Determinants of Continuous Smartwatch Use and Data-Sharing Preferences With Physicians, Public Health Authorities, and Private Companies: Cross-Sectional Survey of Smartwatch Users.

Background: Smartwatches are widely adopted globally for tracking health metrics, offering potential for enhancing individual health care and public health efforts. Continuous use of the devices and users' willingness to share the data collected are critical to realizing their full benefits. Objective: This study aimed to identify key factors that determine continuous smartwatch use and users' comfort levels in sharing health data with health care providers and public health authorities. Methods: A cross-sectional online survey of current and past smartwatch users (aged >18 years) was conducted to assess determinants of continuous use based on the Expectation-Confirmation Model (ECM) and user comfort levels with different data-sharing methods. Structural equation modeling was used to evaluate relationships between habit formation, satisfaction, perceived enjoyment, and perceived usefulness with continuous use. Wilcoxon signed-rank tests were used to analyze user comfort in sharing data, comparing noninternet- versus internet-based sharing methods and fully versus partially anonymized data. Results: A total of 273 responses were analyzed, with participants aged 18-65 (mean 35.6, SD 11.7) years. The results indicate that continuous use of smartwatches is explained by habit (β=.35; P<.001) and satisfaction (β=.38; P<.001), which is in turn explained by perceived usefulness (β=.38; P<.001), perceived enjoyment (β=.32; P<.001), confirmation (β=.24; P<.001), and perceived usability (β=.10; P=.03). Smartwatch users preferred noninternet-based sharing options (z=-5.793; P<.001) when sharing data with their physician. Similarly, users were more comfortable sharing fully anonymized data with public health authorities than partially anonymized data (z=-3.592; P<.001). Conclusions: Habit formation and satisfaction emerged as pivotal drivers of continuous intention to use smartwatches, emphasizing the need for features that foster integration into daily routine and a rewarding user experience. Preferences for noninternet-based data sharing with physicians highlight privacy concerns that must be addressed to build users' trust. By aligning device features and data-sharing protocols with user preferences, manufacturers, health care providers, and policy makers can enhance user engagement and maximize the potential of smartwatches to support individual health management and public health initiatives.