Design and validation of a smart garment to measure positioning practices of parents with young infants

Abstract

The aim of this cross-sectional study was to evaluate the feasibility, construct validity, and reliability of a smart garment to characterize parent-child positioning practices in infants less than six months old. The smart garment (Get Around Garment, GG) was developed through feedback from seven infants and their parents. The final system was then tested with sixteen infants (M = 3.1 ± 1.1 months) assessed in their homes during one visit that consisted of a: 1) Structured Play Assessment (2.5 min): infant was placed in each of five positions (prone, supine, reclined/inclined, and upright) for 30 s, 2) Free Play Assessment (40-60 min): parents were asked to engage in typical daily activities, and 3) second Structured Play Assessment. Infants' body position was both coded from video and identified from sensor data using a custom program. Feasibility was measured by data from a Daily Wearing Log and Garment Perception Questionnaire. Validity was evaluated by comparing the coding and sensor data. Reliability was measured by comparing the sensor data between the two Structured Play Assessments. The GG was considered feasible for use. The smart wearable system showed high levels of accuracy for classifying body position secondby- second and when comparing cumulative duration across time. Reliability of the smart garment was excellent. Young infants spent more time in supine and supported upright positions relative to prone, reclined, or inclined positions. The results suggest that accelerometers can be integrated into garments in a manner that is feasible to provide accurate and consistent data about positioning practices of parents with young infants. Monitoring early positioning practices is important because these practices impact future motor and cognitive developmental trajectories.

Keywords: Accelerometer; Connected health; Infant; Parent-child interaction; Positioning; Wearable technology.

Figure 1.

Examples of activities for the A) Structured Play Assessment and B) Free Play Assessment.

Figure 2.

A) Initial prototype of the Get Around Garment; B) Size reduction of microcontroller from the initial prototype (on the left) to the final prototype (on the right); C) Final prototype of the Get Around Garment

Figure 3.

A) Representation of the five body positions: supine, reclined, supported upright in sitting or standing, inclined, and prone; B) Percentage of time that infants spent in each position during the Free Play Assessment according to data from the smart garment system.

Figure 3.

A) Representation of the five body positions: supine, reclined, supported upright in sitting or standing, inclined, and prone; B) Percentage of time that infants spent in each position during the Free Play Assessment according to data from the smart garment system.

Figure 4.

An example of pitch angle data throughout a full data collection (0–1800 seconds). The first and second structured assessments can be seen in the light grey regions at the start and end of the dataset. The free play assessment between them is shaded darker grey. The cut-off thresholds among positions are marked with horizontal dashed lines with those regions labelled on the right side of the figure.