Feasibility, acceptability and validation of wearable devices for climate change and health research in the low-resource contexts of Burkina Faso and Kenya: Study protocol
Open accessAbstract
As the epidemiological transition progresses throughout sub-Saharan Africa, life lived with diseases is an increasingly important part of a population’s burden of disease. The burden of disease of climate-sensitive health outcomes is projected to increase considerably within the next decades. Objectively measured, reliable population health data is still limited and is primarily based on perceived illness from recall. Technological advances like non-invasive, consumer-grade wearable devices may play a vital role in alleviating this data gap and in obtaining insights on the disease burden in vulnerable populations, such as heat stress on human cardiovascular response. The overall goal of this study is to investigate whether consumer-grade wearable devices are an acceptable, feasible and valid means to generate data on the individual level in low-resource contexts. Three hundred individuals are recruited from the two study locations in the Nouna health and demographic surveillance system (HDSS), Burkina Faso, and the Siaya HDSS, Kenya. Participants complete a structured questionnaire that comprises question items on acceptability and feasibility under the supervision of trained data collectors. Validity will be evaluated by comparing consumer-grade wearable devices to research-grade devices. Furthermore, we will collect demographic data as well as the data generated by wearable devices. This study will provide insights into the usage of consumer-grade wearable devices to measure individual vital signs in low-resource contexts, such as Burkina Faso and Kenya. Vital signs comprising activity (steps), sleep (duration, quality) and heart rate (hr) are important measures to gain insights on individual behavior and activity patterns in low-resource contexts. These vital signs may be associated with weather variables—as we gather them from weather stations that we have setup as part of this study to cover the whole Nouna and Siaya HDSSs—in order to explore changes in behavior and other variables, such as activity, sleep, hr, during extreme weather events like heat stress exposure. Furthermore, wearable data could be linked to health outcomes and weather events. As a result, consumer-grade wearables may serve as a supporting technology for generating reliable measurements in low-resource contexts and investigating key links between weather occurrences and health outcomes. Thus, wearable devices may provide insights to better inform mitigation and adaptation interventions in these low-resource settings that are direly faced by climate change-induced changes, such as extreme weather events.
AI snapshot
Written from the paper’s full text.
TL;DR
This study protocol plans to assess whether consumer-grade wearable devices are feasible, acceptable, and valid for individual-level climate change and health research in the low-resource HDSS contexts of Nouna, Burkina Faso, and Siaya, Kenya. It will recruit 300 participants for feasibility/acceptability and a validation subsample comparing consumer wearables against research-grade ECG, actigraphy, and core-body-temperature devices.
Key findings
- No empirical findings are reported; this is a study protocol. The planned feasibility/acceptability study will recruit n = 300 participants total (Nouna HDSS n = 150; Siaya HDSS n = 150), stratified by age (6–16, 17–45, >45 years) and gender (n = 150 females, n = 150 males).
- The questionnaire includes 13 feasibility items focused on hardware reliability and 29 acceptance items based on the Technology Acceptance Model, plus a structured activity journal reflecting 21 common local activities.
- The validation study will select n = 20 participants per location (n = 10 females, n = 10 males) and compare consumer-grade Withings Pulse HR against Bittium Faros ECG for heart rate and GENEActiv wrist accelerometry for activity, and Tucky shell temperature against Tcore core-body-temperature measurement.
- Ten automated weather stations (5 in Nouna HDSS, 5 in Siaya HDSS) will measure precipitation, wind, radiation, temperature, humidity, and WBGT for planned analyses linking weather to heart rate, activity, sleep, and body shell temperature.
Methods
- Design: a feasibility, acceptability, and validation study protocol conducted in two HDSS sites over a nine-week data collection period comprising three study cycles, each lasting three weeks with n = 50 participants per site per cycle. Participants are allocated to three study arms differing in whether a study nurse or field worker visits and whether participants self-synchronize devices with a smartphone and recharge using a portable solar panel.
- Sample: feasibility/acceptability participants must be HDSS residents, aged 6 years or above, and willing to use a Bluetooth or mobile data-enabled mobile device. Validation participants must be 18–45 years old, live and work near a health care facility, and have no medical condition interfering with data collection, such as cardiovascular, metabolic, or renal disease, or acute malaria or other infectious diseases.
- Analysis: feasibility questionnaire data will be analyzed with deductive thematic analysis; acceptance will use parametric ANOVA across study arms; validation will assess agreement using Bland-Altman plots and Lin’s concordance correlation coefficient; planned weather analyses will use multiple linear regression with heart rate, activity, sleep, and body shell temperature as dependent variables and WBGT, precipitation, air temperature, relative humidity, solar radiation, and wind speed as independent variables.
Limitations
- The paper states that only a limited number of wearable devices were obtained (n = 50 Withings Pulse HR; n = 25 Tucky thermometer) because the study outcome was uncertain and financial resources were not to be exhausted.
- The paper states that seasonality has no bearing on feasibility, acceptability, or validation in this study and is therefore not taken into consideration.
- Evident from the protocol: no empirical results are yet available; the validation subsample is small (n = 20 per location) and restricted to healthy 18–45-year-olds without cardiovascular, metabolic, renal, or acute infectious conditions, limiting generalizability; activity data rely partly on retrospective recall journals.
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Cites
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Claims the paper makes
0 of 50 cited sources checked · 0 supported · 0 flagged
- Study design and conductcitation
For the validation study, a sample size of n=20 participants is deemed sufficient, as reported in the literature.
“For the validation study, considering as a first main outcome HR, a sample size of n = 20 participants is deemed sufficient, as reported in the literature [50–52].”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [50] JG Godino, 2020, Performance of a commercial multi-sensor wearable (Fitbit Charge HR) in measuring physical activity and sleep in healthy children, PloS One source
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- cites [51] G Nazari, 2019, Inter-instrument reliability and agreement of Fitbit charge measurements of heart rate and activity at rest, during the modified Canadian aerobic fitness test, and in recovery, Physiother Can source
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- cites [52] BW Nelson, 2019, Accuracy of consumer wearable heart rate measurement during an ecologically valid 24-hour period: Intraindividual validation study, JMIR MHealth UHealth source
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- Study design and conductcitation
n=150 is deemed sufficient for generating insights with wearable device data, as reported in the literature.
“For generating insights with the wearables devices data, we deemed n = 150 as sufficient, as reported in the literature [49].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [49] SS Coughlin, 2016, Use of Consumer Wearable Devices to Promote Physical Activity: A Review of Health Intervention Studies, J Environ Health Sci source
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- Premisecitation
Most studies using wearable sensors have been conducted in high-income settings like the US and Europe.
“However, most studies were conducted in high-income settings, like the US and Europe [19, 25, 35].”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [19] JM Radin, 2020, Harnessing wearable device data to improve state-level real-time surveillance of influenza-like illness in the USA: a population-based study, Lancet Digit Health source
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- cites [25] J Dunn, 2018, Wearables and the medical revolution, Pers Med source
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- cites [35] AM Müller, 2018, Physical Activity, Sedentary Behavior, and Diet-Related eHealth and mHealth Research: Bibliometric Analysis, J Med Internet Res source
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- Premisecitation
Studies have shown the potential of consumer-grade wearable devices for population-health contexts.
“Studies have shown the potential of such consumer-grade wearable devices for population-health contexts [27].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [27] N Mohammadzadeh, 2020, The application of wearable smart sensors for monitoring the vital signs of patients in epidemics: a systematic literature review, J Ambient Intell Humaniz Comput
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- Study design and conductreasoning
Sample size of n=150 per HDSS was calculated based on a population size of n=100,000, a confidence level of 95% and a margin of error of 8%.
“Sample size calculation (survey/questionnaire) to comprise n = 150 study participants/HDSS was calculated based on a population size of n = 100.000 (total HDSS population excluding children under the age of 6 years), a confidence level of 95% and a margin of error of 8%.”
Quote in the paperSubstantial claim
- Premisecitation
The Tcore heat-flux sensor is a validated device.
“a validated heat-flux sensor (Tcore, Dräger, Germany), connected to a miniaturized data logger (HFUM, KORA Industrie Elektronik, Germany) [44–48]”
Quote in the paperSubstantial claim0 of 5 sources checked- cites [44] S Mendt, 2017, Circadian rhythms in bed rest: monitoring core body temperature via heat-flux approach is superior to skin surface temperature, Chronobiol Int source
Not checked in the free run.
- cites [45] O Opatz, 2013, Temporal and spatial dispersion of human body temperature during deep hypothermia, Br J Anaesth source
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- cites [46] O Opatz, 2010, Determining core body temperature via heat flux-a new promising approach, Resuscitation source
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- cites [47] H-C Gunga, 2009, The Double Sensor—A non-invasive device to continuously monitor core temperature in humans on earth and in space, Respir Physiol Neurobiol source
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- cites [48] AC Stahn, 2017, Increased core body temperature in astronauts during long-duration space missions, Sci Rep source
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- Premisecitation
The double heat-flux sensor technology has been successfully tested during hypothermia, bedrest, and exercise on Earth and in space.
“The double heat-flux sensor technology has been successfully tested during hypothermia, bedrest, and exercise on Earth and in space [44–48].”
Quote in the paperNot a substantial claim0 of 5 sources checked- cites [44] S Mendt, 2017, Circadian rhythms in bed rest: monitoring core body temperature via heat-flux approach is superior to skin surface temperature, Chronobiol Int source
Not checked in the free run.
- cites [45] O Opatz, 2013, Temporal and spatial dispersion of human body temperature during deep hypothermia, Br J Anaesth source
Not checked in the free run.
- cites [46] O Opatz, 2010, Determining core body temperature via heat flux-a new promising approach, Resuscitation source
Not checked in the free run.
- cites [47] H-C Gunga, 2009, The Double Sensor—A non-invasive device to continuously monitor core temperature in humans on earth and in space, Respir Physiol Neurobiol source
Not checked in the free run.
- cites [48] AC Stahn, 2017, Increased core body temperature in astronauts during long-duration space missions, Sci Rep source
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- Premisecitation
Research infrastructures supporting health research in sub-Saharan Africa, especially health and demographic surveillance systems (HDSSs), are not equipped to investigate many of the most pressing climate change and health research needs.
“Furthermore, our research may be able to bridge the gap in the current lack of evidence since oftentimes research infrastructures supporting health research in SSA, especially in health and demographic surveillance systems (HDSSs), are not equipped to investigate many of the most pressing climate change and health research needs [65].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [65] R Sauerborn, 2017, A gaping research gap regarding the climate change impact on health in poor countries, Eur J Epidemiol source
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- Premisecitation
The Nouna HDSS and Siaya HDSS provide access to comprehensive, retrospective health and population data comprising nearly 20 years of data and more than 260,000 people under surveillance.
“The Nouna HDSS, Burkina Faso [59], and the Siaya HDSS, Kenya [40], provide access to comprehensive, retrospective health and population data comprising of nearly 20 years of data and more than 260,000 people under surveillance.”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites [59] A Sié, 2010, The Health and Demographic Surveillance System (HDSS) in Nouna, Burkina Faso, 1993–2007, Glob Health Action source
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- cites [40] FO Odhiambo, 2012, Profile: The KEMRI/CDC Health and Demographic Surveillance System—Western Kenya, Int J Epidemiol source
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- Premisecitation
Low-resource countries such as Burkina Faso and Kenya are predicted to be most vulnerable to climate change.
“Low-resource countries such as Burkina Faso and Kenya are predicted to be most vulnerable to climate change, as the burden of disease of climate-sensitive health outcomes is projected to increase considerably within the next decades [7].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [7] O Serdeczny, 2017, Climate change impacts in Sub-Saharan Africa: from physical changes to their social repercussions, Reg Environ Change source
Not checked in the free run.
- Premisecitation
Wearables accuracy at rest and during physical activity differ.
“Wearables accuracy at rest and during physical activity differ, and we will generate insights by comparing consumer and research-grade wearables in this context.”
Quote in the paperSubstantial claim - Premisecitation
Wearable devices can be deemed unreliable, in particular when human activity impedes measurement.
“Wearable devices can be deemed unreliable, in particular when human activity impedes measurement [63].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [63] AA Tarar, 2020, Wearable Skin Sensors and Their Challenges: A Review of Transdermal, Optical, and Mechanical Sensors, Biosens-BASEL
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- Interpretationreasoning
Population impacts of climate change on health are likely to vary considerably between and within Burkina Faso and Kenya due to unbalanced distribution of diseases and different available levels of adaptation and mitigation measures.
“Due to this unbalanced distribution of diseases, as well as different available levels of adaptation and mitigation measures, population impacts of climate change on health are likely to vary considerably between and within these countries.”
Quote in the paperSubstantial claim - Interpretationreasoning
The two study sites are quite different in their climatic, socioeconomic and disease profile.
“We will conduct the study in two HDSS, as the two study sites are quite different in their climatic, socioeconomic and disease profile.”
Quote in the paperSubstantial claim- Rests on an assumption: The Nouna HDSS surveillance area has a tropical climate with one rainy season usually from May to September, mean annual rainfall of 800mm, and overall high temperatures throughout the year.
- Rests on an assumption: Malnutrition and malaria are both common in the Nouna HDSS.
- Rests on an assumption: The Siaya HDSS surveillance area has a tropical climate with two annual rain seasons, with the heaviest long rains usually occurring from March through May and short rains falling between October and December, mean annual rainfall of 1200mm.
- Interpretationcitation
Our research may be able to bridge the gap in the current lack of evidence on climate change and health research needs in sub-Saharan Africa.
“Furthermore, our research may be able to bridge the gap in the current lack of evidence since oftentimes research infrastructures supporting health research in SSA, especially in health and demographic surveillance systems (HDSSs), are not equipped to investigate many of the most pressing climate change and health research needs [65].”
Quote in the paperNot a substantial claim
- Classified as probably not a substantial claim. 11
- May combine two claims. 6
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationHealth effects of climate change-induced extreme weather events are projected to increase dramatically in the next decades, especially in sub-Saharan Africa.
“Particularly, as the risk of climate change-induced extreme weather events increases, health effects are projected to increase dramatically in the next decades, especially in SSA [5–8].”
Quote in the paperNot a substantial claim0 of 4 sources checked- cites [5] JA Patz, 2005, Impact of regional climate change on human health, Nature source
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- cites [6] LK Wang, 2009, The Health Impact Of Extreme Weather Events In Sub-Saharan Africa, The World Bank
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- cites [7] O Serdeczny, 2017, Climate change impacts in Sub-Saharan Africa: from physical changes to their social repercussions, Reg Environ Change source
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- cites [8] H Green, 2019, Impact of heat on mortality and morbidity in low and middle income countries: A review of the epidemiological evidence and considerations for future research, Environ Res source
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Classified as probably not a substantial claim.
Study design and conductreasoningHeart rate measurements from the Withings Pulse HR will be compared against Bittium Faros ECG as reference.
“Specifically, data collected with Bittium faros ECG will serve as a reference for the hr measurements done with the Withings HR data.”
Quote in the paperSubstantial claimMay combine two claims.
PremisecitationThe GENEActiv wrist accelerometer is a validated device for measuring gross motor activity, sleep schedule variability, sleep quantity, sleep quality, and daytime.
“We will continuously monitor activity with a validated wrist-worn tri-axial accelerometer (resolution up to 100Hz) device (GENEActiv Original, ActiveInsights, UK). The accelerometers are small, rugged, waterproof, actigraphy-based data loggers that record a digitally integrated measure of gross motor activity, as well as sleep schedule variability, sleep quantity, and sleep quality statistics and”
Quote in the paperSubstantial claim0 of 5 sources checked- cites [54] JE Stone, 2020, Accuracy of the GENEActiv Device for Measuring Light Exposure in Sleep and Circadian Research, Clocks Sleep source
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- cites [55] AG Siddall, 2019, Validity of energy expenditure estimation methods during 10 days of military training, Scand J Med Sci Sports source
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- cites [56] E Burton, 2018, Reliability and validity of two fitness tracker devices in the laboratory and home environment for older community-dwelling people, BMC Geriatr source
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- cites [57] AH Montoye, 2018, Cross-validation and out-of-sample testing of physical activity intensity predictions with a wrist-worn accelerometer, J Appl Physiol source
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- cites [58] C Powell, 2017, Simultaneous validation of five activity monitors for use in adult populations, Scand J Med Sci Sports source
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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationCulp and Tonelli et al. (2019) found considerably higher body temperatures, increased heart rate, and respiration rate in the uncomfortable intensity category among agricultural workers.
“The authors discovered considerably higher body temperatures, increased hr, and respiration rate in the uncomfortable intensity category.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [28] K Culp, 2019, Heat-Related Illness in Midwestern Hispanic Farmworkers: A Descriptive Analysis of Hydration Status and Reported Symptoms, Workplace Health Saf source
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May combine two claims.
PremisecitationThe study is conducted in Burkina Faso and Kenya because both are in sub-Saharan Africa and have one of the highest burdens of climate-sensitive diseases, but differ in their climatic, socioeconomic and disease profile.
“The study is conducted in the two African countries of Burkina Faso and Kenya, as both countries are located in SSA and have one of the highest burdens of climate-sensitive diseases, but differ in their climatic, socioeconomic and disease profile [2, 39–41].”
Quote in the paperSubstantial claim0 of 4 sources checked- cites [2] A Sié, 2010, The Health and Demographic Surveillance System (HDSS) in Nouna, Burkina Faso, 1993–2007, Glob Health Action source
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- cites [39] E Diboulo, 2012, Weather and mortality: a 10 year retrospective analysis of the Nouna Health and Demographic Surveillance System, Burkina Faso, Glob Health Action source
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- cites [40] FO Odhiambo, 2012, Profile: The KEMRI/CDC Health and Demographic Surveillance System—Western Kenya, Int J Epidemiol source
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- cites [41] M Sewe, 2015, The association of weather variability and under five malaria mortality in KEMRI/CDC HDSS in Western Kenya 2003 to 2008: a time series analysis, Int J Environ Res Public Health source
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Classified as probably not a substantial claim.
Study design and conductnone givenActivity and heart rate data from Withings Pulse HR will be compared with raw data from the GENEActiv wrist accelerometer.
“We will compare the raw data collected with the wrist accelerometer GENEActiv with the Withings Pulse HR data (hear rate, activity data)”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationLam et al. (2021) found that addressing thermal discomfort early on can help prevent more serious heat-related disorders.
“Lam et al. (2021) explored the association between short-term physiological and psychological thermal adaptation and outdoor thermal comfort in people who exercised in different temperature zones in China and found that addressing thermal discomfort early on can help prevent more serious heat-related disorders [29].”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [29] CKC Lam, 2021, Effects of short-term physiological and psychological adaptation on summer thermal comfort of outdoor exercising people in China, Build Environ source
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May combine two claims.
InterpretationcitationConsumer-grade wearable devices may provide a novel method to generate objective, highly-resolved individual data monitoring physiological parameters such as heart rate, physical activity and sleep duration, and this data may facilitate research on climate change-induced extreme weather events and health outcomes in low-resource contexts.
“Consumer-grade wearable devices may provide a novel method to generate objective, highly-resolved individual data monitoring physiological parameters, such as hr, physical activity and sleep duration. This data may facilitate further research to consider aspects of climate change-induced extreme weather events on health outcomes in populations in low-resource contexts [36–38].”
Quote in the paperSubstantial claim0 of 3 sources checked- cites [36] AM Hickey, 2016, Utility of consumer physical activity trackers as an intervention tool in cardiovascular disease prevention and treatment, Prog Cardiovasc Dis source
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- cites [37] KR Evenson, 2017, Assessing validity of the Fitbit indicators for US public health surveillance, Am J Prev Med source
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- cites [38] ER Dorsey, 2018, Teleneurology and mobile technologies: the future of neurological care, Nat Rev Neurol source
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May combine two claims.
PremisecitationHigh spatial geographical resolutions of weather data, particularly wet bulb globe temperature (WBGT), and individual data on activity and vital signs like heart rate are particularly missing.
“Particularly missing are high spatial geographical resolutions of weather data [14] (particularly wet bulb globe temperature, WBGT, an aggregated measure for heat stress exposure [15]) and individual data on activity and vital signs, like hr.”
Quote in the paperSubstantial claim0 of 2 sources checked- cites [14] FD Longueville, 2016, Long-term analysis of rainfall and temperature data in Burkina Faso (1950–2013), Int J Climatol source
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- cites [15] S Heo, 2019, Comparison of health risks by heat wave definition: Applicability of wet-bulb globe temperature for heat wave criteria, Environ Res source
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Classified as probably not a substantial claim.
Study design and conductnone givenValidity of consumer-grade wearables will be evaluated by comparing them to gold-standard devices.
“Validity will be evaluated by comparing consumer-grade wearable devices to research-grade devices.”
- Also stated in: § Study design · plain
“We will compare the consumer-grade to the gold-standard wearables during the last study cycle (week 6 to week 9).”
Quote in the paperSubstantial claim- Also stated in: § Study design · plain
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenThe feasibility and acceptability study will randomly sample participants from the HDSS population, stratified by age and gender.
“The sampling will be randomly drawn from the respective HDSS population, whereby the study population is stratified according to age (three groups: 6-16yrs, 17-45yrs, >45yrs) and gender (n = 150 females, n = 150 males).”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
Study design and conductnone givenShell body temperature from the Tucky thermometer will be compared with core body temperature from the Tcore sensor.
“we will compare data collected with the Tcore sensor (core body temperature) with the Tucky thermometer data (shell body temperature).”
Quote in the paperSubstantial claimClassified as probably not a substantial claim.
PremisecitationThe burden of disease of climate-sensitive health outcomes is projected to increase considerably within the next decades.
“Low-resource countries such as Burkina Faso and Kenya are predicted to be most vulnerable to climate change, as the burden of disease of climate-sensitive health outcomes is projected to increase considerably within the next decades [7].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [7] O Serdeczny, 2017, Climate change impacts in Sub-Saharan Africa: from physical changes to their social repercussions, Reg Environ Change source
Not checked in the free run.
Classified as probably not a substantial claim.
PremisecitationSubstantial differences exist between various devices and various activities, at times showing significantly high average error as compared to measured resting periods.
“A study has found that substantial differences exist between various devices and various activities, at times showing significantly high average error as compared to measured resting periods [64].”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [64] B Bent, 2020, Investigating sources of inaccuracy in wearable optical heart rate sensors, NPJ Digit Med source
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May combine two claims.
PremisecitationThe TcoreTM sensor employs a non-invasive dual-sensor heat-flux system that accurately and continuously calculates core body temperature following a short ramp-up time.
“Briefly, the Tcore™ employs a non-invasive technology where a unique dual-sensor heat flux system accurately and continuously calculates CBT following a short ramp-up time.”
Quote in the paperSubstantial claim0 of 5 sources checked- cites [44] S Mendt, 2017, Circadian rhythms in bed rest: monitoring core body temperature via heat-flux approach is superior to skin surface temperature, Chronobiol Int source
Not checked in the free run.
- cites [45] O Opatz, 2013, Temporal and spatial dispersion of human body temperature during deep hypothermia, Br J Anaesth source
Not checked in the free run.
- cites [46] O Opatz, 2010, Determining core body temperature via heat flux-a new promising approach, Resuscitation source
Not checked in the free run.
- cites [47] H-C Gunga, 2009, The Double Sensor—A non-invasive device to continuously monitor core temperature in humans on earth and in space, Respir Physiol Neurobiol source
Not checked in the free run.
- cites [48] AC Stahn, 2017, Increased core body temperature in astronauts during long-duration space missions, Sci Rep source
Not checked in the free run.
Probably not a substantial claim: may not pass S2 (checkable).
InterpretationreasoningConsumer-grade wearables may constitute a novel way to explore critical relationships between weather events and health outcomes.
“Therefore, consumer-grade wearables may constitute a novel way to explore critical relationships between weather events and health outcomes.”
Quote in the paperNot a substantial claim
The paper relies on this without support.
Seasonality has no bearing on the feasibility, acceptability, or validation of the wearable measurement in this study.
“Seasonality has no bearing on the feasibility, acceptability, or validation of the wearable measurement in this study, hence it is not taken into consideration.”
The paper relies on this without support.
The wristband size of the Withings Pulse HR is not adequate for children younger than 6 years.
“(as wristband size of the Withings Pulse HR is not deemed adequate for children younger than 6 years)”
The paper relies on this without support.
Objectively measured health outcomes continue to be limited due to a lack of appropriate measurement devices, manpower, and financial resources resulting in a scarcity of longitudinal data.
“In particular, objectively measured health outcomes continue to be limited due to a lack of appropriate measurement devices, manpower, and financial resources resulting in a scarcity of longitudinal data.”
The paper relies on this without support.
The Nouna HDSS surveillance area has a tropical climate with one rainy season usually from May to September, mean annual rainfall of 800mm, and overall high temperatures throughout the year.
“The surveillance area of the Nouna HDSS is characterized by a tropical climate with one rainy season usually lasting from May to September (mean annual rainfall of 800mm) and overall high temperatures throughout the year.”
The paper relies on this without support.
Malnutrition and malaria are both common in the Nouna HDSS.
“Malnutrition and malaria are both common in the Nouna HDSS.”
The paper relies on this without support.
The Siaya HDSS surveillance area has a tropical climate with two annual rain seasons, with the heaviest long rains usually occurring from March through May and short rains falling between October and December, mean annual rainfall of 1200mm.
“In the surveillance area of the Siaya HDSS, the climate is tropical with two annual rain seasons, with the heaviest long rains usually occurring from March through May and short rains falling between October and December (mean annual rainfall of 1200mm).”
The paper relies on this without support.
There is currently a paucity of research on the usability of wearable devices in low-resource contexts.
“Currently, there is a paucity of research on the usability of wearable devices in low-resource contexts.”
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?
Topics such as climate change-induced impacts focusing on extreme weather events as an outcome and impact on health may be approached.
“Topics such as climate change–induced impacts focusing on extreme weather events as an outcome and impact on health [236] may be approached.”
From The impact of wearable technologies in health research: scoping review (2022) · cites this paper as [236]
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“The questionnaire items are grouped according to the employed Technology Acceptance Model constructs [43].”
MethodInfluentialImpact of regional climate change on human health
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“A study has found that substantial differences exist between various devices and various activities, at times showing significantly high average error as compared to measured resting periods [64].”
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(2023) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2023.85.pr8
Khakali, L., Aballa, A. O., Mwigereri, D. G., Weinheimer-Haus, E. M., Njoroge, W., Maina, R., Bunde, A., Musitia, P. M., Nyongesa, M. K., Orwa, J., et al. (2025) · doi:10.2196/preprints.77761
Zout, G., Höver, C., Eggert, E., Gunga, H., Ouèrmi, L., Sié, A., Huhn, S., Bunker, A., Barteit, S., Mendt, S., et al. (2025) · PLoS ONE · doi:10.1371/journal.pone.0330835 · Cited by 1 · see citing works
Self-citationKhakali, L., Aballa, A. O., Mwigereri, D. G., Weinheimer-Haus, E. M., Njoroge, W., Maina, R., Bunde, A., Musitia, P. M., Nyongesa, M. K., Orwa, J., et al. (2026) · JMIR mhealth and uhealth · doi:10.2196/77761
Schipper, R. M., Djibrillah, F. O., Roosink, M., Winkens, L. H. H., John, A., Hazebroek, E. J., Witteveen, A., & Berendsen, A. A. M. (2026) · JMIR mhealth and uhealth · doi:10.2196/87324 · Cited by 1 · see citing works
- Authors
- Barteit, S., Boudo, V., Ouedraogo, A., Zabré, P., Ouremi, L., Sié, A., Munga, S., Obor, D., Kwaro, D., Huhn, S., Bunker, A., Sauerborn, R., Gunga, H.-C., Maggioni, M. A., & Bärnighausen, T.
- Affiliations
- Heidelberg University (DE)
- Centre de Recherche en Santé de Nouna (BF)
- Kenya Medical Research Institute (KE)
- Humboldt-Universität zu Berlin (DE)
- University of Milan (IT)
- Harvard University (US)
- Corresponding author
- Barteit, Sandra
- ORCID
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2021-09-30
- Volume
- 16
- Issue
- 9
- Pages
- e0257170
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC8483291
- OpenAlex
- W3202065335
- Semantic Scholar
- 531e5df19bda5d31f1914e671e2d0f082dee6337
- Cited by
- 51
- References
- 64
- Citations by year
- 2026: 3 · 2025: 16 · 2024: 5 · 2023: 19 · 2022: 8
- FWCI
- 8.99
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Archivio Istituzionale della Ricerca (Universita Degli Studi Di Milano) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Greater South Information System
- Funders
- Deutsche Forschungsgemeinschaft (FOR 2936 / Projekt: 427397328)
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Climate Change and Health Impacts
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Keywords
- consumer-grade wearable devices, feasibility and acceptability, device validation, vital signs, heart rate, sleep, physical activity, heat stress, extreme weather events, health and demographic surveillance system, resource-limited settings, climate change adaptation, Siaya
- MeSH terms
- Wearable Electronic Devices, Adolescent, Adult, Burkina Faso, Child, Feasibility Studies, Female, Health, Health Resources, Humans, Kenya, Male, Middle Aged, Surveys and Questionnaires, Research, Young Adult, Climate Change
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