Engagement and Participant Experiences with Consumer Smartwatches for Health Research: a Longitudinal, Observational Feasibility Study

Background: Wearables provide opportunities for frequent health data collection and symptom monitoring. The feasibility of using consumer cellular smartwatches to provide information both on symptoms and contemporary sensor data has not yet been investigated.
Objectives: To investigate the feasibility and acceptability of using cellular smartwatches to capture multiple patient-reported outcomes per day alongside continuous physical activity data over a 3 month period in people living with knee osteoarthritis.
Methods: For the KOALAP (Knee OsteoArthritis: Linking Activity and Pain) study a novel cellular smartwatch application for health data collection was developed. Participants (age ≥ 50 years; self-diagnosed knee osteoarthritis) received a smartwatch (Huawei Watch 2) with the KOALAP app. When worn, the watch collected sensor data and prompted participants to self-report outcomes multiple times per day. Participants were invited for a baseline and follow-up interview to discuss their motivations and experiences. Engagement with the watch was measured using daily watch wear time and the percentage completion of watch questions. Interview transcripts were analyzed using grounded thematic analysis.
Results: Twenty-six people participated in the study. Good use and engagement was observed over 3 months: most participants wore the watch on 75% of days or more, for a median of 11 hours. The number of active participants declined over the study duration, especially in the final week. Among participants who remained active, neither watch time nor question completion percentage declined over time. Participants were mainly motivated to learn about their symptoms and enjoyed the self-tracking aspects of the watch. Barriers to full engagement were battery life limitations, technical problems and unfulfilled expectations of the watch. Participants reported that they would have liked to report symptoms more than four/five times per day.
Conclusions: This study shows that capture of patient-reported outcomes multiple times per day with linked sensor data from a smartwatch is feasible over at least a 3 month period.