Consumer perceptions of electrocardiography-enabled smartwatches in health management

Smartwatches with electrocardiography (ECG) functionality, capable of detecting cardiac arrhythmias, are promoted as accessible tools for early detection and prevention in cardiovascular healthcare. Despite their popularity, these devices have not been conclusively linked to improved long-term health outcomes - such as reduced stroke risk - in large scale randomized controlled trials. This raises the question whether popularity is driven by health concerns or by broader lifestyle and technological trends. This study combines factors from the Extended Unified Theory of Acceptance and Use of Technologies (UTAUT2) with privacy concerns, innovativeness, health information accuracy and individual health orientations to model adoption intention of ECG-enabled smartwatches. Data from 753 respondents (38.5 % men, M_age = 34.33, SD_age = 15.68), collected via online survey, were analyzed using multiple linear regression. Adoption intention was positively associated with performance expectancy (β = .205), habit (β = .192), personal innovativeness (β = .185), hedonic motivation (β = .169), wearable ownership (β = .143), social influence (β = .139), price value (β = .091), and age (β = .065). In contrast, privacy concerns, effort expectancy, facilitating conditions, health information accuracy, and individual health orientations were not significant. Although perceiving smartwatches as useful for supporting health goals drives adoption intention, this intention is mainly driven by technology attitudes rather than by device-independent health orientations or data credibility perceptions. This finding underscores a key challenge for developers, healthcare professionals and academia to bridge the gap between technological promise and medical value and to promote a more evidence-based understanding of wearables' role in healthcare.