How wearable tech could help indigenous elders spot heart problems – and save lives

Many people with atrial fibrillation have no symptoms. But the heart condition — which involves an irregular and often rapid heartbeat — increases the risk of stroke and heart failure, especially if left untreated.

Wearable devices such as smart watches are playing an increasingly important role in monitoring heart conditions such as atrial fibrillation.

Our recently published study is the first to explore how older Indigenous people living in remote locations can use mobile devices to monitor their health.

Although it was only a small study—11 people over five days—in that time, one woman was able to realize her husband might be at risk. And her knowledge ultimately saved his life.

Using Wearables for Heart Health

Research has rarely explored the potential of wearable devices to monitor atrial fibrillation in Indigenous people. This is despite them being affected by the condition more often and at a younger age than non-Indigenous Australians – and with worse outcomes.

Aboriginal people are three times more likely to be diagnosed with atrial fibrillation after a stroke or heart attack than non-aboriginal people in Australia. One way to detect and treat the condition before it escalates is through the use of wearable devices.

In previous research with Indigenous people from rural, remote and regional areas of New South Wales, the majority (92%) of older women participants said they would like to try a wearable device that would allow them to track their health and fitness.

These results are consistent with other studies that show that indigenous people can be enthusiastic about new technologies.

What did we do?

In our new study, we worked with an Aboriginal health service in remote New South Wales to co-design and evaluate a health program using wearable technology.

Evidence shows that health programmes for Indigenous people that are culturally relevant and developed in partnership with the community are more effective.

Together, we recruited 11 Indigenous people aged 55 to 78 years who had high blood pressure and were at risk for developing atrial fibrillation. Participants had at least one other risk factor:

• another chronic disease

• heart disease that affects the structure of the heart (for example, its walls or valves)

• previous stroke

• history of alcohol use disorder.

People diagnosed with atrial fibrillation or other heart rhythm disorders were not eligible to participate in the study.

For five days, participants wore a chest patch that monitored their heart rate and blood pressure. Nine also wore a smartwatch that recorded heart rate and fitness measurements such as step count.

During daily clinic meetings, the researcher collected and reviewed data, and the participant discussed their experiences. We asked participants about four issues: comfort, cultural safety, convenience, and any concerns.

To collect data, our study used traditional research methods (such as a survey) alongside yarning. This core conversational process encourages people to share stories, reinterpret questions, and add information. Compared to a predetermined survey structure, yarning prioritizes what the participant considers most important.

What we found

Despite challenging conditions – including variable internet connections and temperatures above 36°C – participants were enthusiastic about the programme. Their responses showed that the watches and patches were a convenient, practical and culturally safe way to monitor heart health.

Many participants reported that the program increased their confidence and knowledge about their health. The study also suggested that the increased knowledge could have benefits for other members of the community.

Similar to our previous studies, older women in particular were more likely to spontaneously share health information they learned with family and community members. This highlights the influential role of older indigenous women in their communities.

The knowledge gained helped one of the participants, Aunt Mary, recognize that her husband Lindsay was at risk of developing atrial fibrillation.

She encouraged him to go to a clinic for tests, where he was diagnosed with the condition. Shortly afterward, Lindsay underwent emergency quadruple coronary artery bypass surgery, which saved his life. Aunt Mary told us:

I was really amazed at how everything happened and happened really quickly for Lindsay. (…) He had no symptoms, no pain. Nothing. No pain (…) he was (at risk of) having a heart attack.

Participants also wanted the program to be offered to more younger people in their community. Aunt Mary told us she talked to people about the importance of testing:

Just 30 seconds, you put your fingers on this little machine. 30 seconds and it will save your life. I recommend it to my people.

Participants suggested that future clinical programming should include health education sessions, either in person or online, in small groups, if not individually.

Although it was not part of the study, we also found that participants used their watches as motivation to be more active, for example to track their step count.

Concerns about the wearables program were minimal. Two participants expressed some concerns about how technology companies handle privacy. One told us he trusted universities to keep data private, but he wasn’t sure about the companies that made the wearables.

This led us to create a phone app to extract data from devices and a new research database to store the data. This database provides greater autonomy by allowing participants to decide whether to share data with researchers.

What’s next?

Several participants said they felt they had not historically been prioritized for new health technologies because they lived remotely. However, our research suggests that older Indigenous people may be willing to use health technologies and share their benefits.

Our study is a first step in showing how this type of program could work. But because it involved only 11 people for five days, we’re interested in further research. Participants have expressed interest in a program that combines personalized health data from wearables with fitness.

Our new project will involve online health education and wearing devices that monitor heart activity, blood pressure and exercise (e.g. number of steps) for a period of 28 days.