Lentis/Wearable Activity Trackers

Introduction
Activity trackers have become a social and health fad. These trackers allow a user to view their physical activity and convert it into data in order to help improve their lifestyle. Users enter basic medical information about themselves and then simply wear the device on their wrist as it tracks health information like their number of steps taken in a day, heart rate over time, or even how many hours they slept. Many people would assume that these devices are only for people who exercise all of them time, but companies like Fitbit market their devices differently. In a world dominated by advertising, Fitbit, and other wearable fitness tracker companies, have incredibly targeted statements designed to impact the individual. Instead of selling their product directly, they attempt to sell a lifestyle. Often, they attempt to directly engage new customers by appealing to their desire to live healthier. Their commercials are often filled with athletic people living healthy lifestyles while wearing their product. They highlight the products features and how it can help you look and live like the people you are watching.

Remarkably, the devices seem to follow through on their promises of a healthier lifestyle. In many studies physicians who gave participants activity trackers to wear saw an increase in athletic activities and a drastic change in lifestyle. The trackers link with social media to have an even greater effect on people’s lifestyle. Many of these trackers show your recorded progress, such as steps taken that day, or total weight loss, on social media so anyone can see it. Seeing your friends progress has inspired people to work harder and make changes to their lifestyle as well, it makes getting fit and healthier a competition.

While the technology does have a large support network there are also those who are concerned with the abundance of health information available on the device. Many worry that the activity trackers do not have enough safety mechanisms in place to protect their user’s sensitive information. Other groups are skeptical of the companies that make the products. If pharmaceutical companies want to purchase health information on a large selection of users, or even on individual people, some are worried that there is not enough legal protection of the consumer and that the companies may sell the information for profit.

History
Before Fitbits and other activity trackers the height of that technology was the pedometer. These devices tracked a user's steps, however their design made for very inaccurate results. Looking at a Google word comparison of pedometer and Fitbit, shows that even before the invention of the Fitbit, pedometers, and activity trackers like it, were not very popular. With the addition of the Fitbit, and devices like it, in 2013, the activity tracker market has grown, adding many new competitors. While Fitbit owned nearly 1/3rd of the market back in 2014, companies like Fossil and Garmin have forced Fitbit’s share to almost 13%. The increase in market competitors is an indication of the popularity of the product and its market potential. Despite its significantly smaller market share Fitbit still earned $393 million this quarter. It has become so profitable that even large, well established, companies like Apple have moved into the market and gained a significant foothold. Instead of wearing just a fitness tracker, companies have increased the number of users by integrating it into other convenient places in your life.

Public Support
Wearable fitness trackers found a solid market in a country that wanted to have a healthier lifestyle. In 2014, JAMA conducted a nation-wide study that showed a 35% obesity rate in men and a 40% obesity rate in women. Findings similar to this have led to national health movements like Let’s Move and NFL Play 60 which were designed to motivate children and young adults to lead more active lifestyles. As children were educated about the importance of maintaining physical health, adults began to see fitness as a large component to a healthier lifestyle. Wearable fitness technology began to fill the role of monitoring adult well-being.

Research
Numerous studies have found multiple health benefits to the extended use of wearable fitness trackers. In a study done by Doctors Fritz and Huang of the University of Zurich, 30 participants were given activity trackers to use and to report on their habits and exercise frequency. When they first started using the devices many of the participants said things like, ““I'm a little obsessed with it. I look at it all the time … I'm always curious, like where I am at what point of the day.” (P30, 22 months)”. They couldn’t stop looking at their wrists and checking the number of steps they had. One of the major findings that became clear was “that the numerical feedback for most participants could reinforce and motivate activities”. They began wearing their tracker all of the time and doing extra work to reach their goal steps. Some participants even felt as if workouts or walks without their device was a waste since it couldn't be recorded. While many wearers continued to wear the device, there were some who stopped using it. These users found that they simply didn’t have the time to make the changes in their life to meet the goals their device set for them. Those who continued to use the trackers felt as if the devices had become integrated into their lives. Many participants said “that the use of the device had motivated or helped them make durable changes”. They allow a user to set a certain goal for themselves, and that user is rewarded with a motivational message if the task is completed, therefore reinforcing the positive nature of the goal they set. The transition of these daily goals into routine is what builds a healthy lifestyle for these users, rather than just tasks to finish.

In a study done by Pennsylvania State University users were given activity trackers, in a similar manner as the Fitz and Huang Study. They monitored the participants motivation to be active and awareness of the devices influence on their activity. Over time they found “the results indicate that more FitBit usage could lead to higher motivation to exercise, awareness of one’s activity leve”. However, they did note that 65% of their participants did not using their trackers after two weeks, and many complained that it was hard to keep track of the device when they weren't wearing it. As result of that they just ended up not wearing it at all.

Security
Wearable fitness trackers collect various types of data, acting as advanced pedometers or being able to calculate your heart rate. These devices also store personal information, like emails, physical and electronic addresses. The rapid integration of wearable activity trackers over the last few years have brought security concerns to users. Users fear their data, sensitive or not, may be compromised by a third party or misused by the company. Further concerns include what data is collected and how it is processed. Companies can argue that the data their wearable trackers are collecting don’t classify as ‘health data’, giving the company more freedom to evaluate and distribute the information without user permission. Even though the companies that produce wearable trackers do not sell the data they collect, selling is not the same as sharing or protecting. Craig Spiezel, executive director of the Online Trust Alliance (OTA), said that “data can and has been captured off fitness bands easily with $100 and a determined adversary”. Even though some of the data tracked by wearables are not enough to allow identity theft, but the breach in privacy is still a concern to consumers.

It doesn’t take a trained hacker to learn your whereabouts either. Hilts et al studied the Bluetooth privacy between major retailers of wearables. They collected Bluetooth MAC addresses from the devices and found all but the Apple Watch kept a constant MAC address. When the device is not connected to a phone it broadcasts a unique device address and geographical location, allowing anyone who can see that signal can see where you are. The Apple Watch randomizes its MAC address approximately every 10 minutes, eliminating consistent monitoring. Shopping malls that constantly look for these emitted signals and track the users’ movement from store to store, recording the data for future studies. From there, the store can sell the information to marketing agencies, shifting the blame away from the manufacturers.

For someone who knows what they are doing, getting into a wearable trackers’ Bluetooth signal is pretty easy. From there, they can connect to the mobile device it is paired with, and finally the application’s website between a cellular signal. Anywhere along the chain they can manipulate the software by placing malicious firmware in the software code the device runs on. From then, a hacker could do anything they want; denial of service, compromising device integrity, falsifying the user’s own health data, falsifying another user’s health data, abusing heal data that are intentionally shared, or stealing a user’s health data.

Social Media
Fitbit and other wearable activity tracker companies have fairly large marketing campaigns over non traditional sources, primarily through social media platforms. Much of this marketing is to maintain the image that these devices help to maintain a healthier lifestyle. Companies regularly contribute on Twitter, Facebook, and Instagram to trending topics of health and fitness and most importantly, they directly engage their users. In doing so, they seek to promote a healthier lifestyle rather than simply pushing their product. For example, in November 2017, FitBit India tweeted 38 separate messages. In these tweets, only four of them promote the technology or a new feature of their app. The rest of them are concerned with diet changes, workout tips and stress relief. This trend for social media savviness for a larger technology company is nothing new; it has been supported by numerous studies and is now one of the recommended forms of advertisements to appeal to certain demographics. Wearable tracking companies extend this ideology further by creating their own social media platforms for their consumers. FitBit and Garmin, two of the larger companies, allow users of their apps to connect with other people who use their products, promoting a sense of community and competition.

Conclusion
Portable activity trackers are direct result of a greater societal trend to live a healthier lifestyle. Many worry about the possibilities of security risks due to the abundance of health, financial, and location information stored on the devices. Despite these concerns, however, the adoption of this technology has been fairly widespread due to successful marketing and large campaigns promoting public health. There are many directions that future research into this topic could go. It would be interesting to see if there is a decline in traditional pedometers and watches due to the increased relevance of wearable activity trackers or if the marketing of a healthier lifestyle also boosts sales of the traditional devices. Additionally, much of the findings that we found focused on the 18-34 year old demographic, especially with regards to research and marketing. It would be interesting to see the roles of other demographics in developing additional features for this technology as the market continues to expand.