Projects aiming to reduce health risks from extreme heat are increasingly using devices like wearable health trackers and temperature sensors to capture heat data and explore its physiological impacts on people. However, experiences vary by the geography, the participants, the weather patterns, and the types of devices being used. The HeatNexus initiative organised a seminar to learn from these various contexts and experiences about using wearable devices for heat-health research.
HeatNexus is a global initiative comprising nine project teams all over the world advancing heat adaptation strategies in low-middle-income countries. The Institute of Development Studies (IDS) works across the HeatNexus network to enhance and amplify the efforts and the outcomes of the research projects so that they add up to more than the sum of their parts.
The seminar in October on “Devices, sensors, data collection tools and methods” included. experts from the HAPI (Heat Adaptation for Pregnant women and Infants) and REFLECT teams shared their experiences of deploying various sensors and data collection tools, highlighting the challenges, lessons and innovative practices driving their work. Over 70 participants from across the nine research teams, Wellcome, IDS, and various stakeholders attended the seminar and contributed to the discussions.
Tools and devices used: from wearables to data platforms
The seminar highlighted various devices and platforms designed to monitor heat-related health conditions effectively. Real-time health metrics were tracked using wearable technologies like the Fitbits and Garmin devices while internal body temperatures were measured using Core Body Sensors and iButtons to understand physiological responses to heat.
To monitor environmental conditions, HOBOware sensors captured ambient indoor and outdoor temperatures within participant environments. For data management and visualisation, Fitabase proved valuable but costly, prompting consideration of Labfront as a more affordable alternative for Garmin data collection. The HAPI and REFLECT teams emphasised the need for devices that are affordable, autonomous, and attested, ensuring practicality and reliability in non-invasive heat-health research.
Overcoming procurement and deployment challenges
Those attending the seminar shared device procurement complexities:
- Lengthy Acquisition Timelines: Unlike everyday consumer products, specialised sensors often require longer lead times. “These devices are not like picking up cooking oil from the supermarket,” noted Thabani Bhebe from the HAPI team, referring to the manufacturing delays and foreign exchange restrictions that can complicate the procurement process.
- Theft: The potential for device theft was also raised as a concern. Wider implications raised were the potential for putting participants at risk, potential impact on procurement plans, budget implications, and delays or interruptions on data collection timelines.
Putting participants first
One major challenge highlighted was participant adherence to using wearables and sensors. Key issues and solutions discussed include:
- Comfort : Extended use of tight straps or sensors in plastic housing, such as iButtons, has been reported at times to cause discomfort and, in some cases, contact dermatitis. To mitigate this, the research teams explored options such as using hypoallergenic materials, adjusting fit, and incorporating regular device-free periods to allow the skin to recover. Continuous counselling and support helped to alleviate these concerns by educating participants about proper usage. Calvin Kunaka and Celeste Madondo of the HAPI study urged that “if wearables are included, ongoing technical support and counselling are an important element.”
- Consent and Community Engagement: Effective implementation requires obtaining consent not only from participants but also from key community members and leaders. For instance, installing HOBOware sensors and outdoor weather monitors necessitated permission from heads of households and community members to ensure ethical and culturally appropriate deployment.
- Safety: As noted above, some of these devices are expensive and unaffordable in many of these contexts. Wearing such devices or placing them in selected homes can place participants in harm’s way. As asserted by Memo Cedeño-Laurent, “If you get them to wear a gold Apple watch, you are probably putting your participants at risk,” underscoring the importance of cultural sensitivity and practicality in device selection.
- Privacy: Ethical concerns around data privacy were another concern. Michaela Deglon, the project manager for another HeatNexus project called HABVIA (Heat Adaptation Benefits for Vulnerable groups In Africa) emphasised, “We must be extremely mindful of potential privacy breaches related to GPS data.” She advocated for protocols that prioritise participant consent and data safety.
Navigating technical limitations and maintenance
Maintaining device functionality in challenging environments requires important considerations:
- Infrastructure demands: Many wearables depend on mobile internet, electricity for charging and smartphones for data synchronisation. Participants noted that solar-powered chargers and offline-capable devices like iButtons could mitigate this set of challenges.
- Device Calibration and Data Loss: Regular maintenance, calibration, and data retrieval were essential to prevent data loss. Colleagues mentioned that partnerships with data service companies like Labfront has helped streamline data flows and supported device maintenance.
- Data Gaps: Participants’ inability to consistently wear devices due to cultural practices, household tasks, or device limitations (e.g., sensors requiring movement to remain active) often led to data gaps. This was addressed through targeted data collection windows during peak heat exposure and tailored participant training sessions. However, the reality of these situations begs the question about how to treat the data gaps and the implications of those decisions on data analysis and interpretation.
Data management and interpretation: balancing volume and relevance
Managing the vast amounts of data generated by these devices was identified as a significant challenge. The HAPI team noted using platforms like Fitabase for data management, though its high cost ($5,000 annually) posed challenges for scalability. Dr. Cedeño-Laurent from the REFLECT team reiterated the value of collaborating with cost-effective data collection services like Labfront. Comprehensive training for staff on data selection, cleaning, and analysis was considered vital for ensuring data relevance and applicability.
Data management needs to be addressed
The HeatNexus seminar provided a comprehensive view of integrating wearables and sensors into heat-health research. By addressing procurement challenges, emphasising participant comfort, and adopting innovative data management solutions, researchers can gain deeper insights into the complex dynamics of heat-health adaptation.
However, several questions remain. Issues around data standardisation, data governance, and transitioning from data extraction to its management and use in analysis—particularly handling missing data—are high priorities for the teams to address collaboratively next.
The shared lessons serve as a valuable guide for current adaptations as well as future initiatives, promoting more efficient, ethical, and impactful research practices.
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