Feasibility and Preliminary Efficacy of Health Wearable-Based Physical Education to Improve Physical Activity and Psychosocial Beliefs among Underserved Adolescents: A Quasi-Experimental Study

Abstract

Introduction: Physical inactivity and its associated adverse health outcomes disproportionately affect underserved populations, including racial/ethnic minorities and individuals from low socioeconomic backgrounds in the United States (U.S.). During adolescence, individuals experience a crucial stage of human development as they go through puberty, during which their minds, bodies, and lifestyle habits are established. Research demonstrates that health wearables foster physical activity (PA) through effective behavior change techniques. However, there is a concerning lack of high-quality research on the potential benefits of health wearables for underserved adolescents in physical education (PE) classes. Therefore, this pilot study aims to test the feasibility of a health wearable-based PE intervention and examine the preliminary efficacy for improving PA, psychosocial beliefs, and motivation among underserved adolescents. Method: Sixth to eighth grade students (11–14 years) from a Title I school in the Midwest participated in this quasi-experimental study. Four PE classes were assigned (1:1) to the intervention group (health wearable PE condition) and the comparison group (traditional PE condition). Specifically, the intervention group employed a heart rate sensor to display students’ real-time heart rate and different activity zones through various colors. The outcomes included accelerometer-measured PA levels, as well as self-reported psychosocial beliefs and situational motivation. Feasibility outcomes were assessed using descriptive analyses to examine study progress and the acceptability of the intervention. Accelerometry and psychosocial data were collected before and after the intervention and analyzed in SPSS to observe changes in these outcomes. Results: Recruitment capability and retention benchmarks were met, with 55 out of 88 students participating and 52 students retained. Survey data collection (91%) and intervention adherence were also achieved, indicating uninterrupted delivery. However, pre-PA data collection, participant adherence, and intervention dose progression were not met. A significant interaction effect was observed, demonstrating improvements in percentage of time spent in moderate-to-vigorous PA (MVPA) for the intervention group (mean difference = 0.04), while MVPA decreased for the comparison group (mean difference = -0.04). No meaningful improvements were observed in psychosocial beliefs and situational motivation outcomes. Conclusion: The study's findings support the potential of health wearable-based PE to enhance MVPA in underserved adolescents. This study provides essential information that can assist future researchers in identifying strategies to develop more feasible ways to leverage health wearable technology for underserved adolescents in PE settings.