Exploring the role of digital health technologies in assessing functional mobility and physical activity: Insights from qualitative interviews in adults with obesity or overweight

Abstract

Background

Digital health technologies (DHTs) offer passive, objective, and continuous monitoring of difficult-to-report mobility-related behaviors like physical activity (PA) and functional mobility (FM), which are important concepts of interest in obesity-related clinical studies. This study was conducted to identify which aspects of FM/PA are meaningful to people living with obesity or overweight and establish how those concepts can be measured by passive monitoring using DHTs.

Methods

Qualitative concept elicitation interviews were conducted among 4 groups of adults (≥18 years) with obesity (body mass index [BMI] ≥30 kg/m²) and no obesity-related complications, overweight (BMI ≥27 kg/m²) with type 2 diabetes, overweight with obstructive sleep apnea, and overweight with lower-limb osteoarthritis. Two rounds of interviews were conducted to first identify the most important concepts of interest relating to FM/PA and then determine what level of change in FM and PA would be considered meaningful and important in the context of obesity treatment.

Results

A total of 48 participants were recruited for Round 1 (n = 24) and Round 2 (n = 24). The most frequently reported concepts of interest identified for FM and PA were walking on a flat surface, moderate-to-vigorous physical activity (MVPA), climbing stairs, walking uphill, and standing. All four most frequently reported concepts of FM/PA in Round 1 (MVPA, going up stairs, walking, and standing) were also considered relevant and bothersome in Round 2. The majority of the participants confirmed that measuring step count and changes in minutes of MVPA would be meaningful for them with respect to treatment for obesity.

Conclusion

People with obesity or overweight reported the ability to perform MVPA, going up stairs, walking, and standing as meaningful FM/PA outcomes. DHTs have the potential to provide relevant information about the functional status of people with obesity and could be more frequently implemented in obesity treatment studies and clinical practice.