Determinants of Continuous Smartwatch Use and Data-Sharing Preferences with Physicians, Public Health Authorities, and Private Companies: A Survey of Smartwatch Users (Preprint)

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BACKGROUND Smartwatches are widely adopted globally for tracking health metrics, offering potential for enhancing individual healthcare and public health efforts. Continuous use of the devices and users’ willingness to share the data collected are critical to realizing their full benefits. This survey examines the key factors influencing continuous use of smartwatches and users’ comfort levels in sharing health data with healthcare providers, public health authorities, and private companies. OBJECTIVE To identify key factors that determine continuous smartwatch use and users’ comfort levels in sharing health data with healthcare providers and public health authorities. METHODS A cross-sectional online survey of current and past smartwatch users (age >18) was conducted to assess determinants of continuous use based on the Expectation-Confirmation Model (ECM) and user comfort levels with different data-sharing methods. Structural Equation Modeling (SEM) evaluated relationships between habit formation, satisfaction, perceived enjoyment, and perceived usefulness with continuous use. Wilcoxon Signed-Rank tests were used to analyse user comfort in sharing data, comparing non-internet versus internet-based sharing methods and fully versus partially anonymized data. RESULTS 273 responses were analyzed, with participants aged 18-65 years (mean = 35.6, SD = 11.7). Habit formation was the most significant factor influencing continuous smartwatch use, showing strong association with continuance intention (HAB1: 0.655, p < 0.001). Satisfaction (SAT1: 0.618, p < 0.001) and perceived enjoyment (e.g., ENJ3: 0.466, p < 0.001) also emerged as strong drivers. Smartwatch users preferred non-internet-based sharing options (Z = -5.793, p < 0.001) when sharing data with their physician. Similarly, users were more comfortable sharing fully anonymized data with public health authorities than partially anonymized data (Z = -3.592, p < 0.001). CONCLUSIONS Habit formation, satisfaction, and enjoyment emerged as pivotal drivers of continuous intention to use smartwatches, emphasizing the need for features that foster integration into daily routine and a rewarding user experience. When sharing with public health authorities, users expressed a preference for sharing fully anonymized data over partially anonymized data. Preferences for non-internet based data sharing with physicians highlights privacy concerns which must be addressed to build user trust. User trust is evidently lacking in private industry, which indicates that companies must take steps to build policy that promotes transparency in order to benefit from these data in the long term. By aligning device features and data-sharing protocols with user preferences, manufacturers, healthcare providers, and policymakers can enhance user engagement and maximize the potential of smartwatches to support individual health management and public health initiatives. INTERNATIONAL REGISTERED REPORT RR2-doi: 10.1136/bmjopen-2023-081228

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