Acceptability and usability of an ambulatory health monitoring system for use by military personnel
Abstract
OCCUPATIONAL APPLICATIONS A physiological status monitoring system was evaluated for use by soldiers in the field. Two different designs were evaluated, with the design based on previous human factors evaluations proven to be more comfortable and acceptable for use. This study demonstrated that the advanced design of the EQ-02 physiological status monitoring system met dismounted soldier needs. Furthermore, this study validated the use of a usability evaluation in the successful design/advancement of a physiological status monitoring system. TECHNICAL ABSTRACT Background: Previous research has shown that the form factor of a physiological status monitoring system, the Equivital™ EQ-01 (Hidalgo Ltd., Cambridge, UK) had problems associated with comfort and usability of the system for soldiers. Previous data gathered was used to guide improvements in the physiological status monitoring system. Purpose: Assess whether the previous feedback from usability evaluations helped guide improvements in comfort, acceptability, and usability of a physiological status monitoring system for dismounted soldiers. Improvements to the EQ-01 system were incorporated into the next-generation EQ-02 (Hidalgo Ltd., Cambridge, UK) system. Methods: Thirty-nine infantry dismounted soldiers were randomly assigned to wear either an EQ-01 or EQ-02 system while performing standard military field training. They filled out a survey on fit, comfort, irritation to the body, impact on military performance, and acceptability. They then wore the other system and filled out the same survey. Results: The Equivital™ EQ-02 system was superior in terms of fit (51% better in overall fit), ease of donning (10% easier), comfort (45% more comfortable), impact on military performance (45% less impact), impact on the body (17% less impact), and acceptability (32% more acceptable). All these measures are subjective self-report ratings. Conclusions: A human factors engineering approach provided an effective means of guiding improvements and the production of a physiological status monitoring system that dismounted soldiers were more likely to accept and wear.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The number of patients used in the study is large enough compared to other wearability studies and evaluations of monitoring systems for Parkinson's disease and other movement disorder diseases.
“To our knowledge the number of patients used in our study is large enough compared to other wearability studies [26–29] and evaluation of monitoring systems for the Parkinson's disease and other movement disorder diseases.”
From Wearability Assessment of a Wearable System for Parkinson’s Disease Remote Monitoring Based on a Body Area Network of Sensors (2014) · cites this paper as [28]
Cites
A review of wearable sensors and systems with application in rehabilitation
Patel, S., Park, H., Bonato, P., Chan, L., & Rodgers, M. (2012) · Journal of NeuroEngineering and Rehabilitation · doi:10.1186/1743-0003-9-21 · Cited by 2,396 · see citing works
A strategy for human factors/ergonomics: developing the discipline and profession
Dul, J., Bruder, R., Buckle, P., Carayon, P., Falzon, P., Marras, W. S., Wilson, J. R., & van der Doelen, B. (2012) · Ergonomics · doi:10.1080/00140139.2012.661087 · Cited by 931 · see citing works
A Wearable Health Care System Based on Knitted Integrated Sensors
Paradiso, R., Loriga, G., & Taccini, N. (2005) · IEEE Transactions on Information Technology in Biomedicine · doi:10.1109/titb.2005.854512 · Cited by 729 · see citing works
Soldier Load Carriage: Historical, Physiological, Biomechanical, and Medical Aspects
Knapik, J. J., REYNOLDS, K. L., & Harman, E. A. (2004) · Military Medicine · doi:10.7205/milmed.169.1.45 · Cited by 599 · see citing works
Martin, T. L., Jovanov, E., & Raŝković, D. (2002) · International Symposium on Wearable Computers · doi:10.1109/iswc.2000.888463 · Cited by 236 · see citing works
Body-Worn Sensor Design: What Do Patients and Clinicians Want?
Bergmann, J., & McGregor, A. H. (2011) · Annals of Biomedical Engineering · doi:10.1007/s10439-011-0339-9 · Cited by 216 · see citing works
A tool to assess the comfort of wearable computers
Knight, J. F., & Baber, C. (2005) · Human Factors The Journal of the Human Factors and Ergonomics Society · doi:10.1518/0018720053653875 · Cited by 164 · see citing works
A survey on wearable biosensor systems for health monitoring
Pantelopoulos, A., & Bourbakis, N. (2008) · Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC) · doi:10.1109/iembs.2008.4650309 · Cited by 147 · see citing works
Wireless Sensor Network for Wearable Physiological Monitoring
Pandian, P. S., Safeer, K. P., Gupta, P. P., Shakunthala, D. T., Sundersheshu, B. S., & Padaki, V. C. (2008) · Journal of Networks · doi:10.4304/jnw.3.5.21-29 · Cited by 124 · see citing works
A Comprehensive Ubiquitous Healthcare Solution on an Android™ Mobile Device
Hii, P.-C., & Chung, W. (2011) · Sensors · doi:10.3390/s110706799 · Cited by 113 · see citing works
Rationale for a Personal Monitor for Heat Strain
Bernard, T. E., & Kenney, W. L. (1994) · American Industrial Hygiene Association Journal · doi:10.1080/15428119491018772 · Cited by 91 · see citing works
Proceedings of the 2013 International Symposium on Wearable Computers
(2013) · doi:10.1145/2493988 · Cited by 34 · see citing works
Psychrometric Limits to Prolonged Work in Protective Clothing Ensembles
Kenney, W. L., Lewis, D. A., Armstrong, C. G., Hyde, D. E., Dyksterhouse, T., Fowler, S. R., & WILLIAMS, D. A. (1988) · American Industrial Hygiene Association Journal · doi:10.1080/15298668891379954 · Cited by 28 · see citing works
Development of a Remote Medical Monitoring System to Meet Soldier Needs
Tharion, W. J., Buller, M. J., Karis, A. J., & Hoyt, R. W. (2010) · Advances in human factors and ergonomics series · doi:10.1201/ebk1439835012-c50 · Cited by 6 · see citing works
Ambulatory Recording of Physiological Variables During an Ascent of Mt Aconcagua
Wagner, D. R. (2011) · Wilderness and Environmental Medicine · doi:10.1016/j.wem.2010.10.006 · Cited by 6 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Hinde, K., White, G., & Armstrong, N. C. D. (2021) · Sensors · doi:10.3390/s21041061 · Cited by 172 · see citing works
Wearable physiological monitoring for human thermal-work strain optimization
Buller, M. J., Welles, A. P., & Friedl, K. E. (2017) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00353.2017 · Cited by 104 · see citing works
Cancela, J., Pastorino, M., Tzallas, A., Tsipouras, M., Rigas, G., Arredondo, M., & Fotiadis, D. (2014) · Sensors · doi:10.3390/s140917235 · Cited by 97 · see citing works
Akintola, A. A., van de Pol, V., Bimmel, D., Maan, A. C., & van Heemst, D. (2016) · Frontiers in Physiology · doi:10.3389/fphys.2016.00391 · Cited by 88 · see citing works
Methods for improving thermal tolerance in military personnel prior to deployment
Ashworth, E. T., Cotter, J. D., & Kilding, A. E. (2020) · Military Medical Research · doi:10.1186/s40779-020-00287-z · Cited by 40 · see citing works
Estimating Resting Core Temperature Using Heart Rate
Looney, D. P., Buller, M. J., Gribok, A. V., Leger, J., Potter, A. W., Rumpler, W. V., Tharion, W. J., Welles, A. P., Friedl, K. E., & Hoyt, R. W. (2018) · Journal for the Measurement of Physical Behaviour · doi:10.1123/jmpb.2017-0003 · Cited by 37 · see citing works
Anwer, S., Li, H., Antwi‐Afari, M. F., Umer, W., Mehmood, I., Al‐Hussein, M., & Wong, A. Y. L. (2021) · Journal of Building Engineering · doi:10.1016/j.jobe.2021.103348 · Cited by 34 · see citing works
Evolution of Physiological Status Monitoring for Ambulatory Military Applications
Tharion, W. J., Friedl, K. E., Buller, M. J., Arango, N. H., & Hoyt, R. W. (2019) · doi:10.1093/oso/9780190455132.003.0007 · Cited by 33 · see citing works
The Wearing Comfort and Acceptability of Ambulatory Physical Activity Monitoring Devices in Soldiers
Beeler, N., Roos, L., Delves, S. K., Veenstra, B., Friedl, K. E., Buller, M. J., & Wyss, T. (2018) · IISE Transactions on Occupational Ergonomics and Human Factors · doi:10.1080/24725838.2018.1435431 · Cited by 31 · see citing works
Beating the heat: military training and operations in the era of global warming
Moran, D. S., DeGroot, D. W., Potter, A. W., & Charkoudian, N. (2023) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00229.2023 · Cited by 29 · see citing works
Perceived Usefulness and Ease of Use of Wearable Sensor-Based Systems in Emergency Departments
Claudio, D., Velázquez, M. A., Bravo-Llerena, W., Okudan, G. E., & Freivalds, A. (2015) · IIE Transactions on Occupational Ergonomics and Human Factors · doi:10.1080/21577323.2015.1040559 · Cited by 29 · see citing works
Real-Time Physiological Monitoring While Encapsulated in Personal Protective Equipment
Tharion, W. J., Potter, A. W., Duhamel, C. M., Karis, A. J., Buller, M. J., & Hoyt, R. W. (2013) · Journal of Sport and Human Performance · doi:10.12922/jshp.0030.2013 · Cited by 20 · see citing works
Friedl, K. E., Buller, M. J., Tharion, W. J., Potter, A. W., Manglapus, G. L., & Hoyt, R. W. (2016) · Cited by 16 · see citing works
A mental workload based patient scheduling model for a Cancer Clinic
Huggins, A., & Claudio, D. (2018) · Operations Research for Health Care · doi:10.1016/j.orhc.2018.10.003 · Cited by 16 · see citing works
Biosignal-integrated robotic systems with emerging trends in visual interfaces: A systematic review
Lee, J., Miri, S., Bayro, A., Kim, M., Jeong, H., & Yeo, W. (2024) · Biophysics Reviews · doi:10.1063/5.0185568 · Cited by 15 · see citing works
MacLean, B. L., MacLean, K., Stewart, I. B., & Hunt, A. P. (2020) · International Archives of Occupational and Environmental Health · doi:10.1007/s00420-020-01600-y · Cited by 13 · see citing works
Sandsund, M., Aamodt, E., & Renberg, J. (2024) · Industrial Health · doi:10.2486/indhealth.2023-0151 · Cited by 12 · see citing works
Spencer, C., Koc, I. A., Suga, C., Lee, A., Dhareshwar, A. M., Franzén, E., Iozzo, M., Morrison, G., & McKeown, G. J. (2020) · doi:10.31234/osf.io/en5r3 · Cited by 11 · see citing works
Taylor, N., Carroll, A., & Gifford, R. M. (2023) · BMJ Military Health · doi:10.1136/military-2023-002524 · Cited by 4 · see citing works
Gilgen-Ammann, R., Buller, M. J., Bitterle, J. L., Delves, S. K., Veenstra, B., Roos, L., Beeler, N., & Wyss, T. (2018) · Current Issues in Sport Science (CISS) · doi:10.15203/ciss_2018.011 · Cited by 3 · see citing works
Expected and Perceived Usability of a Wearable Device That Monitors Physiological Metrics
Reddy, M. K., Fleischman, B. A., Loftin, M. C., Recker, R. S., Knust, S. K., & Lee, T. (2025) · Military Medicine · doi:10.1093/milmed/usaf102 · Cited by 2 · see citing works
Capella, S., Eager, M., Koivula, F. N. M., Gifford, R. M., Cresswell, D., & Taylor, N. (2025) · Journal of Medical Engineering & Technology · doi:10.1080/03091902.2025.2583495 · Cited by 1 · see citing works
Prototype Monitoring System Detecting Mental Workload During Pilot Simulation Training
Stavrev, S., & Ginchev, D. (2023) · International Conference on Military Technologies · doi:10.1109/icmt58149.2023.10171264 · Cited by 1 · see citing works
Snider, D. H., Rice, G. M., VanBrunt, T. B., & Hoyt, R. E. (2016) · International Conference on Computational Science and Computational Intelligence (CSCI) · doi:10.1109/csci.2016.0017 · Cited by 1 · see citing works
Early Detection of Inpatient Deterioration Using Wearable Monitors
Bonnici, T. (2019) · doi:10.13140/rg.2.2.26843.92967 · Cited by 1 · see citing works
Ashworth, E. T., Keaney, L. C., Cotter, J. D., & Kilding, A. E. (2021) · Research Square · doi:10.21203/rs.3.rs-673619/v1
A Review of Robust Wearable Sensor Systems for Monitoring in Extreme Environments*
Leary, S. E. S., O’Brien, A., Martinez, J. I., Webb, A. K., & Arquilla, K. S. (2025) · Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC) · doi:10.1109/embc58623.2025.11252779
- Authors
- Tharion, W. J., Buller, M. J., Potter, A. W., Karis, A. J., Goetz, V., & Hoyt, R. W.
- Affiliations
- U.S. Army Research Institute of Environmental Medicine (US)
- Venue
- IIE Transactions on Occupational Ergonomics and Human Factors
- Publisher
- Informa UK Limited
- Published
- 2013-10
- Volume
- 1
- Issue
- 4
- Pages
- 203-214
- ISSN
- 2157-7323 (ISSN-L)
- 2157-7331
- OpenAlex
- W2020409825
- Cited by
- 27
- References
- 15
- Citations by year
- 2025: 3 · 2024: 2 · 2023: 3 · 2021: 3 · 2020: 3 · 2019: 2 · 2018: 4 · 2017: 1 · 2016: 3 · 2015: 1 · 2014: 1 · 2013: 1
- FWCI
- 6.29
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- IIE Transactions on Occupational Ergonomics and Human Factors (publishedVersion)
- Funders
- U.S. Department of Defense
- Topics
- Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Performance
- Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
- Physical Sciences › Computer Science › Human-Computer Interaction › Usability and User Interface Design
- Keywords
- military personnel, dismounted soldiers, wearable sensors, usability evaluation, acceptability, comfort, form factors, human factors engineering, military field training
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review