Determinants of Willingness to Share Wearable Health Data with Health Care Providers in Appalachian Populations: an Exploratory Study.

Background: Wearable health devices capture metrics (e.g., physical activity, ECG, sleep) that can enhance care when shared with providers. Yet, willingness to share wearable data may differ in Appalachia, where chronic disease burdens, mistrust, and limited infrastructure pose unique challenges. Objective: This study explored (1) which sociodemographic, health, and digital behaviors correlate with willingness to share wearable data and (2) how these insights can guide region-specific interventions in Appalachia. Methods: We analyzed 320 Appalachian respondents from the Health Information National Trends Survey (HINTS 6). Descriptive statistics and logistic regression models examined willingness to share wearable data. Because of small cell counts, we supplemented with a Firth (penalized) logistic regression for robustness. Results: Approximately 25.0% unweighted (27.9% weighted) were willing to share wearable data, but two-thirds did not respond or were inapplicable. The final adjusted model (n=47) revealed:Income: Higher income correlated with increased willingness (e.g., aOR=8.52e+04 for $35-49k vs.Self-Rated Health: "Good" or "very good" health was associated with higher odds of sharing than "poor" health (aOR=4406.52; p<.05).Messaging: Surprisingly, participants who never messaged providers showed greater willingness (aOR=1.93e+07; p. Conclusions: These preliminary findings suggest that household income, perceived health, and digital behaviors influence wearable data-sharing in Appalachia, whereas national demographic trends may not apply. Future work should use larger samples, mixed methods, and region-specific approaches to address mistrust, privacy concerns, and infrastructural barriers, aiming to enhance remote patient monitoring and reduce health disparities.