During the past several decades, it has become apparent that a person’s “health” is influenced by many more factors than health care alone. These other “determinants” are defined by the environment- where we are born, live, work, and age. The financial, social, familial, and educational aspects of a person’s life, as well as the physical environment in which the person lives, are termed the social determinants of health (SDOH).
The Centers for Disease Control and Prevention (CDC) identifies social determinants as conditions shaped by “money, power, and resources that people have.” According to the New England Journal of Medicine, researchers have estimated that overall health (and risk of premature death) is determined by individual behavior (40 percent), genetics (30 percent), social circumstance (15 percent), environmental factors (5 percent), and health care (10 percent).
So, I was interested to read that the National Institutes of Health’s (NIH) All of Us**Research Program will be using Fitbit devices for a pilot study to gain better insights into the influence of behavioral, biological, and environmental influences on health (SDOH). This study is through a collaboration with the Scripps Translational Science Institute (STSI) funded through a supplemental grant awarded to The Scripts Research Institute (TSRI) by the NIH. STSI will be working with Fitbit to deploy 10,000 activity trackers to participants in the All of Us Research Program. This will be among the largest deployments of wearables in a population-based study, according to Job Godino, PhD, scientific lead for digital health technologies, STSI.
“The goal of this research is to gain insight into how a wearable device might impact compliance and engagement in a large national cohort study of this scale,” says Adam Pellegrini, general manager of Fitbit Health Solutions. Wearable technologies are the measurement tools that will quantify the sort of individual differences that could give the insights needed to deliver precision medicine, according to Godino. The hope is that researchers will be able to use the data to understand how health indicators (physical activity, sleep and heart patterns) differ by age, geography, and disease to create a personalized approach to medicine that will help prevent and treat disease.
“We also want to learn how we can best motivate a large and diverse group of participants, to wear the device we give them, consistently over a long period of time. This is something that has not been done before.” The data collected from the Fitbit devices will be de-identified and released along with a lot of other data from the All of Us Research Program, says Godino. “Data sharing is a high priority to both researchers and participants, and should help answer some unique and important research questions.”
Pellegrini says “Because All of Us will build one of the world’s largest data sets with the goal of improving the ability to prevent and treat disease based on individual differences in lifestyle, environment, and genetics, this has the potential to create more effective and efficient treatment and prevention of disease,” he says. Also, researchers will study the impact of providing a Fitbit device on engagement with other All of Us Research Program activities.
**The All of Us Research Program is a historic effort to gather data from one million or more people living in the US to accelerate research and improve health. By taking into account individual differences in lifestyle, environment, and biology, researchers will uncover paths toward delivering precision medicine. (PMI) The program is launching in stages, beginning with a beta testing phase and then a national rollout in Spring 2018. The Fitbit Pilot effort is anticipated to begin in mid-2018.