CSU's The Audit

Whether it's an Apple Watch, a Fitbit, a Garmin or even an Oura ring, wearable health trackers are big business right now. A $54 billion business.

These devices monitor everything from how many steps we take in a day to how many calories you burn during a workout, to how well we sleep at night. But does this technology actually encourage better health? Does hearing that little voice declare "exercise ring closed" actually motivate people to work out?

That's the question Natalie Pennington decided to answer. An assistant professor of communication studies at Colorado State University, Pennington looks at interpersonal communication and the use of communication technology. Pennington teaches classes in interpersonal, nonverbal, and professional communication and persuasion. Currently, she is part of an international team of experts developing public health guidelines for social connection. Her work has been published in journals such as Communication Research and Computers and Human Behavior.

Pennington recently spoke to CSU’s The Audit about her recent research on how motivating wearable health trackers really are, and the role technology can play in helping or harming our health.

(This transcript has been lightly edited for clarity.)

Host Stacy Nick: Thanks so much for being here.

Natalie Pennington: Thanks so much for having me.

What was it that led you to look at wearable health trackers, in particular?

This was a really fun project that was a collaboration with my colleague when I worked at the University of Nevada, Las Vegas, Dr. Linda Dam. Dr. Dam is a good friend and colleague. We were working together one day, and we both wear Apple Watches. Linda got a ding on hers that was about a competition with a friend. And I was like, “Oh, my gosh, I don't do that at all.” Linda was like, “What? How can you not with an Apple Watch?”

I should clarify and say that you can compete with other people. You can share whether you’re closing your rings, who's doing better, that kind of thing. And I don't do that at all. And Linda was so surprised. So, it was sort of this well, what's the reasoning? And as somebody who studies interpersonal communication, I don't know that people always want to share that information. They might not be comfortable with it. And she felt it was a fun way to compete. So, we decided to do a study.

And there's no doubt, as I said earlier, that wearable health trackers are popular. The question is, are they actually good for our health? Do they encourage us to engage in healthier activities? What were your findings? I mean, does my Apple Watch make me healthier?

So, Linda and I did two studies. We first surveyed a college student population, to find out what those motivating factors are. We started from the premise that there's a lot of research that, for physical health, this is absolutely a good thing. But one of the things that we pulled in with our study was some of the mental health factors as well. So, things like negative social comparison, and also self-esteem and sort of how those might correlate back, because we know that our mental health absolutely has an impact on our physical health, as well.

In the first study, we noticed that students were definitely using their devices quite a bit, but not for social reasons. It was much more about competition. We did see some of that negative social comparison, which is a little bit of a concern for us. But we also noticed overwhelmingly that they had smartwatches. So, like a Samsung or an Apple Watch, not a dedicated tracker like you mentioned before — things like a Fitbit or a Garmin or the Oura ring. So, we repeated the survey with a public, panel research company online to say, “Hey, if you've got a wearable tracker, we'd love to talk to you more” to see if there were some things about those dedicated devices, not just a smartwatch.

We actually found a lot of the same findings. Across both studies, people were more motivated by competition if they had social component. So, sharing with other people could be really good. But it was such a small number of people that were doing it. For me, I felt vindicated, versus Linda who found it surprising. But again, we know that it can be good for people in both cases.

What about folks who maybe don't want to compete against others or have others see their health stats? Can they still benefit from this?

It is an interesting tension. Because we know that competition is a motivator and creates a sort of gamification of the device. Right? You close the rings; you get the badge. That's something you can do by yourself. I don't have to be connected to anyone else to get that sort of connection opportunity to see that I finished my workout today and got the badge or I did 10 workouts in a row and got a badge. That's certainly something that benefits people. But on the flip side, if you want to connect, there's definitely opportunities.

I think one of the ones that gets lost is people assume they have to connect with family and friends, which is certainly one of the easiest opportunities. But there's actually devices that create the opportunity for you to connect and do leaderboards with strangers, too. So, if you don't have that comfort of seeking support from friends and family, which was one of the factors we looked at, then there's different ways to use it.

For us, it said, there's lots of different motivating factors with these devices, and how can we educate people to know that there are many ways you can use it without it being shared with people. You can even just use it to learn a little bit more about yourself.

What about drawbacks? Are there any with this type of technology? Can we take that competition aspect a little too far?

That was one of the concerns we had, especially with the college student sample. It is something that's been supported in past research, as well. That's why we included those variables of self-esteem and a negative social comparison.

What we found was that, for college students, there was a higher probability that if they were seeing, friends and family, performing better than them, like this person closed their rings but they hadn’t yet, that it increased their use of the device.

So, on the one hand, it's great because they're exercising more. But that can go too far, and that can certainly impact someone's self-esteem if they're constantly seeing someone else, perform really well. Like for me. I mean, Linda does 5Ks, she does races. She's far more active of an individual than I am. I take hikes on the weekends with my dogs. So, that healthy comparison is certainly a concern that we, we highlight in that mental health aspect, and being aware of how that (competition) can influence people.

Maybe that tendency to take things too far.

Exactly right. There was a past study, not our research, but one that resonated with me. There was a story about a girl who had injured herself. She wasn't able to exercise at the level she had in the past but was seeing her friends closing their circles and beating her. It made her want to start exercising again and it wasn’t healthy yet for her.

Does our reasoning for being more active matter as long as we're being motivated? And I'm thinking about the fact that for me, when I exercise, I have to set my watch so that it knows that I'm doing this because otherwise in my mind “it doesn't count.”

There are many different things that can motivate us. One of the things that we found in the study was that a lot of people who got these devices in the first place, the motivation was that it was a gift. They actually didn't have a reason to want it. Somebody gave it to them, or their health insurance incentivized it.

Those were their initial factors, but then they found things like, I can learn, or I can compete and so it created that opportunity. For us, I think one of those takeaways again goes back to “within reason,” right. All in moderation. If it becomes something that distracts from your day-to-day otherwise or starts to negatively influence your mental health, then that's where we want to be concerned. But, honestly, if there's opportunities for folks to be active and take ownership over their health, I think that's a good thing.

We often think of technology as having a negative impact on our health, and I'm thinking about particularly, social media. The amount of time we spend glued to our phones and our computers. Are there any other formats, like wearable health trackers, that also have a positive impact?

So, my primary area of research is around the broader use of communication technology and networking with friends and family and some of our weaker ties, and social media in particular is definitely a hot topic.

One of the things continuously found in research is this idea of active versus passive use. So, if I sit, waiting before class, and scroll my phone and look at and see what people are up to, that can cause some social comparison, which can be problematic, like, “Oh, these people are doing cooler things than me.” That can potentially have some negative impacts on our physical and mental health.

But if we are actively communicating with people, say I direct message someone or I send a funny, meme or GIF to a friend. Those things can actually be really good for our well-being. It's really a balance between not just consuming information -- a good friend of mine who I collaborate with, Dr. Jeff Hall, calls it empty calories. I scroll and scroll, and I feel like I've connected but I haven't actually connected with anyone. Later, I still kind of feel lonely and sad.

Making sure that we use technology in active ways can be helpful. That's where things like texting and phone calls can also be really great outlets for our mental health, which we know, spills over into our physical health as well.

So, you're saying my nightly habit of scrolling right before bed is maybe not good? I already knew that, but...

Yeah, it's one where it helps to be smart about it. Let's say you love to scroll TikTok before bed. Well, if you find a funny TikTok, send it to a friend, let them know you're thinking about them. And that sort of helps balance that passive consumption as you're winding down, with an active opportunity to network with someone you maybe haven't talked to in a while.

Well, thank you so much for your time.

Thank you so much for having me.

Natalie Pennington is an assistant professor of communication studies at Colorado State University, researching interpersonal communication and the use of communication technology. I'm your host, Stacy Nick, and you're listening to CSU's The Audit.