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Importance: The use of consumer-grade wearable devices for collecting data for biomedical research may be associated with social determinants of health (SDoHs) linked to people's understanding of and willingness to join and remain engaged in remote health studies. Objective: To examine whether demographic and socioeconomic indicators are associated with willingness to join a wearable device study and adherence to wearable data collection in children. Design, Setting, and Participants: This cohort study used wearable device usage data collected from 10 414 participants (aged 11-13 years) at the year-2 follow-up (2018-2020) of the ongoing Adolescent Brain and Cognitive Development (ABCD) Study, performed at 21 sites across the United States. Data were analyzed from November 2021 to July 2022. Main Outcomes and Measures: The 2 primary outcomes were (1) participant retention in the wearable device substudy and (2) total device wear time during the 21-day observation period. Associations between the primary end points and sociodemographic and economic indicators were examined. Results: The mean (SD) age of the 10 414 participants was 12. 00 (0. 72) years, with 5444 (52. 3%) male participants. Overall, 1424 participants (13. 7%) were Black; 2048 (19. 7%), Hispanic; and 5615 (53. 9%) White. Substantial differences were observed between the cohort that participated and shared wearable device data (wearable device cohort WDC; 7424 participants 71. 3%) compared with those who did not participate or share data (no wearable device cohort NWDC; 2900 participants 28. 7%). Black children were significantly underrepresented (-59%) in the WDC (847 11. 4%) compared with the NWDC (577 19. 3%; P <. 001). In contrast, White children were overrepresented (+132%) in the WDC (4301 57. 9%) vs the NWDC (1314 43. 9%; P <. 001). Children from low-income households (<24 999) were significantly underrepresented in WDC (638 8. 6%) compared with NWDC (492 16. 5%; P <. 001). Overall, Black children were retained for a substantially shorter duration (16 days; 95% CI, 14-17 days) compared with White children (21 days; 95% CI, 21-21 days; P <. 001) in the wearable device substudy. In addition, total device wear time during the observation was notably different between Black vs White children (β = -43. 00 hours; 95% CI, -55. 11 to -30. 88 hours; P <. 001). Conclusions and Relevance: In this cohort study, large-scale wearable device data collected from children showed considerable differences between White and Black children in terms of enrollment and daily wear time. While wearable devices provide an opportunity for real-time, high-frequency contextual monitoring of individuals' health, future studies should account for and address considerable representational bias in wearable data collection associated with demographic and SDoH factors.
Kim et al. (Thu,) studied this question.