Use of Health and Well-Being Technology, Basic Psychological Needs, and the Mediating Role of Technological Identity in 6 European Countries: Prospective Longitudinal Survey Study.

backgroundDigital health technologies are increasingly used to monitor and improve personal health and well-being. Simultaneously, they can influence user behavior and self-understanding. As health technologies advance and are embedded in everyday life, understanding their broader psychological impacts, as well as the role of identity in shaping these outcomes, is crucial.

objectiveThis prospective longitudinal survey study examined how usage of health and well-being technologies predicts experiences of new technology-related basic psychological needs over time, reflecting the psychological outcomes of digital health technologies. Furthermore, we investigated whether technological social identity serves as a pathway through which health technology use is associated with basic needs.

methodsWe used 3-wave survey data (2022-2024) collected from participants aged 18-75 years in Finland (n=1541), France (n=1561), Germany (n=1529), Ireland (n=1112), Italy (n=1530), and Poland (n=1533). Participants were recruited through a survey research panel, and follow-up data were collected from the same cohort. The sample was representative of the target populations by age (average age 46.79, SD 15.50 years) and gender (4304/8806, 48.88% male). The measure of digital health technology usage included smartphone health and well-being apps, well-being coaching apps, fitness trackers or watches, and smart rings. We applied a dynamic panel model within a structural equation modeling framework to examine both contemporaneous and lagged effects of technology use on the outcome variables-autonomy frustration, competence frustration, and relatedness satisfaction, measured with the Technology Effects on Need Satisfaction in Life scale. Mediation analysis was performed to assess whether social identification as a new technology user explained the relationship between technology use and need experiences.

resultsUsage of health and well-being technologies was associated with higher technology-mediated relatedness (β=.14, 95% CI 0.11-0.18; P<.001). Autonomy frustration (β=.06, 95% CI 0.02-0.10; P=.003) and competence frustration (β=.06, 95% CI 0.02-0.10; P=.008) also demonstrated small but positive connections with technology use. We found no statistically significant differences across countries. Mediation analysis revealed that the relationships between technology use and psychological needs were largely explained by social identification as a technology user.

conclusionsUnlike most existing studies, this research focuses on the technology-related psychological effects of everyday health and well-being technologies and provides longitudinal and cross-national evidence of how they shape broader outcomes beyond health content and goals. The findings demonstrate that health technologies can both support users' social needs and undermine their personal sense of agency. They also provide insights into the significance and dual-edged role of technology users' social identity in transmitting these effects. The study highlights the central role of technology-related basic needs and identity processes in understanding the larger outcomes of rapidly advancing digital health technologies. It offers valuable insights for health technology designs and implementations that aim to enable need-supportive technology engagement.