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Participant-Centered Engagement for Sustained Adherence to Smartwatches: A 12-Month Prospective Decentralized Digital
Angelina R Wilton1,2, Christina T Saliba1,2, Jean Marrero-Polanco1
1Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota, USA.
Clinical and Translational Science
|February 15, 2025
Summary
Participant adherence in long-term digital health studies can be improved with technology support and engagement strategies. Decentralized studies show high retention and adherence when participants perceive positive impacts on well-being.
Area of Science:
- Digital health
- Wearable technology
- Participant adherence
Background:
- Adherence and retention decrease in digital health studies exceeding 12 months.
- US Food and Drug Administration guidelines emphasize engagement, adherence, and diversity in decentralized digital health studies.
- Sustained participant engagement is critical for long-term digital health research.
Purpose of the Study:
- To assess the feasibility of participant engagement and technology support for sustained adherence in a 12-month decentralized digital health study.
- To evaluate participant perceptions of well-being and technology interaction.
- To identify factors influencing adherence in extended digital health monitoring.
Main Methods:
- A 12-month decentralized digital health study utilizing smartwatch data collection.
- Protocolized procedures for participant engagement and technology support.
- Inductive thematic analysis (ITA) of participant free-response feedback on smartwatch use and well-being.
- Correlation analysis between ITA themes and smartwatch adherence rates.
Main Results:
- High retention (92%) and adherence (77.4% average wear-time) were achieved over 12 months in 298 participants.
- Participants reporting perceived behavior changes (sleep, physical activity) showed higher adherence.
- Participants reporting discomfort or intrusiveness had statistically lower adherence.
- 23% of participants were from non-white ethnic groups, indicating improved diversity.
Conclusions:
- Technology support and engagement are vital for maintaining adherence in extended decentralized digital health studies.
- Participant-reported benefits, such as improved sleep and physical activity, correlate with higher adherence.
- Addressing participant comfort is essential for optimizing adherence in wearable technology studies.
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