Introduction
Accelerometers are now ubiquitous in physical activity research. Device acceptability and protocol are critical to rigorous measurement and are a particular concern with children. However, few studies report pragmatic, qualitative information to improve accelerometer wear protocols. This qualitative study reports child and parent experiences of the ActiGraph WGT3X-BT accelerometer, as used in the ACTIWEB-PA trial.
Methods
The ACTIWEB-PA pilot randomized controlled trial tested a physical activity intervention in 41 children aged 8-11 years. Children wore the ActiGraph on their right hip for 7 days at baseline and again at 12 weeks. Interviews with children and parents were conducted at 12 weeks and transcribed. Dedoose software was used to code and identify key themes regarding device comfort, usability, and suggestions for improvement.
Results
Thirty-four child-parent pairs completed the interview (83% of sample). Children were 9.35±0.98 years old; 52.9% were female, and among parents, 85.3% were mothers. While children generally found the device unobtrusive, several reported discomfort, particularly related to waist placement. Common issues included the device riding up during physical activity and the belt slipping during the day, causing irritation and itchiness. As one child noted, "It got in the way when I was running; it kept going up and down." Parents also faced challenges in ensuring their children wore the device consistently. Despite these difficulties, many children enjoyed the social aspect of wearing the device, often viewing it as a "badge of participation" in a research study, with one child sharing, “I liked showing it off at school.” However, some parents observed that children’s initial enthusiasm waned over time. Suggestions for improvement included offering the belt in a variety of colors, integrating the device with smartphone apps for easier wear-time logging, redesigning the belt for greater comfort and security, and considering a wrist-worn version.
Conclusions
The accelerometer was generally well-tolerated by children, but discomfort related to waist placement and belt design was common. These issues, along with declining engagement, suggest improvements to hip-worn accelerometer comfort and usability are overdue. A more secure, comfortable belt or attachment system, as well as fun customization options, could enhance user experience, sustain engagement, and improve data completeness in future studies with children.