Background/Purpose: Current evidence indicates wearable physical activity trackers could support persons with knee osteoarthritis (OA) to be more physically active. Recent empirical evidence also identifies, however, some persons with arthritis experience guilt or worry while using a wearable if they are not as active as they should be. Questions remain around how persons with knee OA experience benefits or downsides in using a physical activity wearable in their everyday lives. Better understanding of these experiences are needed if wearable technology is to be incorporated in arthritis self-management in ways that are ethically aware. Our aim was to use an ethics lens to describe a range of experiences (positive or negative) from persons with knee OA who used a wearable as part of a physical activity counselling intervention study.

Methods: This is a secondary analysis of qualitative interviews (60-90 mins) nested within a randomized controlled trial (RCT). Guided by phenomenography, we explored the experiences of persons with knee OA, following their participation in a physical activity counselling intervention. The intervention consisted of participants attending a 1.5-hour education session about physical activity, using a Fitbit Flex, and receiving 4 biweekly phone calls for activity counselling with a study physiotherapist (PT) in an 8-week period. All PTs were trained in the Brief Action Planning approach, whereby they guided participants to identify activity goals, develop an action plan, and identify barriers and solutions. Benefits or downsides in participants’ experiences of using the wearable were identified using a relational ethics lens, with attention paid to any impacts on their relationships with themselves (i.e., their self-perception) or the study PT.

Results: Interviews with 21 participants (12 females; 9 males) aged 40-82 years were analyzed. Education ranged from high school graduate (n=4) to bachelor’s degree or above (n=11). Three categories of description were identified: 1) Participants experienced their wearable as a motivating or nagging influence to be more active, depending on how freely they were able to make autonomous choices about physical activity in their everyday lives; 2) Some participants felt a sense of accomplishment from seeing progress in their wearable data, which fuelled motivation. One participant experienced negative emotions (e.g., self-blame) if his wearable data indicated physical activity goals were not met; 3) For some participants, sharing wearable data helped to build mutual trust in their relationship with the study PT. They also expressed, however, there was potential for sharing wearable data to undermine this trust if, for example, they perceived the data as inaccurate.

Conclusion: To our knowledge, this is the first qualitative study that uses a relational ethics lens to explore how persons with arthritis experienced changes in their relationship with a health professional when using a wearable during research participation. Findings also provide an early glimpse into positive and negative emotional impacts of using a wearable that can be experienced by participants with knee OA when participating in an RCT to support physical activity participation.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/experiences-of-wearable-technology-by-persons-with-knee-osteoarthritis-participating-in-a-physical-activity-counselling-intervention-study-a-relational-ethics-lens/