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<article xmlns:xlink="http://www.w3.org/1999/xlink">
  <front>
    <journal-meta />
    <article-meta>
      <title-group>
        <article-title>Development of a Mobile Application to Measure Youth Health Using Machine Learning and Smart Band</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <string-name>Tatyana Mykaela Chávez Barrios</string-name>
          <email>tatyana.chavez@ucsm.edu.pe</email>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Pablo Sandoval</string-name>
          <email>pablosandoval2191@gmail.com</email>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Diego Pardo Yepez</string-name>
          <email>diego.pardo@ucsm.edu.pe</email>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Karina Rosas Paredes</string-name>
          <email>kparedes@ucsm.edu.pe</email>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>José Sulla-Torre</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <aff id="aff0">
          <label>0</label>
          <institution>Universidad Católica de Santa María</institution>
          ,
          <addr-line>Urb. San José s/n Umacollo, Arequipa, 04000</addr-line>
          ,
          <country country="PE">Perú</country>
        </aff>
      </contrib-group>
      <abstract>
        <p>The present research aims to use Machine Learning technologies and wearable technologies, as well as the development of a framework for creating a mobile application, to develop a solution that emerges from the convergence of the tools. The solution consists of developing an application that allows the visualization of data collected by a wearable technology known as "Smart Band," which captures a series of measurements related to physical activity (steps, calories burned, among others). Using a model built from tools in the artificial intelligence subfield, the application can determine the user's health status, automating motor competence evaluations aimed at schoolchildren in Arequipa aged 6 to 17. A questionnaire for the usability evaluation “System Usability Scale” was applied, according to which an average of 82.5 was obtained, demonstrating that the software passed the usability test and was considered efficient. The mobile application can be used by those interested in school health.</p>
      </abstract>
      <kwd-group>
        <kwd>eol&gt;Mobile application</kwd>
        <kwd>machine Learning</kwd>
        <kwd>smart band</kwd>
        <kwd>health</kwd>
        <kwd>youth 1</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <body>
    <sec id="sec-1">
      <title>1. Introduction</title>
      <p>In today's digital age, mobile technology has become relevant in various areas of society.
Educational and medical fields have yet to be immune to this technological revolution, where
integrating mobile applications has opened many possibilities to improve the teaching and
learning experience. Among these opportunities, the need arises to use technology to measure
and monitor students' physical health, promote healthy lifestyles, and optimize their academic
performance.</p>
      <p>This research proposes the development of an innovative mobile application, which is
complemented using a “Smart Band,” to accurately and continuously measure various parameters
related to student's physical health. This application would allow teachers to access the health
history of each student, providing valuable information to understand her physical condition,
identify possible health problems, and design personalized interventions that promote
comprehensive development.</p>
      <p>
        The importance of measuring physical health in schoolchildren lies in its impact on their
general well-being and academic performance [
        <xref ref-type="bibr" rid="ref1">1</xref>
        ]. Globally, the incidence of overweight in age
groups 5 to 19 years is increasing; the WHO in 2015 [
        <xref ref-type="bibr" rid="ref2">2</xref>
        ] estimated that almost one in five
schoolage children and adolescents were overweight, representing 338 million students who have
problems related to obesity, lack of physical activity and poor diet, which can lead to chronic
diseases and learning difficulties. According to UNICEF, [
        <xref ref-type="bibr" rid="ref3">3</xref>
        ] Latin America is in second place in the
prevalence of obesity in this age group with a percentage of 33.5%. In the Peruvian context, a
worrying increase in obesity and a sedentary lifestyle has been observed in schoolchildren, with
one in four Peruvian children having some degree of excess weight. In adolescents, this
prevalence reaches 14.2% [
        <xref ref-type="bibr" rid="ref4">4</xref>
        ]. At the regional level, Arequipa has a high obesity rate in children
and adults, being one of the ten regions that exceed the general average of overweight at the
national level [
        <xref ref-type="bibr" rid="ref5">5</xref>
        ]
      </p>
      <p>Implementing this mobile application, supported by Machine Learning techniques, would
represent a significant advance in monitoring students' physical health. Analyzing and processing
the data collected and generating predictions would facilitate interpreting the information and
help identify relevant patterns.</p>
      <p>In this sense, the main objective of this study is to design and develop a mobile application
that, using a Smart Band and data analysis using Machine Learning, contributes to improving
students' physical health and promotes a healthier educational environment. Implementing this
technological tool is expected to provide teachers with a more complete and objective view of the
health of their students, allowing timely and personalized interventions that promote healthy
lifestyles and improve their comprehensive well-being.</p>
    </sec>
    <sec id="sec-2">
      <title>2. State of the Art</title>
      <p>
        As the first related work, it presents an independent and portable system for detecting driver
drowsiness using a smartwatch. The system is based on collecting motion data and using a
support vector machine (SVM) classifier to determine the driver's drowsiness level [
        <xref ref-type="bibr" rid="ref6">6</xref>
        ].
      </p>
      <p>
        Other related work was also found, oriented towards research using portable technology in
preschoolers and schoolchildren. They indicated that wearable devices can be used as a
motivational tool to improve physical activity behaviors and evaluate physical activity
interventions. However, the different levels of reliability of the other devices used in the studies
may compromise the analysis and understanding of the results [
        <xref ref-type="bibr" rid="ref7">7</xref>
        ]
      </p>
      <p>
        At an international level, the research work “Smart Real-Time Health Monitoring Band Using
Machine Learning and IoT” [
        <xref ref-type="bibr" rid="ref8">8</xref>
        ] can be highlighted, which proposes the integration of different
technologies, such as IoT and ML, to use calculations to examine the clinical problem of people.
Data on the person's heart rate, blood pressure, and temperature are collected using IoT. This
information can be obtained through a smart band or a mobile phone application. The data is sent
to the cloud and analyzed using machine learning techniques. The testing stage checks for any
abnormalities in the clinical problem from the sensor data collected through the IoT framework.
A genuine evaluation is performed on the data collected in the cloud from the IoT devices to
evaluate the accuracy of the prediction rate.
      </p>
      <p>Certain similarities are presented in this work, such as data collection in real-time and the use
of calculation tools from ML. However, it is clear to highlight the difference between the scope
proposed in both projects, the one presented in this article being oriented to a particular target
audience, and that said information serves to evaluate their physical performance, which
subsequently has an academic effect of being considered by the teacher who carries out the
evaluation.</p>
      <p>
        At the same time, the work titled “Smart Band for Senior Citizens” [
        <xref ref-type="bibr" rid="ref9">9</xref>
        ] focused on senior
citizens seeking to develop a portable device that monitors them and uses machine learning
algorithms to detect their falls and send alerts to the caregiver. The models are trained and tested
on the generated dataset by collecting various accelerometer sensor values for different actions
[walking, falling, and sitting]. Furthermore, our system monitors the body parameters like
temperature, heart rate, and SpO2 levels of senior citizens and provides the facility for a reminder
system. This work uses the same technologies and contemplates the same parameters as this
document's proposed project. Still, without the focus of its model, it is different from helping older
people.
      </p>
      <p>
        Another notable work is “Mental Health Monitoring with Multimodal Sensing and Machine
Learning” [
        <xref ref-type="bibr" rid="ref10">10</xref>
        ], which begins by highlighting personal and ubiquitous detection technologies,
such as smartphones, which have allowed the continuous collection of data in a non-intrusive
manner. Machine learning methods have been applied to sensor data to predict contextual user
information, such as location, mood, physical activity, etc. Relatedly, it is essential to recognize
that there has been growing interest in leveraging ubiquitous sensing technologies for mental
healthcare applications, enabling continuous automatic monitoring of different mental
conditions, such as depression, anxiety, stress, and so on. Based on this, the present research
reviews recent work on mental health monitoring systems (MHMS) using sensor data and
machine learning. It focuses on research work on mental disorders/conditions such as
depression, anxiety, bipolar disorder, stress, etc. Of these, the one that is most closely related to
the project that is being proposed in this document is the one titled “A survey on wearable
sensorbased systems for health monitoring and prognosis" [
        <xref ref-type="bibr" rid="ref11">11</xref>
        ] that focuses on patient health
monitoring, which, although it applies the same approach, does not seek to achieve the same
objectives previously stated in this article.
      </p>
      <p>
        In the local environment of the study, a work was developed where Machine learning for the
classification of motor competence with wearable technology in schoolchildren [
        <xref ref-type="bibr" rid="ref12">12</xref>
        ] was applied,
which allowed for generating the percentiles of the evaluation metrics and classifying motor
performance using machine learning techniques in schoolchildren from educational centers. I
used smart bands as wearable technologies for data capture during the evaluation of motor
competence tests. As a result of applying the decision tree algorithm, an accuracy of 96.97% was
obtained in the classification of motor performance in these students.
      </p>
      <p>
        Within the Backend as a Service area, the work “An API-first methodology for designing a
microservice-based Backend as a Service platform” [
        <xref ref-type="bibr" rid="ref13">13</xref>
        ] was recognized. This document
addresses the creation of its Backend as a Service (BaaS) platform instead of relying on
thirdparty providers. The approach is based on microservices architecture, allowing loose coupling,
scalability, and integration with third-party services. An architectural design is proposed based
on an appropriate and representative API of the BaaS platform. The proposed method was
implemented and tested to meet the functional requirements, using specific test cases that reflect
the actual workflow of the BaaS platform.
      </p>
    </sec>
    <sec id="sec-3">
      <title>3. Materials and Methods</title>
      <p>To carry out the development of the mobile application that serves as a conduit to visualize the
information obtained from the Machine Learning model to measure youth health, the following
steps are proposed:
• Develop a mobile application that allows student registration with their essential data.
• Collect data from the smart bands of the different students to create a database with
which to train the model.
• Analyze the possibility of building and implementing an ML model.</p>
      <p>From these and following the planning in phases using the scrum framework, the next project
is defined, the scope of which will be the design of a mobile application that automates motor
competence evaluations (physical activity) in schoolchildren in Arequipa.</p>
      <p>The software tools used were the Flutter framework, an open-source SDK developed by Google
to create high-quality, high-performance mobile applications for iOS, Android, and the web using
the Dart programming language for design. Of the interface, such as the Python language and
some of its libraries available for calculations. The entire structure of the prototype will be raised
in the source code editor, Visual Studio Code.</p>
      <p>A database will also be designed to preserve the information collected to retrain the model
and periodically improve its accuracy.</p>
      <sec id="sec-3-1">
        <title>3.1. Scrum Methodology</title>
        <p>
          The Scrum methodology is an agile project management methodology focusing on
continuously delivering functional software in short cycles called sprints. Additionally, Scrum
encourages flexibility and adaptability, allowing development teams to respond quickly to
changes in the Project environment [
          <xref ref-type="bibr" rid="ref14">14</xref>
          ].
        </p>
        <p>The workflow was carried out following the Scrum methodology, which was implemented to
improve efficiency and organization in project development. In this sense, the practice of daily
meetings known as sprint daily was established in which a structured monitoring and planning
process was carried out.</p>
        <p>During these meetings, a detailed report was made of the activities carried out the previous
day, giving the team a clear vision of the progress and achievements. In addition, the activities to
be carried out during the current day were discussed, establishing priorities and collaboratively
assigning responsibilities.</p>
        <p>Likewise, a space was dedicated to identifying and addressing any impediments or obstacles
that could delay the progress of the work. This approach facilitated collaboration and
participation across the team, ensuring all members were informed of each other's activities and
working together to overcome challenges.</p>
      </sec>
      <sec id="sec-3-2">
        <title>3.2. Kanban Methodology</title>
        <p>Kanban is a visual management methodology to optimize workflow and improve project
efficiency. It is based on using a Kanban board, a visual tool that clearly and organized shows
tasks or work items, their status, and their progress over time.</p>
        <p>Using this Kanban board made it possible to maintain precise control over activities, allowing
each team member to assign a task and evaluate the difficulty associated with its completion. The
cards representing the activities were completed following the best practices established by
Kanban.</p>
        <p>In this way, the Kanban board became an invaluable tool for managing and monitoring tasks,
providing a clear and concise view of work progress. Additionally, it encouraged efficient
allocation of responsibilities and effective collaboration among team members. By following the
guidelines and principles of Kanban, greater efficiency was achieved in the project's development,
guaranteeing quality and compliance with established objectives.</p>
        <p>The Kanban board is visualized in Fig. 1, where each activity includes four states: new activity,
in progress, ready to test, and completed; the activities were separated into three types: those
dedicated to the front end, those dedicated to the back end, and those dedicated to preparing the
report, allowing the division of responsibilities under the same approach.</p>
      </sec>
      <sec id="sec-3-3">
        <title>3.3. Good practices in Git</title>
        <p>
          Gitflow [
          <xref ref-type="bibr" rid="ref15">15</xref>
          ] is an alternative for managing branches. This functionality allows for better
control of the development of the application, where there are two main branches: the branch
generated by default when creating the repository and the development branch, which is where
the project is developed for each task assigned in our kanban methodology a branch is made with
the task code, so we do not generate conflicts in the development of the project, as we see in
Figure. 4.
        </p>
      </sec>
      <sec id="sec-3-4">
        <title>3.4. Scrumban Methodology</title>
        <p>Scrumban is a combination of Scrum and Kanban methodologies. This hybrid approach seeks
to take advantage of the strengths of both methods for project management.</p>
        <p>In Scrumban, some elements of Scrum, such as sprints and roles, were used along with Kanban
visualization and visual workflow management. This allows flexibility and adaptability by
combining the planning and iterative delivery of Scrum with the transparency and visual control
of Kanban.</p>
        <p>The combination of Scrumban allowed for more fluid and adaptable project management. The
Kanban board provided a clear and up-to-date visualization of task status, while Scrum elements
such as daily scrums and sprints made it easy to coordinate and track the team. In this way,
greater transparency, agility, and responsiveness were achieved as the development of the
application progressed.</p>
        <p>To build the application, a series of data necessary for the evaluation of the health and physical
condition of the students was used. The fields to be used are specified below:
The Functional and Non-functional requirements of the software product are detailed below:</p>
      </sec>
      <sec id="sec-3-5">
        <title>3.4.1. Requirements</title>
        <sec id="sec-3-5-1">
          <title>1. Functional Requirements Functional requirements are shown from Table 1 to Table 6:</title>
          <p>RF-5.1</p>
          <p>Manage evaluations</p>
          <p>Priority</p>
          <p>Requirement number
Requirement name
Description</p>
          <p>Priority
3.4.2. Design</p>
          <p>The user must be able to create assessments, assign promotions of the
evaluation, assign activities to the review, view their pending
assessments, and record assessment results for each student.
High
RF-6.1
See results
The user must be able to see the ML-processed result of the
assessment, modeled in a statistical graph demonstrating their
students' performance.</p>
          <p>High</p>
        </sec>
        <sec id="sec-3-5-2">
          <title>2. Non-functional Requirements Non-functional requirements are shown in Table 7</title>
          <p>Description
The security requirements allow the user to have privacy in their
data; the assigned authorities will access their private information.</p>
          <p>The interface requirements allow the system to be understandable
and intuitive.</p>
          <p>Compatibility requirements allow the application to be adaptable
to different mobile operating systems.</p>
          <p>The resource efficiency requirements allow the application not to
harm the equipment and the user in its use in the foreground and
background.</p>
          <p>The Maintenance Requirements allow the application always to be
adaptable to new versions of the device and always correct bugs.</p>
          <p>For the design phase of the application, different design proposals have been evaluated and
proposed, thus achieving a series of mockups that represent the interfaces that will be
implemented; these were built considering the previously proposed requirements. These were
developed in Figma, a tool for modeling and designing interfaces that allow collaborative work
and description of the flow of activities, among many other attributes.</p>
          <p>In Figure 5, you can see the first interface displayed when the user accesses the application;
this refers to how an account will be accessed in the application, either by registering a new
account or by logging in. from an existing account. You can see the login screen, which contains
an email and password entry form to validate and authorize the entry.</p>
          <p>Next in Figure 6 is the registration screen, which will be in 2 steps; the first is shown on the
left, filling out a form with the vital information to create the account, including email and
password, and the rest of the data is shown on the right. Personal information of the user,
including names, surnames, ID, and school to which they are associated, the latter being a multiple
selection.</p>
          <p>Figure 7 is the main screen that includes the directions to the different options that the
application allows; it consists of a button that redirects to the profile, three control options that
meet requirements 3, 4, and 5 that will enable you to see the registered promotions, create
evaluations and view the history of these evaluations, in addition, the screen has a panel with the
pending, completed assessment so that they are easily accessible to the user, including crucial
information such as the year of the assigned promotion, the class of the rise, the date of creation
and current status of the evaluation. The user's personal information can be seen as the teacher's
registered information and the ability to modify it if necessary.</p>
          <p>In Figure 8, you can see the view promotions screen where you can manage promotions by
creating and viewing them. You know, a promotion screen where you can see its information, add
students, see the students on the rise, see evaluations, and edit its information.</p>
          <p>In Figure 9. The view students screen displays all the students of a selected school and allows
you to create students. Likewise, there is a screen to create a student where their information on
height, weight, height, etc., is recorded.</p>
        </sec>
      </sec>
      <sec id="sec-3-6">
        <title>3.4.3. Development</title>
        <p>This work proposes that, based on the application of computer science and a branch of
artificial intelligence defined as Machine Learning, the creation of a mobile application that allows
users to access physical state data collected by the device known as Smart Band and through a
machine learning algorithm to determine whether it is suitable for carrying out high or moderate
performance physical activities. It is intended that the teacher in charge of the motor competence
evaluation can, with the knowledge acquired from the model and the information treated,
optimally evaluate the physical condition of his students and eventually prevent pre-existing
pathologies unknown to the students before the exercise, such as It can be respiratory or cardiac.
For the construction of the model, agile methodologies were used, as mentioned in the materials
and methods section, both being highly effective for the performance of tasks.</p>
        <sec id="sec-3-6-1">
          <title>1. Persistence</title>
          <p>For data persistence, it was decided to use a PostgreSQL database, that is, a relational database.
We began by creating the entity-relationship model, as shown in Fig. 10. This model has how
the recorded information will be stored. The students have data such as:
The school table stores the school's name and records the date when the new record is created.
We also have the class table, which holds the school class, related by a foreign key to school_id.
Next, the teacher table stores the teachers ' ID, name, password, and email fields. We also have
the promotion table, which identifies the promotion year.</p>
          <p>In addition, there is also the exercise and result table, which in the exercise table mentions the
exercises performed, and in the result table, the results of the activities are shown; all tables
are related through Foreign Keys. We reached step 4 of normalization.</p>
        </sec>
        <sec id="sec-3-6-2">
          <title>2. SQL-Alchemy Sql-Alchemy [16] is a library that allows you to treat databases directly from the programming language; this tool is known as object-relationship mapping (ORM) [17], as we see in Figure 11.</title>
        </sec>
        <sec id="sec-3-6-3">
          <title>3. API-REST</title>
          <p>The Flask framework was used to connect to the database, using it as a backend area. Flask is
a lightweight and flexible web framework written in Python that allows you to build fast and
efficient web applications. With its minimalist approach, Flask offers URL routing, view
controllers, database integration, templates, extensions, and a built-in development server. It
is widely used due to its ease of use and ability to adapt to different projects, from small
applications to complex web projects.</p>
        </sec>
        <sec id="sec-3-6-4">
          <title>4. Authentication</title>
          <p>The authentication was carried out using the Flask framework; that is, it was done by creating
a database that was done previously, where the user will be registered and can be verified
with the data entered in real time.</p>
        </sec>
        <sec id="sec-3-6-5">
          <title>5. Development of intelligent model</title>
          <p>As stated in previous sections, it was necessary to carry out a data survey in different
institutions throughout the city of Arequipa. For this first stage, only two exercises were
defined to train the model only with data from said exercises. These exercises were a 6-minute
walk and recreational activities for 15 minutes.</p>
          <p>From these exercises, 330 records were collected for both years. Both datasets will be used for
training the model, which, due to the nature of the data and the absence of a critical value that
serves as a label for its classification, will require using an unsupervised learning algorithm
over a supervised one.</p>
          <p>Of the known algorithms, the k-means algorithm was chosen to initially group the data into 2
clusters if they predispose to good or bad health. Centroids are defined from both adjusted as
the model is trained with the data. This way, the model can be consolidated after appropriately
cleaning the data obtained. This was achieved using the scikit learn library in Python.
After training the model, the results can be seen in a comparative average heart rate and age
graph. If it has a suitable status, it is denoted in blue. Otherwise, it is red. This is visible in
Figure 12:</p>
          <p>It should be noted that this model cannot currently be implemented in the REST service built
in Flask and hosted on the Render cloud platform due to the resources that it demands to
process the data that train the model and the response times that could be generated. Provide
the same since no complete hosting plan provides primary processing services. For practical
or demonstration purposes, the model was evaluated based on the passage of data in a
dictionary, thus emulating the behavior it would have if it received the data with the same
format that the back-end would receive from an HTTP POST request, as can be seen in figure
18:</p>
        </sec>
      </sec>
    </sec>
    <sec id="sec-4">
      <title>4. RESULTS</title>
      <p>A questionnaire that follows the usability evaluation “System Usability Scale” was applied to
know the users' appreciation and identify areas for improvement.</p>
      <p>Opinions were collected from the users from whom the results shown in Table 8 were
obtained, from which a total of 82.5 was considered the final average, demonstrating that the
software passed the usability test and was considered efficient. In addition, a general view of the
responses from the users is found in Figure 14 as a bar graph. From this, we can conclude that,
for the most part, the application was not complex and that the evaluators considered that it
would be easy for other people to learn to use this system, demonstrating satisfaction with what
was developed.</p>
      <p>In the future, it is planned to improve the view of results so that the analysis is more precise
with ML and to extend the number of exercises proposed to provide better evaluation to teachers.
In addition, they are implementing a new user guide to better introduce new users to the various
functionalities of the application so they can take advantage of all the services provided.
1. Overall, I would use this app
frequently.
2. I find the app needs to be simplified.</p>
      <p>4
2
4
2
4
3
3
3
3
5
4
5
4
3
4
2
4
5
3
1
4
3
4
2
4</p>
    </sec>
    <sec id="sec-5">
      <title>5. Conclusions</title>
      <p>The development of the “Vital” mobile application made it possible to design the data capture,
processing, and analysis of the physical activity motor tests that determined the health of
schoolchildren in their educational centers.</p>
      <p>The importance of measuring and monitoring physical health in schoolchildren is highlighted
by the increasing incidence of problems related to overweight and lack of physical activity in this
population. The proposed mobile application not only addresses this problem but also provides
teachers with a comprehensive tool to understand and improve students' overall well-being,
positively impacting their academic performance and adoption of healthy lifestyles.</p>
      <p>Through the Usability Scale System evaluation, 82.5 was obtained as a final average,
demonstrating that the software passed the usability test and was considered efficient.</p>
      <p>As a final point, the satisfactory results of the research are recognized, achieving the
development of the application and good feedback from the users with hopes of improving the
application. Expanding the physical activity tests to be evaluated to contrast the results obtained
is suggested as a future recommendation.</p>
    </sec>
    <sec id="sec-6">
      <title>Acknowledgments</title>
      <p>We thank the Universidad Católica de Santa María for its support in the development of the paper.
[17] J. Muro, “¿Qué es un ORM?,” ¿Sabes qué es un Object Relational Mapping?, 2020.</p>
    </sec>
  </body>
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