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Study: Race, income linked to wearable-based research participation among children

Black children and kids from lower socioeconomic backgrounds were less likely to participate, share data and engage with research that used wearable devices, according to a study published in JAMA Network Open

The study included wearable device data collected from more than 10,000 children ages 11 through 13 years old in the ongoing Adolescent Brain and Cognitive Development (ABCD) Study. 

There was a 59% lower relative proportion of Black children in the wearable device group than in the group that didn’t use wearables. But the study had a 132% higher relative proportion of white children in the wearable group. 

Researchers also found a significantly lower proportion of children with household incomes less than $24,999 per year in the wearables cohort. Children of parents who had a lower educational attainment (equivalent to late high school) were less likely to join the wearable group too. 

The study also found differences in retention for Black children and those in lower socioeconomic groups. Black children shared data for 16 days compared with 21 days for white kids. Those who lived in households with incomes of less than $25,000 were retained for only 15 days, while those whose parents had completed upper high school shared wearable data for 17 days. However, children with parents who had finished an equivalent of an associate’s degree were retained for 20 days. 

Children from racial and ethnic minority groups also wore their devices for less time compared with their white counterparts, and kids from the southwestern region of the U.S. had lower wear times as well. Researchers also found wear times were lower for children who were recruited during the COVID-19 pandemic compared with those who joined before the pandemic. 

“The findings of this study suggest that without factoring in the broader social determinants of health that may affect individual and group experiences and participation in research, inequities in data collection using wearable technologies may continue to exist, especially for youths belonging to racial and ethnic minority groups,” the study’s authors wrote. 


Racial and ethnic minorities are already underrepresented in clinical trials, which could affect how well drugs and devices work for these populations. 

The study’s authors note that consumer wearable devices have the potential to allow for early detection and intervention for health concerns, but some studies have found their heart rate data is less reliable for darker skin tones. Still, as more research includes consumer wearables, it’s necessary to ensure equitable access to these studies.

“Future wearable device research should address various sociotechnical and human factors to improve wearable device–based data collection. These can range from participants’ and their families’ understanding of the study, consent and assent language, the potential influence of personal data sharing, its secondary usage and their overall trust in the study team,” researchers wrote. “Characteristics of the study team may also inform whether participants opt in to studies, as racial and ethnic minority communities are more likely to trust those that are like them and understand their experiences.”

Jeremy Petch will offer more detail at the HIMSS23 session “Opening the Black Box: Promise and Limitations of Explainable AI.” It’s scheduled for Wednesday, April 19 at 10 a.m. – 11 a.m. CT at the South Building, Level 5, room S503.

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