Using Step Trackers Among Older People Receiving Aged Care Services Is Feasible and Acceptable: A Mixed-Methods Study

Healthcare (Basel). 2025 Dec 30;14(1):86. doi: 10.3390/healthcare14010086.

Abstract

Background: Maintaining physical activity (PA) is vital for older people, particularly those with frailty and mobility limitations. Wearable activity trackers and digital feedback tools show promise for encouraging PA, but their feasibility and acceptability in aged care remain underexplored. This study evaluated the feasibility and acceptability of using wearable and mobile devices for step tracking and examined the usability of three interfaces (Fitbit, mobile app, and website) for reviewing PA progress in aged care. Methods: This is a user experience and feasibility study that does not involve objective physical activity quantification or device performance analysis. It is a mixed-methods feasibility study conducted with 14 participants aged ≥65 years from residential and community aged care services in metropolitan and regional New South Wales, Australia. Participants used a Fitbit Inspire 3 linked to a study website and a mobile phone step-counting app to monitor their steps across the three interfaces for four weeks. Feasibility was evaluated through enrolment and retention, and acceptability through a facilitator-led survey. Quantitative items on usability, comfort, motivation and device preference were summarised descriptively; open-ended responses were analysed thematically to identify user experiences, benefits, and barriers. Results: Step tracking was feasible, with 82% enrolment and 93% retention. Participants preferred the Fitbit over the mobile phone or website due to its ease of use, visibility and more enjoyable experience. Step tracking increased awareness of PA and supported confidence to move more. Participants valued reminders, rewards and opportunities for social sharing. Reported barriers included illness, usability challenges and occasional technical issues. Conclusions: Wearable step trackers show promise for supporting PA among older people receiving aged care. Despite the small sample and short follow-up, strong acceptability signals suggest that simple digital tools could enhance the reach and sustainability of mobility-promoting interventions into aged care systems. Future studies should examine long-term adherence, usability across diverse mobility and cognitive needs, and conditions for successful scale-up.

Keywords: Fitbits; aged care; digital health; fall prevention; older people; physical activity; physiotherapy; wearable activity trackers.

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