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A wearable-supported digital health intervention with personalized feedback and light incentives improves attitudes toward sleep and physical activity but shows limited behavioral change in a community setting

This proof-of-concept study tested a wearable device (Oura Ring or Fitbit) integrated with the Welloop app and light incentives in 130 participants (median age 49, 83% women) in Kobe, Japan. Attitudinal outcomes showed significant or near-significant improvements in perceived enjoyment and necessity of physical activity and a significant shift in dietary stage of change, while objective behavioral changes were modest (small improvements in exercise duration, walking time, reduced sleep procrastination) and mostly not statistically significant.

Last updated: Jul 9, 2026•0 RCTs•📖 Read as article →

Evidence Score

Evidence Score34/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Feasibility and behavioral impact of a wearable-supported digital health intervention on attitudes and behaviors toward sleep and physical activity: A proof-of-concept study in Kobe City.

observational

Hayashi H, Hasegawa K, Takagi Y, Mizutani H · Digital health (2026)

Participants: N/A
Duration: 12 weeks (January 10 to March 31, 2024)
Intervention: Wearable device (Oura Ring or Fitbit) integrated with Welloop mobile application and a light incentive feature, providing personalized lifestyle recommendations based on biometric data
Outcome: Changes in attitudes (perceived enjoyment and necessity of physical activity, stage of change for dietary habits) and self-reported and device-based behavioral indicators (exercise duration, walking time, sleep procrastination)
Effect Size: N/A (effect sizes not reported in abstract)
Population: Adults aged 20-65 years in Kobe, Japan, who owned a smartphone, registered as Healthcare Citizen Supporters, and agreed to wear a wearable device (N=130, median age 49, 83% women, 60% with university degree or higher)

Result:

PubMed: 42416388DOI: 10.1177/20552076261466410

Mechanism Graph

Participants receive personalized lifestyle recommendations based on biometric data via mobile app
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Light incentive feature supports engagement
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Self-monitoring and feedback improve attitudes toward physical activity and sleep
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Result: Attitudinal improvements but limited behavioral change

Limitations

  • ⚠Single-arm design with no control group limits causal inference
  • ⚠Most behavioral outcomes were not statistically significant, indicating limited efficacy
  • ⚠High proportion of women (83%) and educated participants (60% university degree) may limit generalizability

Frequently Asked Questions

What wearable devices were used in this study?▼

Participants used either an Oura Ring or a Fitbit device throughout the study period.

Did the intervention significantly change sleep or physical activity behaviors?▼

Behavioral changes were modest and mostly not statistically significant, though small improvements in exercise duration, walking time, and reduced sleep procrastination were observed.

What were the main attitudinal improvements?▼

Significant or near-significant improvements were found in perceived enjoyment and necessity of physical activity, and a significant shift in the stage of change for dietary habits.

How long did the study last?▼

The study was conducted from December 2023 to March 2024, with the intervention phase from January 10 to March 31, 2024.

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References

  1. 1.Hayashi H, Hasegawa K, Takagi Y, Mizutani H. "Feasibility and behavioral impact of a wearable-supported digital health intervention on attitudes and behaviors toward sleep and physical activity: A proof-of-concept study in Kobe City.." Digital health, 2026. PMID: 42416388 DOI: 10.1177/20552076261466410
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.