King's College London

Research portal

Using Smartphones and Wearable Devices to Monitor Behavioral Changes During COVID-19

Research output: Contribution to journalArticlepeer-review

Shaoxiong Sun, Amos A Folarin, Yatharth Ranjan, Zulqarnain Rashid, Pauline Conde, Callum Stewart, Nicholas Cummins, Faith Matcham, Gloria Dalla Costa, Sara Simblett, Letizia Leocani, Per Soelberg Sørensen, Mathias Buron, Ana Isabel Guerrero Pérez, Ana Zabalza, Brenda Wjh Penninx, Femke Lamers, Sara Siddi, Josep Maria Haro, Inez Myin-Germeys & 6 more Aki Rintala, Til Wykes, Vaibhav A Narayan, Giancarlo Comi, Matthew Hotopf, Richard J B Dobson

Original languageEnglish
Article numbere19992
JournalJournal of Medical Internet Research
Issue number9
Early online date26 Jul 2020
Accepted/In press26 Jul 2020
E-pub ahead of print26 Jul 2020
Published25 Sep 2020

King's Authors


Background: In the absence of a vaccine or effective treatment for COVID-19, countries have adopted nonpharmaceutical interventions (NPIs) such as social distancing and full lockdown. An objective and quantitative means of passively monitoring the impact and response of these interventions at a local level is needed.

Objective: We aim to explore the utility of the recently developed open-source mobile health platform Remote Assessment of Disease and Relapse (RADAR)–base as a toolbox to rapidly test the effect and response to NPIs intended to limit the spread of COVID-19.

Methods: We analyzed data extracted from smartphone and wearable devices, and managed by the RADAR-base from 1062 participants recruited in Italy, Spain, Denmark, the United Kingdom, and the Netherlands. We derived nine features on a daily basis including time spent at home, maximum distance travelled from home, the maximum number of Bluetooth-enabled nearby devices (as a proxy for physical distancing), step count, average heart rate, sleep duration, bedtime, phone unlock duration, and social app use duration. We performed Kruskal-Wallis tests followed by post hoc Dunn tests to assess differences in these features among baseline, prelockdown, and during lockdown periods. We also studied behavioral differences by age, gender, BMI, and educational background.

Results: We were able to quantify expected changes in time spent at home, distance travelled, and the number of nearby Bluetooth-enabled devices between prelockdown and during lockdown periods (P<.001 for all five countries). We saw reduced sociality as measured through mobility features and increased virtual sociality through phone use. People were more active on their phones (P<.001 for Italy, Spain, and the United Kingdom), spending more time using social media apps (P<.001 for Italy, Spain, the United Kingdom, and the Netherlands), particularly around major news events. Furthermore, participants had a lower heart rate (P<.001 for Italy and Spain; P=.02 for Denmark), went to bed later (P<.001 for Italy, Spain, the United Kingdom, and the Netherlands), and slept more (P<.001 for Italy, Spain, and the United Kingdom). We also found that young people had longer homestay than older people during the lockdown and fewer daily steps. Although there was no significant difference between the high and low BMI groups in time spent at home, the low BMI group walked more.

Conclusions: RADAR-base, a freely deployable data collection platform leveraging data from wearables and mobile technologies, can be used to rapidly quantify and provide a holistic view of behavioral changes in response to public health interventions as a result of infectious outbreaks such as COVID-19. RADAR-base may be a viable approach to implementing an early warning system for passively assessing the local compliance to interventions in epidemics and pandemics, and could help countries ease out of lockdown.

View graph of relations

© 2020 King's College London | Strand | London WC2R 2LS | England | United Kingdom | Tel +44 (0)20 7836 5454