Can Wearable Cameras be Used to Validate School-Aged Children's Lifestyle Behaviours?

Abstract

Wearable cameras combined with accelerometers have been used to estimate the accuracy of children's self-report of physical activity, health-related behaviours, and the contexts in which they occur. There were two aims to this study; the first was to validate questions regarding self-reported health and lifestyle behaviours in 9⁻11-year-old children using the child's health and activity tool (CHAT), an accelerometer and a wearable camera. Second, the study sought to evaluate ethical challenges associated with taking regular photographs using a wearable camera through interviews with children and their families. Fourteen children wore an autographer and hip-worn triaxial accelerometer for the waking hours of one school and one weekend day. For both of these days, children self-reported their behaviours chronologically and sequentially using the CHAT. Data were examined using limits of agreement and percentage agreement to verify if reference methods aligned with self-reported behaviours. Six parent⁻child dyads participated in interviews. Seven, five, and nine items demonstrated good, acceptable, and poor validity, respectively. This demonstrates that the accuracy of children's recall varies according to the behaviour or item being measured. This is the first study to trial the use of wearable cameras in assessing the concurrent validity of children's physical activity and behaviour recall, as almost all other studies have used parent proxy reports alongside accelerometers. Wearable cameras carry some ethical and technical challenges, which were examined in this study. Parents and children reported that the autographer was burdensome and in a few cases invaded privacy. This study demonstrates the importance of adhering to an ethical framework.

Keywords: autographer; child’s health and activity tool (CHAT); health and lifestyle behaviours; observation; parent-child dyad; previous day recall; self-report; wearable cameras.

Figure 1

A Bland–Altman plot demonstrating the difference between self-reported and autographer-derived getting up time (n = 12). A mean bias of −10 min (±17 min) with limits of agreement (LOA) of +23 and −42 min is shown.

Figure 2

A Bland–Altman plot demonstrating the difference between self-reported and autographer-derived sleep time (n = 6). A mean bias of +27 min (±21 min) with LOA of + 68 and −13 min is shown.

Figure 3

Bland–Altman plot demonstrating the difference between self-reported and autographer-derived before lessons screen time (n = 12). A mean bias of −1 min (±18 min) with LOA of + 33 and −36 min is shown.

Figure 4

Bland–Altman plot demonstrating the difference between self-reported and autographer-derived after school screen time (n = 7). A mean bias of −43 min (±46 min) with LOA of +47 and −134 min is shown.

Figure 5

Bland–Altman plot demonstrating the difference between self-reported and autographer-derived homework and reading duration before school (n = 12). Six data points overlap shown by the darker outline. A mean bias of +2 min (±8 min) with LOA of +17 and −13 min is shown.

Figure 6

Bland–Altman plot demonstrating the difference between self-reported and autographer-derived homework and reading duration after school (n = 7). A mean bias of +1 min (±9 min) with LOA of +19 and −16 min is shown.

Figure 7

Pen Profile showing parents’ and children’s reactions to the information sheet and the recruitment video (B = Boy, G = Girl, F = Father, M = Mother); n shows the number of individual responses.

Figure 8

Pen profile depicting children’s thoughts and feelings when wearing the autographer at home and in public (B = Boy, G = Girl). n shows the number of individual responses.

Figure 9

Pen profile illustrating parental views as a third party to the autographer (F = Father, M = Mother). n shows the number of individual responses.