Wearables Among the Invincibles – Shaping the Future of Population Health

Wearable sensing devices are widely accepted and utilized in young adult populations (a.k.a. the “Invincibles”). The use of wearable technologies that collect personal health information introduce new ethical issues that are currently under discussion amongst members of the CORE (Connected and Open Research Ethics). The CORE initiative was launched in 2015 at UC San Diego bringing together researchers, IRB members, study participants and others who are interested in research ethics and the intersect with emerging tech. The CORE initiative aims to bridge the gap between researchers using digital health technologies and the ethics review boards charged with protecting research participants. The CORE community can exchange ideas, ask questions and share resources and expertise related to the ethical and regulatory implications of digital/mobile health research. Information about the CORE Network, Forum and Resource Library can be found here.

Who are the “Invincibles”?
In the healthcare world, young adults who are 18-34 years of age are known as “Invincibles”. Invincibles comprise the generation defined by a lower interest in buying health insurance – possibly due to their young age and relative good health; yet, also because they find healthcare to be unaffordable and inaccessible.

Although access to healthcare services is a harsh reality for many people across all age groups, the Invincibles will be influencers of future health services. For example, TechCrunch reported that Invicibles are more interested in health-related wearables and apps and that about 30% will be wearable users in 2017. This interest in health and self-monitoring has given rise to movements like DIY Health and Quantified Self where health-related data (e.g. steps, heart rate, sleep, mental health) are routinely tracked. Wearable devices and mobile apps are creating the potential for consumers to have direct access to personal analytics that can be used to make sense of their health, facilitate preventive care and aid in the management of ongoing illness.

Can Wearables Improve Health?
Wearable tech and mobile apps are increasingly being used in behavioral and biomedical research . Moreover, data generated from these tools are beginning to inform clinical care. Regardless of the clinical care or research applications, there are opportunities and obstacles that must be addressed before widespread adoption. Dr. Camille Nebeker, Assistant Professor at UC San Diego in Family Medicine and Public Health is exploring the ethical dimensions of research studies that utilize emerging technologies (e.g., wearable sensors, mobile apps) that gather personal health data. Needless to say, there are ethical and regulatory concerns associated with wearable/digital/mobile technologies that need to be better understood.

What is the future of health for the Invincibles?
Research using passive sensors and digital strategies to observe and/or intervene with individual and population health is in its infancy. It is anticipated that wearable technologies will engage people in ways that may improve health communication and enhanced self-management , however more research is needed in this area to begin to address the future health needs of the Invincibles. The CORE initiative is focused on assisting researchers who are designing digital/mobile health research studies and, the IRBs who are charged with evaluating study risks and benefits. We want to hear from those of you who have questions about how to do this research and/or who are willing to share your expertise and lessons learned. Share your comments below or join the conversation on this and other 21st century research topics by signing up for the CORE Network here.

Written by Rubi Linares-Orozco, MAS, CCRP, CIP
Research Assistant, UC San Diego CORE


1 https://www.washingtonpost.com/opinions/five-myths-about-young-invincibles/2013/11/26/7caa1dea-5208-11e3-9fe0-fd2ca728e67c_story.html?
2 http://health.younginvincibles.org/
3 https://techcrunch.com/2016/12/21/u-s-wearable-market-is-doing-much-worse-than-expected/
4 http://c-hit.org/2015/07/09/millennials-embrace-mobile-health-and-fitness-apps/
5 https://www.diyhealth.org/
6 Nafus, D., & Sherman, J. (2014). Big Data, Big Questions| This One Does Not Go Up To 11: The Quantified Self Movement as an Alternative Big Data Practice. International Journal Of Communication, 8, 11. Retrieved from http://ijoc.org/index.php/ijoc/article/view/2170
7Piwek, L., Ellis, D. A., Andrews, S., & Joinson, A. (2016). The Rise of Consumer Health Wearables: Promises and Barriers. PLoS Medicine13(2), e1001953. http://doi.org/10.1371/journal.pmed.1001953
8 http://www.appliedclinicaltrialsonline.com/growing-availability-wearable-devices-perspective-current-applications-clinical-trials
9 http://www.healthagen.com/blog/wearable-devices- and-future- population-health
10 http://www.healthagen.com/blog/wearable-devices-and-future-population-health
11 Young, H.M. & Nesbitt, T.S. J GEN INTERN MED (2017) 32: 398. doi:10.1007/s11606-016-3952-3

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