Many individuals with atrial fibrillation do not experience symptoms, but this heart condition, characterized by an irregular and often rapid heartbeat, can increase the risk of stroke and heart failure if left untreated. Wearable devices, such as smartwatches, are increasingly valuable tools for monitoring heart conditions like atrial fibrillation. Our recent study, the first of its kind, explored the use of wearables among older Indigenous people living in remote areas. Although small, involving just 11 participants over five days, the study revealed important findings. For instance, one woman realized her husband’s potential risk and was able to save his life due to the insights she gained. Despite facing a higher prevalence and younger onset of atrial fibrillation than non-Indigenous Australians, with worse outcomes, research has seldom focused on Indigenous people in this context. Indigenous individuals are three times more likely to be diagnosed with atrial fibrillation after suffering a stroke or heart attack compared to non-Indigenous Australians. Wearables offer a way to detect and address the condition early.
Previous research in rural, remote, and regional New South Wales suggested a strong interest in using wearable devices among 92 percent of older Indigenous women. These participants were keen to track their health and fitness, aligning with other studies showing Indigenous communities’ willingness to adopt new technology. Our recent study involved collaboration with an Aboriginal-controlled health service in remote New South Wales, working together to design and evaluate a wearable technology health program. Evidence indicates that health programs are more effective when tailored to the cultural context and developed in collaboration with the community. We recruited 11 Indigenous individuals aged 55 to 78 with high blood pressure and atrial fibrillation risk factors. Each participant had at least one other risk factor, such as another chronic condition, structural heart disease, a history of stroke, or alcohol use disorder.
Those with diagnosed atrial fibrillation or other irregular heartbeats were excluded. For five days, participants wore a chest patch to monitor heartbeat and blood pressure, and nine participants wore a smartwatch tracking heart rate and fitness metrics like step count. Daily clinic meetings allowed for data review and discussions on the participants’ experiences, focusing on comfort, cultural safety, convenience, and any concerns. Data collection combined traditional research methods like surveys with yarning, an Indigenous conversational process that fosters storytelling and prioritizes what participants find important. Despite challenges, including inconsistent internet and high temperatures, participants responded enthusiastically to the program. Their feedback indicated that the wearable technology was comfortable, convenient, and culturally safe for heart health monitoring. The study suggested that increased health knowledge gained from the program could benefit other community members, as older women often shared the information with family and community, highlighting their influential roles.
For example, Aunty Mary recognized her husband Lindsay’s risk for atrial fibrillation, prompting him to seek testing at the clinic. Diagnosed with the condition, he underwent life-saving quadruple bypass surgery. Aunty Mary expressed amazement at how quickly events unfolded, as Lindsay had experienced no symptoms or pain. Participants were eager for the program to be expanded to include more people, including younger individuals. Aunty Mary shared the importance of testing with others, noting it could be life-saving and recommended it to her community. Participants suggested incorporating health education sessions into future programs, potentially offered in-person or online and tailored to small groups or individuals.
Observations during the study indicated that participants used the watches to encourage physical activity, such as tracking steps. Concerns about the program were minimal, though two participants expressed apprehension about data privacy. Some distrusted tech companies despite trusting universities with their data. This led to plans for a phone application to extract data and a new research database, providing participants with the choice regarding data sharing. Some participants felt that their remote location had previously excluded them from priority access to new health technologies. However, the research suggests that older Indigenous people are eager to adopt health technology and share its advantages. This study is a preliminary step in demonstrating the program’s potential but calls for further investigation due to its small scale. Participants showed interest in a program integrating personalized health data from wearables with fitness.