Why do people use and abandon smartwatch-based activity tracking functionality?

The activity tracking function of wearable devices is becoming more and more popular. A report from Insight indicated that 13 million wearable devices were carrying the activity tracking function, from a total of 19 million such devic [1]. It is clear from this that almost 69% of devices have the activity tracking function, which also shows the huge market for wearable devices, including smartwatches. Users adopt this function to record their daily activities, track their actions, and monitor their sleep duration and quality. Users could use this function to improve their habits and customs or remind them to do some exercise. However, even though the function is popular, some issues still exist. One significant phenomenon is the rapid adoption of activity tracking devices, but with little sustainable and long-term use. For example, a 2017 report found that around 30% to 70% activity tracking products were abandoned after only a few months [2]. This phenomenon – the rapid adoption of activity tracking devices but subsequent limited use of functions – is of interest to study both academically and practically.

The ‘tracker’ was first invented by Dr Yoshiro Hatano in 1956 and aimed to combat obesity by counting users’ steps and thus encouraging them to take more exercise. This is the embryonic form of activity tracking [3]. Modern activity tracking then appeared, applied to various devices, including mechanical machines and wearable devices. In recent years, with the spread of innovation in advanced electronic technology as a new popular lifestyle, Levy notes the increasing interest in and adoption of these tools [4]. Most activity tracking functions are carried on wearable devices, such as smartwatches and smartphones, of which the smartwatch is one of the most notable and widely worn examples [5]. Hence, when investigating activity tracking on wearable devices, studying the smartwatch could be more representative and convenient. Moreover, the research of Harrion argues that participants have started to give up using the activity tracking function on different devices, including the smartwatch [6]. This illustrates that there are barriers to the users adopting the activity tracking on smartwatches. 

My own research investigates the adoption conditions of smartwatch-based activity tracking by identifying the facilitators and barriers. It employed a mixed-methods research approach that contains both quantitive and qualitative research, involving 10 semi-structured interviews and a questionnaire with 213 valid respondents. Through semi-structured interviews, data regarding personal usage from experience on the activity tracking function was gathered and analysed. We obtained key facilitators and barriers from the interview, and then used these as the main questions of the questionnaire, which was administered online with results being analysed using SPSS. 

The survey shows that 96.7% of the responders’ adoption frequency was decreasing. This indicates that most users reduce their usage frequency over time. Also, 47% of participants were not satisfied with the activity tracking function, while only 9% were satisfied. 59% of participants agreed there are barriers that exist to the adoption of smartwatch-based activity tracking.

After the analysis, the identified key facilitators and barriers are detailed in Figure 1. The key facilitators are activity tracking capabilities, design, smartwatch functionality, interaction and improvement of living habits. Among these factors, ‘activity tracking capabilities’ and ‘improving lifestyle’ are the two most important. The main barriers include five perspectives: data, technical, interaction and user-friendliness, design and social comparison. Each of the perspectives contains its own sub-barriers. 

Figure 1 Facilitators and barriers of smartwatch-based activity tracking adoption

Using ANOVA and T-test, we compared the different facilitators and different barriers. ‘Activity tracking capabilities’ and ‘improving living habits’ were regarded as the main points attractive to users, with 89.70% and 64.3% of participants supportive, respectively.

Table 1 Facilitating factors affecting activity tracking adoption.

As the table above indicates, during the long-term usage of smartwatch-based activity tracking, users consider ‘activity tracking capabilities’ as the most vital encouraging factor, while ‘smartwatch functionality’ was the least important. In addition, based on the different mean-values of the other three factors, their mean-value was equal to 4.16, 3.6 and 3.24, respectively (improve living habits > design and appearance > interaction and user-friendliness). In this case, among these five facilitators, ‘activity tracking capabilities’ and ‘improving lifestyle’ had more positive promotional effects of encouraging the users to adopt than the other three.

Table 2 The degree of influence of the barriers

Table 2 above provides evidence to explain the degree of influence of the five barriers. Thus, the mean of each factor shows the degree of influence compared to the others. The data indicate that ‘technology’ and ‘data’ were the most important barriers to users’ adoption of the smartwatch-based activity tracking function. However, according to participants, the barrier ‘social comparison’ had least impact on the use of this function.

Figure 2 shows the degree of influence of all sub-barriers on participants’ adoption of the activity tracking function on smartwatches using ANOVA and T-test. We set 1 to equal ‘strongly not influence’ and 5 to equal ‘strongly influence’.

Figure 2 Users’ sub-barrier scores

To conclude, in order to enhance users’ experience, application producers should develop the facilitators and pay attention to solving the issues of the main barriers. The key factors that encourage users’ long-term adoption of activity tracking are a) activity tracking capabilities, b) design, c) smartwatch functionality, d) interaction and e) improving the living habits. The ‘activity tracking capabilities’ was the best performing factor to motivate the users’ long-term usage. The second most important factor was ‘improving lifestyle’, which indicates that users pay attention to their habits and behaviours via the activity tracking function. Also, to the researcher’s surprise, ‘design and appearance’ and ‘interaction’ were far behind as facilitating factors. However, ‘smartwatch functionality’ was the least important factor that stimulated users’ long-term usage. Also, female users are attracted more by ‘smartwatch functionality’ and ‘interaction and user-friendliness’ factors than male users.

In terms of the research into barriers, ‘technology’ and ‘data’ have the largest influence on usage. Among ‘technology’, ‘battery issues’ and ‘pairing’ factors had quite a large impact on usage. In addition, the second most significant barrier to usage was ‘data’, specifically ‘data inaccuracy’ and ‘insufficient data categories’ being the two most influential factors. Moreover, the perspective of ‘interaction’ and ‘design’ was almost equally as important in preventing users’ adoption. However, ‘social comparison’ fell far behind, which was less than half as important as the most important perspective. This indicates that ‘social comparison’ has not hindered usage too much. Additionally, female users consider ‘data’ and ‘technology’ have more degree of preventing influence than male users. The user who goes to the gym seems to regard ‘data’ and ‘technology’ as the more serious barriers when compared to the users who do not go to the gym.

In practical terms, the product should increase the accuracy and integrity of the data produced by devices. Producers could add more abundant data categories for sports, such as tennis or basketball. The battery issues, including battery life, heating, and rechargeability, were shown to be vital by this study’s respondents. The producers and designers should provide more charging methods, such as solar charging, to increase convenient usage. Employing more smart voice control to replace Bluetooth is another method worthy of further enhancement given pairing issues. The use of holograms could also be seen as an ideal way to solve existent screen size or quality limitations. In improving interaction to enhance lifestyles, designers might, in future, focus on smart or customised feedback to enhance user experience. For example, calculating daily calorie intake and providing recipes or dividing data between aerobic and anaerobic exercise would represent novel developments. More generally, the long-term use of smartwatch-based activity tracking could be enhanced by strengthening the facilitators and addressing the barriers identified by this study.


[1] Berg Insight. 2019. Shipments of connected wearables will reach 168 million in 2019. Berg Insight. Retrieved from: http://www.berginsight.com/News.aspx. 

[2] H. Lee, and Y. Lee, “A look at wearable abandonment. In MDM 2017: 18th IEEE International Conference on Mobile Data Management,” IEEE, pp. 392-393, 2017.

[3] Maurer, U., Smailagic, A., Siewiorek, D. P., & Deisher, M. (2006). Activity recognition and monitoring using multiple sensors on different body positions. International Workshop on Wearable and Implantable Body Sensor Networks (BSN’06), 4–7. 

[4] Levy, H. (2015). Wearable Technology Beyond Smartwatches. Retrieved from: https://www.gartner.com/smarterwithgartner/wearable-technology-beyond- smartwatches 3/ 

[5] Page, T. (2015). Barriers to the Adoption of Wearable Technology. Journal on Information Technology4(3), 1–13. 

[6] Harrion, D., Marshall, P., Bianchi-Berthouze, N., & Bird, J. (2015). Activity tracking. Proceedings of the 2015 ACM International Joint Conference on Pervasive and Ubiquitous Computing – UbiComp ’15, 617–621. 

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Can social media messaging benefit those in the Global South who are visually impaired?

Globally, 285 million people are visually impaired, a quarter of whom live in India. The disease burden results in significantly lower employment and productivity. The national blindness prevention strategy aims at eyecare promotion through health behaviour change by raising awareness. Traditionally, this strategy relies on healthcare information disseminated through radio, television, mass media campaigns, printed medium, and interpersonal communication. Despite their appeal, these communication channels have constraints related to their cost and infrastructure. Moreover, social remoteness resulting from gender and cultural bias, illiteracy, rigid societal hierarchy, and sociocultural prejudices, acts as a major barrier to accessing this information for people from marginalised and disadvantaged communities.    

Alongside the inadequacies of the traditional information channels, there has been a demographic frameshift in many developing countries like India, which results in differential and patchy developmental practices. Consequently, India is now facing an aging population and an epidemiological change toward non-communicable diseases. This has been further compounded by rapid and unplanned urbanisation, economic migration to larger cities with over-burdened infrastructure, a lack of universal access to healthcare, and a widening digital divide. Unsurprisingly, this is putting enormous pressure on existing inadequate public health services and worsening eye health outcomes for those belonging to socioeconomically challenged backgrounds.  

However, effective public health service providers can address poor eye health outcomes, using simple measures like addressing the knowledge gap amongst disadvantaged members of society, easier access to regular eye check-up clinics, advocating hygienic practices, dispelling myths and unscientific healthcare practices and taboos, provision of cost-effective surgeries, and mobile health services. This approach has the potential of empowering the communities with new knowledge by addressing social determinants that act as a barrier to accessing eye healthcare, and their negative impact on vision. Additionally, this strategy is in alignment with the United Nation’s vision of sustainable developmental goals for 20301, as this will help poverty reduction, increase productivity, and address the inequity of health, education, and gender. This argues for the case of improving eye health care as principally a human developmental issue. Aligned with the UN strategy, is the ambitious goal of the World Health Organisation to provide Universal Eye Care, irrespective of geographical boundaries and socioeconomic divide2.  

Over the past decade, there has been an exponential increase in social media usage in developing nations like India. In particular, the penetration of WhatsApp, a social media platform that allows the exchange of audio-visual material through a free-to-use user-friendly platform, has increased to the extent that this may be regarded as an important communication channel, particularly so for the rural, remote, and socioeconomically challenged communities3. WhatsApp has the potential to reach all communities, rich or poor, urban or rural, and facilitate two-way communication in real-time. In the Indian context, it provides a desirable platform for health communication and can be used in eye healthcare care, to improve outcomes.   

In my thesis titled “WhatsApp In Health Communication: The Case Of Eye Health In Deprived Settings In India” [link to full PDF], I have tried to explore the benefits and challenges of using a social media communication platform like WhatsApp in addressing the knowledge gap on eye health among deprived members of the society4–6. The participants in this project were a large urban tertiary eye care institution (Susrut Eye Hospital) and a group of women residents from a deprived setting in a village near the eastern Indian city of Kolkata. Over a series of educational sessions undertaken at a school close to the deprived community, audio-visual content matter on eye health, carefully prepared by Susrut, was disseminated using WhatsApp as the health communication channel. This process was facilitated by two neo-literate facilitators who were also resident members of the deprived community, and participants were actively encouraged to pose questions and queries to Susrut using the WhatsApp channel.

Fig 1. Conceptual flow of information in the study

Fig 2. The flow of information between the providers and the recipients through WhatsApp

Acceptability of WhatsApp-based information dissemination amongst the study participants was high with reported benefits of increased awareness of eye diseases, their preventative management, remedial measures, and the availability of affordable eye care services. Additionally, study participants found WhatsApp technology appealing and intuitive. The resultant increase in self-confidence, consequent to heightened awareness, boosted social empowerment and enabled study participants to challenge prevalent social and cultural norms.

In conclusion, my study demonstrated that WhatsApp can be effectively used as a suitable vehicle for information dissemination on eye care in mediating behavioural change in deprived settings. Findings from this study may be considered in developing policies that develop and disseminate eye care information. This low-cost technology has the potential of being used as a data collection tool, for information governance and surveillance, and in situations of urgency. The wider implications and impact of this study lie in disseminating healthcare information related to other important public health issues to marginalised populations. 

References:

1.         THE 17 GOALS | Sustainable Development, https://sdgs.un.org/goals 

2.         World Health Organization. Universal eye health: a global action plan 2014-2019. Geneva, Switzerland: World Health Organization. https://www.who.int/publications/i/item/universal-eye-health-a-global-action-plan-2014-2019

3.         WhatsApp. Statista Research Department. https://www.statista.com/topics/2018/whatsapp/#topicOverview

4.         Maitra C, Rowley J. Delivering eye health education to deprived communities in India through a social media-based innovation. Health Inf Libr J 2021; 38: 139–142. http://onlinelibrary.wiley.com/doi/abs/10.1111/hir.12370

5.         Maitra C. WhatsApp In Health Communication – The Case Of Eye Health In Deprived Settings In India. Manchester Metropolitan University, https://e-space.mmu.ac.uk/627599/1/WhatsApp%20In%20Health%20Communication%20-%20The%20Case%20Of%20Eye%20Health%20In%20Deprived%20Settings%20In%20India.pdf  (2021).

6.         Maitra C, Rowley J. Using a social media based intervention to enhance eye health awareness of members of a deprived community in India. Inf Dev 2021; http://journals.sagepub.com/doi/10.1177/02666669211013450

Latest Digital Development Outputs (Data, Economy, Health, Platforms, Water) from CDD, Manchester

Using SmartphoneRecent outputs – on Data-for-Development; Digital Economy; Digital Health; Digital Platforms; Digital Water – from Centre for Digital Development researchers, University of Manchester:

DATA-FOR-DEVELOPMENT

Strengthening the Skills Pipeline for Statistical Capacity Development to Meet the Demands of Sustainable Development: Implementing a Data Fellowship Model in Colombia” (open access) by Pete Jones, Jackie Carter, Jaco Renken & Magdalena Arbeláez Tobón, considers the importance of quantitative data skills development implied by the UN Sustainable Development Goals. The success of a partnership programme in the UK is used to explore how ‘data fellowships’ can fulfil some of the unmet capacity needs of the SDGs in a developing country context, Colombia.

Building Information Modelling Diffusion Research in Developing Countries” (open access) by Samuel Adeniyi Adekunle, Obuks Ejohwomu & Clinton Ohis Aigbavboa undertakes a literature review – including current and future research trends – on the adoption of building information modelling in developing countries.

DIGITAL ECONOMY / PLATFORMS

Conceptualising Digital Platforms in Developing Countries as Socio-Technical Transitions” (open read access) by Juan Erasmo Gomez-Morantes, Richard Heeks & Richard Duncombe demonstrates how the multi-level perspective approach can be used to analyse the lifecycle of digital platforms: the process of innovation, rapidity of scaling, and development impacts relating to resource endowments, institutional formalisation, and shifts in power.

Digital Platforms and Institutional Voids in Developing Countries” (open access) by Richard Heeks, Juan Erasmo Gomez-Morantes, Brian Nicholson and colleagues from the Fairwork project, analyses how digital platforms change markets through their institutional actions.  Using the example of ride-hailing, it finds platforms have formed a market that is more efficient, effective, complete and formalised.  At the same time, though, they have institutionalised problematic behaviours and significant inequalities.

Navigating a New Digital Era Means Changing the World Economic Order” (open access) by Shamel Azmeh, discusses the implications of digital shifts for global economic governance.

DIGITAL HEALTH

Cost-Effectiveness of a Mobile Technology-Enabled Primary Care Intervention for Cardiovascular Disease Risk Management in Rural Indonesia” by Gindo Tampubolon and colleagues demonstrates how to determine the economic impact of m-health.  It calculates the cost-effectiveness of a mobile-based health intervention at c.US$4,300 per disability-adjusted life year averted and US$3,700 per cardiovascular disease event avoided.

Delivering Eye Health Education to Deprived Communities in India through a Social Media-Based Innovation” by Chandrani Maitra & Jenny Rowley aims to develop understanding of the benefits of, and the challenges associated with the use of social media to disseminate eye health information in deprived communities in India.

Using a Social Media Based Intervention to Enhance Eye Health Awareness of Members of a Deprived Community in India” (open access) by Chandrani Maitra & Jennifer Rowley reports on a WhatsApp-based intervention to promote eye health communication in deprived settings. This research highlights the potential benefits of WhatsApp in increasing awareness on eye problems, amongst deprived communities where the disease burden remains very high.

DIGITAL WATER

Digital Innovations and Water Services in Cities of the Global South: A Systematic Literature Review” (open access) by Godfred Amankwaa, Richard Heeks & Alison Browne reviews the literature on digital and water in Southern cities.  It summarises findings to date on implementation and impact and sets out the future research agenda.