typically younger, walking was the primary activity, and rewards were mainly exchanged for fitness or outdoor products. Remaining to be determined is whether members were already physically active at time of registration and are representative of healthy adherers, or were previously inactive and were incentivized to change their behavior. As challenges are gamified, there is an opportunity to investigate the role of superusers and healthy adherers, impacts on behavioral norms, and how cooperative games and incentives can be leveraged across stratified populations. Study limitations and future research agendas are discussed.

Individualized arrhythmia detection with ECG signals from wearable devices

Low cost pervasive electrocardiogram (ECG) monitors is changing how sinus arrhythmia are diagnosed among patients with mild symptoms. With the large amount of data generated from long-term monitoring, come new data science and analytical challenges. Although traditional rule-based detection algorithms still work on relatively short clinical quality ECG, they are not optimal for pervasive signals collected from wearable devices - they don't adapt to individual difference and assume accurate identification of ECG fiducial points. To overcome these short-comings of the rule-based methods, this paper introduces an arrhythmia detection approach for low quality pervasive ECG signals. To achieve the robustness needed, two techniques were applied. First, a set of ECG features with minimal reliance on fiducial point identification were selected. Next, the features were normalized using robust statistics to factors out baseline individual differences and clinically irrelevant temporal drift that is common in pervasive ECG. The proposed method was evaluated using pervasive ECG signals we collected, in combination with clinician validated ECG signals from Physiobank. Empirical evaluation confirms accuracy improvements of the proposed approach over the traditional clinical rules.

A novel context ontology to facilitate interoperation of semantic services in environments with wearable devices

The LifeWear-Mobilized Lifestyle with Wearables (Lifewear) project attempts to create Ambient Intelligence (AmI) ecosystems by composing personalized services based on the user information, environmental conditions and reasoning outputs. Two of the most important benefits over traditional environments are 1) take advantage of wearable devices to get user information in a nonintrusive way and 2) integrate this information with other intelligent services and environmental sensors. This paper proposes a new ontology composed by the integration of users and services information, for semantically representing this information. Using an Enterprise Service Bus, this ontology is integrated in a semantic middleware to provide context-aware personalized and semantically annotated services, with discovery, composition and orchestration tasks. We show how these services support a real scenario proposed in the Lifewear project.

An Internet of Things approach for managing smart services provided by wearable devices.

The Internet of Things (IoT) is growing at a fast pace with new devices getting connected all the time. A new emerging group of these devices are the wearable devices, and Wireless Sensor Networks are a good way to integrate them in the IoT concept and bring new experiences to the daily life activities. In this paper we present an everyday life application involving a WSN as the base of a novel context-awareness sports scenario where physiological parameters are measured and sent to the WSN by wearable devices. Applications with several hardware components introduce the problem of heterogeneity in the network. In order to integrate different hardware platforms and to introduce a service-oriented semantic middleware solution into a single application, we propose the use of an Enterprise Service Bus (ESB) as a bridge for guaranteeing interoperability and integration of the different environments, thus introducing a semantic added value needed in the world of IoT-based systems. This approach places all the data acquired (e.g., via Internet data access) at application developers disposal, opening the system to new user applications. The user can then access the data through a wide variety of devices (smartphones, tablets, computers) and Operating Systems (Android, iOS, Windows, Linux, etc.).

Integration of wearable devices in a wireless sensor network for an e-health application

Applications based on Wireless Sensor Networks for Internet of Things scenarios are on the rise. The multiple possibilities they offer have spread towards previously hard to imagine fields, like e-health or human physiological monitoring. An application has been developed for its usage in scenarios where data collection is applied to smart spaces, aiming at its usage in fire fighting and sports. This application has been tested in a gymnasium with real, non-simulated nodes and devices. A Graphic User Interface has been implemented to suggest a series of exercises to improve a sportsman/woman s condition, depending on the context and their profile. This system can be adapted to a wide variety of e-health applications with minimum changes, and the user will interact using different devices, like smart phones, smart watches and/or tablets.

Development of a human movement monitoring system based on wearable devices

It is essential to remotely and continuously monitor the movements of individuals in many social areas, for example, taking care of aging people, physical therapy, athletic training etc. Many methods have been used, such as video record, motion analysis or sensor-based methods. Due to the limitations in remote communication, power consumption, portability and so on, most of them are not able to fulfill the requirements. The development of wearable technology and cloud computing provides a new efficient way to achieve this goal. This paper presents an intelligent human movement monitoring system based on a smartwatch, an Android smartphone and a distributed data management engine. This system includes advantages of wide adaptability, remote and long-term monitoring capacity, high portability and flexibility. The structure of the system and its principle are introduced. Four experiments are designed to prove the feasibility of the system. The results of the experiments demonstrate the system is able to detect different actions of individuals with adequate accuracy.

Influence of body weight support on wearable devices reproducing normal gait

Oral presentation en ESMAC 2015

A paradigm shift:alternative interaction techniques for use with mobile & wearable devices

Desktop user interface design originates from the fact that users are stationary and can devote all of their visual resource to the application with which they are interacting. In contrast, users of mobile and wearable devices are typically in motion whilst using their device which means that they cannot devote all or any of their visual resource to interaction with the mobile application -- it must remain with the primary task, often for safety reasons. Additionally, such devices have limited screen real estate and traditional input and output capabilities are generally restricted. Consequently, if we are to develop effective applications for use on mobile or wearable technology, we must embrace a paradigm shift with respect to the interaction techniques we employ for communication with such devices.This paper discusses why it is necessary to embrace a paradigm shift in terms of interaction techniques for mobile technology and presents two novel multimodal interaction techniques which are effective alternatives to traditional, visual-centric interface designs on mobile devices as empirical examples of the potential to achieve this shift.

Heterogeneous error-resilient scheme for spectral analysis in ultra-low power wearable electrocardiogram devices

Wearable devices performing advanced bio-signal analysis algorithms are aimed to foster a revolution in healthcare provision of chronic cardiac diseases. In this context, energy efficiency is of paramount importance, as long-term monitoring must be ensured while relying on a tiny power source. Operating at a scaled supply voltage, just above the threshold voltage, effectively helps in saving substantial energy, but it makes circuits, and especially memories, more prone to errors, threatening the correct execution of algorithms. The use of error detection and correction codes may help to protect the entire memory content, however it incurs in large area and energy overheads which may not be compatible with the tight energy budgets of wearable systems. To cope with this challenge, in this paper we propose to limit the overhead of traditional schemes by selectively detecting and correcting errors only in data highly impacting the end-to-end quality of service of ultra-low power wearable electrocardiogram (ECG) devices. This partition adopts the protection of either significant words or significant bits of each data element, according to the application characteristics (statistical properties of the data in the application buffers), and its impact in determining the output. The proposed heterogeneous error protection scheme in real ECG signals allows substantial energy savings (11% in wearable devices) compared to state-of-the-art approaches, like ECC, in which the whole memory is protected against errors. At the same time, it also results in negligible output quality degradation in the evaluated power spectrum analysis application of ECG signals.

Contribution towards intelligent service management in wearable and ubiquitous devices

Hoy en día asistimos a un creciente interés por parte de la sociedad hacia el cuidado de la salud. Esta afirmación viene apoyada por dos realidades. Por una parte, el aumento de las prácticas saludables (actividad deportiva, cuidado de la alimentación, etc.). De igual manera, el auge de los dispositivos inteligentes (relojes, móviles o pulseras) capaces de medir distintos parámetros físicos como el pulso cardíaco, el ritmo respiratorio, la distancia recorrida, las calorías consumidas, etc. Combinando ambos factores (interés por el estado de salud y disponibilidad comercial de dispositivos inteligentes) están surgiendo multitud de aplicaciones capaces no solo de controlar el estado actual de salud, también de recomendar al usuario cambios de hábitos que lleven hacia una mejora en su condición física. En este contexto, los llamados dispositivos llevables (weareables) unidos al paradigma de Internet de las cosas (IoT, del inglés Internet of Things) permiten la aparición de nuevos nichos de mercado para aplicaciones que no solo se centran en la mejora de la condición física, ya que van más allá proponiendo soluciones para el cuidado de pacientes enfermos, la vigilancia de niños o ancianos, la defensa y la seguridad, la monitorización de agentes de riesgo (como bomberos o policías) y un largo etcétera de aplicaciones por llegar. El paradigma de IoT se puede desarrollar basándose en las existentes redes de sensores inalámbricos (WSN, del inglés Wireless Sensor Network). La conexión de los ya mencionados dispositivos llevables a estas redes puede facilitar la transición de nuevos usuarios hacia aplicaciones IoT. Pero uno de los problemas intrínsecos a estas redes es su heterogeneidad. En efecto, existen multitud de sistemas operativos, protocolos de comunicación, plataformas de desarrollo, soluciones propietarias, etc. El principal objetivo de esta tesis es realizar aportaciones significativas para solucionar no solo el problema de la heterogeneidad, sino también de dotar de mecanismos de seguridad suficientes para salvaguardad la integridad de los datos intercambiados en este tipo de aplicaciones. Algo de suma importancia ya que los datos médicos y biométricos de los usuarios están protegidos por leyes nacionales y comunitarias. Para lograr dichos objetivos, se comenzó con la realización de un completo estudio del estado del arte en tecnologías relacionadas con el marco de investigación (plataformas y estándares para WSNs e IoT, plataformas de implementación distribuidas, dispositivos llevables y sistemas operativos y lenguajes de programación). Este estudio sirvió para tomar decisiones de diseño fundamentadas en las tres contribuciones principales de esta tesis: un bus de servicios para dispositivos llevables (WDSB, Wearable Device Service Bus) basado en tecnologías ya existentes tales como ESB, WWBAN, WSN e IoT); un protocolo de comunicaciones inter-dominio para dispositivos llevables (WIDP, Wearable Inter-Domain communication Protocol) que integra en una misma solución protocolos capaces de ser implementados en dispositivos de bajas capacidades (como lo son los dispositivos llevables y los que forman parte de WSNs); y finalmente, la tercera contribución relevante es una propuesta de seguridad para WSN basada en la aplicación de dominios de confianza. Aunque las contribuciones aquí recogidas son de aplicación genérica, para su validación se utilizó un escenario concreto de aplicación: una solución para control de parámetros físicos en entornos deportivos, desarrollada dentro del proyecto europeo de investigación “LifeWear”. En este escenario se desplegaron todos los elementos necesarios para validar las contribuciones principales de esta tesis y, además, se realizó una aplicación para dispositivos móviles por parte de uno de los socios del proyecto (lo que contribuyó con una validación externa de la solución). En este escenario se usaron dispositivos llevables tales como un reloj inteligente, un teléfono móvil con sistema operativo Android y un medidor del ritmo cardíaco inalámbrico capaz de obtener distintos parámetros fisiológicos del deportista. Sobre este escenario se realizaron diversas pruebas de validación mediante las cuales se obtuvieron resultados satisfactorios. ABSTRACT Nowadays, society is shifting towards a growing interest and concern on health care. This phenomenon can be acknowledged by two facts: first, the increasing number of people practising some kind of healthy activity (sports, balanced diet, etc.). Secondly, the growing number of commercial wearable smart devices (smartwatches or bands) able to measure physiological parameters such as heart rate, breathing rate, distance or consumed calories. A large number of applications combining both facts are appearing. These applications are not only able to monitor the health status of the user, but also to provide recommendations about routines in order to improve the mentioned health status. In this context, wearable devices merged with the Internet of Things (IoT) paradigm enable the proliferation of new market segments for these health wearablebased applications. Furthermore, these applications can provide solutions for the elderly or baby care, in-hospital or in-home patient monitoring, security and defence fields or an unforeseen number of future applications. The introduced IoT paradigm can be developed with the usage of existing Wireless Sensor Networks (WSNs) by connecting the novel wearable devices to them. In this way, the migration of new users and actors to the IoT environment will be eased. However, a major issue appears in this environment: heterogeneity. In fact, there is a large number of operating systems, hardware platforms, communication and application protocols or programming languages, each of them with unique features. The main objective of this thesis is defining and implementing a solution for the intelligent service management in wearable and ubiquitous devices so as to solve the heterogeneity issues that are presented when dealing with interoperability and interconnectivity of devices and software of different nature. Additionally, a security schema based on trust domains is proposed as a solution to the privacy problems arising when private data (e.g., biomedical parameters or user identification) is broadcasted in a wireless network. The proposal has been made after a comprehensive state-of-the-art analysis, and includes the design of a Wearable Device Service Bus (WDSB) including the technologies collected in the requirement analysis (ESB, WWBAN, WSN and IoT). Applications are able to access the WSN services regardless of the platform and operating system where they are running. Besides, this proposal also includes the design of a Wearable Inter-Domain communication Protocols set (WIDP) which integrates lightweight protocols suitable to be used in low-capacities devices (REST, JSON, AMQP, CoAP, etc...). Furthermore, a security solution for service management based on a trustworthy domains model to deploy security services in WSNs has been designed. Although the proposal is a generic framework for applications based on services provided by wearable devices, an application scenario for testing purposes has been included. In this validation scenario it has been presented an autonomous physical condition performance system, based on a WSN, bringing the possibility to include several elements in an IoT scenario: a smartwatch, a physiological monitoring device and a smartphone. In summary, the general objective of this thesis is solving the heterogeneity and security challenges arising when developing applications for WSNs and wearable devices. As it has been presented in the thesis, the solution proposed has been successfully validated in a real scenario and the obtained results were satisfactory.

A study on situational awareness security and privacy of wearable health monitoring devices

Situational Awareness provides a user centric approach to security and privacy. The human factor is often recognised as the weakest link in security, therefore situational perception and risk awareness play a leading role in the adoption and implementation of security mechanisms. In this study we assess the understanding of security and privacy of users in possession of wearable devices. The findings demonstrate privacy complacency, as the majority of users trust the application and the wearable device manufacturer. Moreover the survey findings demonstrate a lack of understanding of security and privacy by the sample population. Finally the theoretical implications of the findings are discussed.

Under the skin: Wearable technology futures

Artist statement – Artisan Gallery I have a confession to make… I don’t wear a FitBit, I don’t want an Apple Watch and I don’t like bling LED’s. But, what excites me is a future where ‘wearables’ are discreet, seamless and potentially one with our body. Burgeoning E-textiles research will provide the ability to inconspicuously communicate, measure and enhance human health and well-being. Alongside this, next generation wearables arguably will not be worn on the body, but rather within the body…under the skin. ‘Under the Skin’ is a polemic piece provoking debate on the future of wearables – a place where they are not overt, not auxiliary and perhaps not apparent. Indeed, a future where wearables are under the skin or one with our apparel. And, as underwear closets the skin and is the most intimate and cloaked apparel item we wear, this work unashamedly teases dialogue to explore how wearables can transcend from the overt to the unseen. Context Wearable Technology, also referred to as wearable computing or ‘wearables’, is an embryonic field that has the potential to unsettle conventional notions as to how technology can interact, enhance and augment the human body. Wearable technology is the next-generation for ubiquitous consumer electronics and ‘Wearables’ are, in essence, miniature electronic devices that are worn by a person, under clothing, embedded within clothing/textiles, on top of clothing, or as stand-alone accessories/devices. This wearables market is predicted to grow somewhere between $30-$50 billion in the next 5 years (Credit Suisse, 2013). The global ‘wearables’ market, which is emergent in phase, has forecasted predictions for vast consumer revenue with the potential to become a significant cross-disciplinary disruptive space for designers and entrepreneurs. For Fashion, the field of wearables is arguably at the intersection of the second and third generation for design innovation: the first phase being purely decorative with aspects such as LED lighting; the second phase consisting of an array of wearable devices, such as smart watches, to communicate areas such as health and fitness, the third phase involving smart electronics that are woven into the textile to perform a vast range of functions such as body cooling, fabric colour change or garment silhouette change; and the fourth phase where wearable devices are surgically implanted under the skin to augment, transform and enhance the human body. Whilst it is acknowledged the wearable phases are neither clear-cut nor discreet in progression and design innovation can still be achieved with first generation decorative approaches, the later generation of technology that is less overt and at times ‘under the skin’ provides a uniquely rich point for design innovation where the body and technology intersect as one. With this context in mind, the wearable provocation piece ‘Under the Skin’ provides a unique opportunity for the audience to question and challenge conventional notions that wearables need to be a: manifest in nature, b: worn on or next to the body, and c: purely functional. The piece ‘Under the Skin’ is informed by advances in the market place for wearable innovation, such as: the Australian based wearable design firm Catapult with their discreet textile biometric sports tracking innovation, French based Spinali Design with their UV app based textile senor to provide sunburn alerts, as well as opportunities for design technology innovation through UNICEF’s ‘Wearables for Good’ design challenge to improve the quality of life in disadvantaged communities. Exhibition As part of Artisan’s Wearnext exhibition, the work was on public display from 25 July to 7 November 2015 and received the following media coverage: WEARNEXT ONLINE LISTINGS AND MEDIA COVERAGE: http://indulgemagazine.net/wear-next/ http://www.weekendnotes.com/wear-next-exhibition-gallery-artisan/ http://concreteplayground.com/brisbane/event/wear-next_/ http://www.nationalcraftinitiative.com.au/news_and_events/event/48/wear-next http://bneart.com/whats-on/wear-next_/ http://creativelysould.tumblr.com/post/124899079611/creative-weekend-art-edition http://www.abc.net.au/radionational/programs/breakfast/smartly-dressed-the-future-of-wearable-technology/6744374 http://couriermail.newspaperdirect.com/epaper/viewer.aspx RADIO COVERAGE http://www.abc.net.au/radionational/programs/breakfast/wear-next-exhibition-whats-next-for-wearable-technology/6745986 TELEVISION COVERAGE http://www.abc.net.au/radionational/programs/breakfast/wear-next-exhibition-whats-next-for-wearable-technology/6745986 https://au.news.yahoo.com/video/watch/29439742/how-you-could-soon-be-wearing-smart-clothes/#page1

Mobile Wearable Communications

This special issue provides the latest research and development on wireless mobile wearable communications. According to a report by Juniper Research, the market value of connected wearable devices is expected to reach $1.5 billion by 2014, and the shipment of wearable devices may reach 70 million by 2017. Good examples of wearable devices are the prominent Google Glass and Microsoft HoloLens. As wearable technology is rapidly penetrating our daily life, mobile wearable communication is becoming a new communication paradigm. Mobile wearable device communications create new challenges compared to ordinary sensor networks and short-range communication. In mobile wearable communications, devices communicate with each other in a peer-to-peer fashion or client-server fashion and also communicate with aggregation points (e.g., smartphones, tablets, and gateway nodes). Wearable devices are expected to integrate multiple radio technologies for various applications' needs with small power consumption and low transmission delays. These devices can hence collect, interpret, transmit, and exchange data among supporting components, other wearable devices, and the Internet. Such data are not limited to people's personal biomedical information but also include human-centric social and contextual data. The success of mobile wearable technology depends on communication and networking architectures that support efficient and secure end-to-end information flows. A key design consideration of future wearable devices is the ability to ubiquitously connect to smartphones or the Internet with very low energy consumption. Radio propagation and, accordingly, channel models are also different from those in other existing wireless technologies. A huge number of connected wearable devices require novel big data processing algorithms, efficient storage solutions, cloud-assisted infrastructures, and spectrum-efficient communications technologies.

User Effects on Wearable Conformal SCMR System

The performance of a compact, wearable Conformal Strongly Coupled Magnetic Resonance (CSCMR) system is studied when the antenna is in the air and is worn on a user’s arm. The wireless powering system consists of the receiver and load elements designed on a printed circuit board that is attached to a polyester fabric band. The wearable antenna achieves high efficiency, has a small volume, and can be easily printed on substrates. Although the user effect on mobile terminal antennas has been studied in detail, absorption losses in wearable antennas have not been widely investigated. Our results show that efficiency of the antenna in free space is 70% and on a user’s arm is 50%. Human tissue in the close proximity of our wearable Conformal SCMR caused a decrease in radiated efficiency and total efficiency. This undesired degradation in antenna efficiency might be attributed to body loss and absorption losses. Our findings can be used as a reference for future studies on wearable devices and their applications, such as health and sports monitoring.

Sustaining safety and mobility amongst older adults : the multilevel older driver self-regulation model

This multidisciplinary research advanced the current understanding of self-regulation – a critical component in safe and sustainable mobility for older adults. It investigates the sociodemographic and psychosocial factors that underlies older adults' self-regulation, and examines their travel behaviours using a combination of self-report, in-vehicle and wearable devices. This research developed a novel theoretical model that significantly predicts self-regulation and objectively driving behaviours among older drivers.