Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article


Master of Science




Mitchell, Marc

2nd Supervisor

Prapavessis, Harry


Little device-measured data are available to describe the physical activity (PA) of rural-dwelling individuals living with chronic disease. PURPOSE: From accelerometer data collected using a smartphone app (‘Carrot Rewards’), we sought to provide mean daily step counts for app users in general and by age and gender for those living in rural/urban areas and those self-reporting a chronic disease or not. METHODS: This cross-sectional cohort study used device-assessed data from Ontario app users (i.e., PA data collected over a 7-day period for each user) who completed an in-app chronic disease survey from December 2018 to April 2019. A series of ANCOVAs controlling for date were conducted. RESULTS: Overall, 11,162 users (Mage=34.7) accumulated 5,342 steps per day (SE=33.41). Chronic disease status, gender and age bracket significantly influenced (p<.001) mean daily step count, whereas rural/urban status did not (p=.367). Post hoc testing suggested females living with chronic disease(s) were more likely to have insufficient PA. CONCLUSION: Using smartphone-assessed daily step count data, we describe PA behaviours in several population subgroups in Ontario and add to the existing PA surveillance literature.

Summary for Lay Audience

Regular physical activity (PA) can reduce the rate and severity of many chronic diseases. Possibly because of lower PA levels, rural-dwelling (vs. urban) individuals are at higher risk of developing preventable chronic diseases. Those living with chronic disease may also be less active than their healthy peers, worsening their conditions. To date, little objective data are available to describe PA and inform interventions for these higher-risk populations. This study looked at the daily step counts of Ontario users from a popular Canadian smartphone app called Carrot Rewards. Our objective was to provide daily step counts for app users in general and by gender and age as well as those living in urban versus rural areas and those self-reporting a chronic disease or not. Overall, users took approximately 5,342 steps per day. Males took more steps than females, and there were step differences between 6 of 13 age brackets. Individuals who self-reported having at least one chronic disease took fewer steps per day than healthy individuals. There was no difference in daily step counts between individuals living in rural or urban settings. This study provides a unique perspective on the PA behaviours of Ontarians. Our data may help public health policy makers to better understand, target, and specialize interventions for specific subsets of the population.