Do health wearables change behavior?

Wearable devices are the most visible type of mobile health technology, popularized by sleek fitness trackers and smartwatches now used by one in six Americans. But how effective are wearables at promoting behavior that improves health outcomes?

If you’re already a healthy individual the simple answer is “not very” or “there isn’t enough data.” Basically, there aren’t enough longitudinal or randomized control studies to say that wearables improve a healthy users’ behavior. But wearables offer a lot of promise for encouraging better compliance in patients with a defined illness.

An example is home telemonitoring for patients with long-term chronic conditions like heart failure. Patients can effectively manage chronic heart failure with lifestyle changes like increased exercise and eating less salt, and research shows that remote monitoring can reduce hospital admission rates. As sensors become cheaper and more effective, wearable devices will increasingly support positive behavior change.

This is good news for patients but also for the healthcare system more broadly. Chronic conditions like high blood pressure and diabetes affect 15 percent of the US population and account for 80 percent of Medicare spending. As medical innovation leader George Lewis writes, “For patients with chronic diseases, wearables should remind, warn, encourage, and perhaps most importantly, supply the patient with innovative strategies to comply with treatment regimens.”

The challenge is that wearables still haven’t been used in many clinical trials, and existing studies show that sustaining behavior change isn’t easy. For example, wearable activity trackers can increase physical activity in older adults, but within a broader population 50 percent of wearable users stop wearing their device within a year.

One solution is for manufacturers of fitness trackers and other wearables to design devices targeted for a broader community of users that could directly benefit from the information. Most consumers of fitness trackers are already pretty healthy and definitely not the sickest Americans. But people with chronic conditions need the constant updates on their personal health data - like heart rate, blood oxygen levels, or blood glucose levels - that wearables are good at capturing.

Why not design wearables specifically for the more than half of American adults have one or more chronic health problem? After all, these individuals are already twice as likely to monitor their personal health data than others.

As authors recently argued in a Scientific American piece, “part of the problem may be the narrow set of health-related concerns that personal health wearables tend to emphasize.” As more wearable devices are catered to patients with chronic conditions, we may begin to see their potential to support sustained behavior change for improved health outcomes.