Digital Health Health IT Wearables

Tech troubles for older adults: Does buying a tracker require a phone upgrade first?

(Note: Having recently returned from the 2017 Connected Health Conference, the role of apps and wearables in improving health is top of mind. While attending the conference, I was fortunate to spend time with the team from RecycleHealth and learned more about the work they are doing to make wearables more accessible to underserved populations to help improve their health and fitness. The two guest bloggers who contributed this post are representatives of RecycleHealth.)

I am grateful to Sandra Rosenbluth, MS, and Lisa Gualtieri, PhD, ScM for contributing this post to my blog. Their bios appear at the end of the post.


Tracker commercials flash sporty-dressed joggers working up a sweat during a run, or muscled athletes pushing it at the gym. These fit individuals look at their wrist to check their steps, or pull out their brand new iPhone 8 or Samsung Galaxy s8 to interact with their tracker app. Advertisers have made it pretty clear that trackers (like Fitbits or Garmins) are geared toward millennials—i.e. those who are young, healthy, and have disposable incomes.

While the strategy behind this no doubt stems from a business standpoint, it leaves a large segment of people missing out on an important product that could be used to improve their health. Though designed with active youth in mind, trackers can provide benefits to many populations—particularly older adults. In 2013, Pew Research found that individuals with two or more chronic diseases are most likely to track health indicators (62%) and are most likely to say that health tracking has had a positive impact on their health (76%). And if tracking health measures is most beneficial to those with chronic diseases, it makes sense to target the population that is most likely to be managing one or more. Over 8 in 10 (80%) older adults have at least one chronic condition, and more than 7 in 10 (77%) have at least two. That’s a huge portion of the population that can benefit from these devices.

Though some older adults may find adopting new technologies more challenging, these barriers to engagement are not insurmountable. In our pilot research at Tufts University School of Medicine, we have found that many older adults are excited to try trackers—especially when provided at no cost and with some assistance getting set up. In fact, the largest obstacle we’ve encountered has nothing to do with engagement at all—it’s a tech problem.

The older adults enrolling in our studies are required to have a smartphone—which isn’t too hard to recruit for, as just over four out of ten (42%) adults ages 65 and older report owning smartphones—up from just under two in ten (18%) in 2013, according to a recent report by Pew Research.

Unfortunately, the term “smartphone” does not appear to mean the same thing to everyone. Prospective study participants come to us with Samsung phones that are three generations too old, or are using an Android phone with an unrecognizable model name. These smartphones end up having one thing in common: they are not able to sync to the tracker devices, or are not able to support downloading the tracker app. Even tablets like the iPad mini, which are occasionally brought in as hopeful alternatives, sometimes fail to work. Potential participants leave our recruitment sessions disappointed that they will not be able to participate, and with a promise to return—should they get a new phone.

This incompatibility seems unfortunate in an age where trackers are so prevalent. In March of 2016, two out of every ten (20%) of US households reported owning a tracker, a number which is expected to grow. But one has to wonder, will only the households that own the latest iPhone or Android devices be able to use trackers? If the barriers created by mismatched tech are not resolved, how can the other barriers of cost and self-efficacy be effectively addressed? How can we successfully engage older adults, who would likely benefit from tracker use more than any other segment of the population?

Sandra Rosenbluth, MS, is a digital health consultant who graduated from Tufts University with a Masters in Nutrition Communication and a Certificate in Digital Health Communication. Her passions include writing and tweeting about health, helping patients and underserved populations, and blending fun smoothies. Email: Twitter: @sanrosenb

Lisa Gualtieri, PhD, ScM. teaches at Tufts University School of Medicine and directs the Certificate Program in Digital Health Communication (which Sandra is a graduate of). She founded and runs RecycleHealth, a non-profit that provides trackers to underserved populations. Email: Twitter: @lisagualtieri

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