Health Characteristics and Adherence Patterns in Electronic Wearable Device Users: A Study in Low- and Middle-Income Countries

OBJECTIVES: The present study aims to examine the health characteristics of individuals using electronic wearable devices (EWD) according to adherence to the use of the EWD.

METHODS: A prospective cohort study undertaken between December 2021 and May 2023. We selected individuals EWD users age 18 or older, using convenience sampling. At baseline, the participants completed enrollment self-reporting questionnaire to record demographic characteristics, physical activity, smoking, dietary, alcohol intake, sleep duration and chronic diseases. Using smartwatch data, we calculated average daily step counts, stair climbing, heart rate, blood pressure, sleep duration and oxygen saturation. Adherence to device usage was assessed based on the total days of automatic data collection. Participants were categorized into two groups based on the EWD utilization patterns (engaged: ≥120 days of use, non-engaged: <120 days of use).

RESULTS: Over the course of 18 months, we enrolled 3911 participants [median age 37 years (P25-P50: 30-45), 55% women], representing 39% of potentially eligible participants. 2006 (51.3%) were engaged and 1.905 (48.7%) non-engaged device users. Significant difference between groups was found for age group, cholesterol (p=0.02) and steps counts. A higher prevalence was observed in the 31-40 and 51-60 age groups for engaged group, while for the non-engaged group the prevalence was higher in the 20-30 age group (p=0.01). The median step count for non-engaged group was significant higher in the first 30 days (p=0.04) compared to engaged group. However, no significant difference was observed in the last 30 days (p=0.31). There was no significant difference between the groups for smoking (p=0.72), dietary (1.00), alcohol intake (0.77), sleep duration (0.26) and chronic diseases.

CONCLUSIONS: The results suggest no differences in long-term EWD use between groups. Older individuals are more engaged, and there may be an association with cholesterol comorbidity, indicating a higher need for physical activity in this group.