Poster W4 - The Development and Feasibility Testing of a Wearable Heart Rate Variability Monitor to Support Secondary School Student Well-being

Introduction: Young people, aged 10-24, make up 27% of the global population [1]. Among this demographic in Ireland, second level school students (12-18 years) are experiencing decreasing overall well-being and increasing levels of stress and loneliness [2, 3]. As digital engagement rises with these students, there is an opportunity to use the technologies they engage with to deliver information and interventions to support stress management. Recent studies have increasingly looked at the use of wearable devices measuring heart rate variability (HRV) to track and manage stress [4]. This presents a potential opportunity to provide new strategies to support students. However, these devices and their connected apps must be co-created with the intended student users to best align the technology with their needs. Based on feedback from the initial phase of this project, this study focuses on the development and 6-week-long feasibility implementation study of the first version of a co-created HRV monitor and connected app during the end of students' penultimate year of second level schooling.

Materials and

Methods: Following the Stanford Biodesign process, this project involved an initial needs assessment, design phases and implementation testing with three secondary schools in Ireland [5]. Public and Patient Involvement (PPI) principles have been integral to incorporate students and teachers in the decision making process during the development of the app and wearable [6]. The HRV monitor, encased in 3D-printed nylon, was assembled using existing integrated circuits. The connected mobile app, named ‘Wellby: Your Well-being Buddy’ by students, was created for both Android and iOS devices, facilitating minute-long HRV recording sessions, access to educational resources, and text-based communication with a health coach. The wearable provided metrics such as time-domain HRV values (SDNN and RMSSD), average heart rate, and signal quality. During the final six weeks in the 2023-2024 school year, students (n = 44) at three schools and teachers (n = 6) at one school tested the app and wearable, and were encouraged to complete recordings with their wearable at least twice a week. App engagement was tracked throughout the study and feedback was collected using the User Version of the Mobile App Rating Scale (uMARS) questionnaire and focus group discussions at each school [7].

Results, Conclusions, and Discussions: Initial feedback gathered from the uMARS survey at two schools (n = 21) indicated that 76% of students felt the app and wearable aligned well with their well-being needs. Similarly, 76% of students felt that the app content was geared towards students as the target audience. Additionally, 63% of students noted an increase in awareness of their well-being, and 70% felt that they were motivated to address specific aspects of their well-being. In focus group discussion, students suggested improvements to the device for increased usability and engagement. One student noted that they were “surprised by the battery life. [They] found that it lasts about 3 hours then [they] have to charge it again.” Students at another school also shared that they would wear the device more if it were more fashionable and they recommended ways to change the appearance of the device. Further analysis of engagement and HRV metrics will continue once the study finishes on May 31st.

This feasibility study facilitated the implementation testing of the Wellby device and app. It confirmed the potential for a student-specific, co-created wearable and app to improve secondary school students’ awareness, knowledge and motivation related to their well-being goals. The feedback gathered from this feasibility study will guide further refinements in preparation for a year-long pilot study beginning in September 2024.

Acknowledgements (Optional): I would like to acknowledge the students and teachers at the three secondary schools (St. Wolstan's Community School, Gorey Community School, and Youthreach Rush) involved in this project who have helped with testing and given feedback throughout this project. I would specifically like to thank the teachers Brendan Bonner, Christine Hughes, Colm Feighery, Christine Hughes, and Liam McCotter.