Wearable Devices and Data Sharing in the US.

Importance: Large-scale efforts to expand the role of wearables in digital health require a contemporary assessment of patterns and drivers of wearable use, willingness to share data, and actual data sharing. Objective: To characterize national trends in wearable device use, daily engagement, willingness to share wearable-derived health data, and actual sharing with clinicians among US adults from 2020 to 2024. Design, Setting, and Participants: This serial survey study used data from 3 consecutive cycles of the Health Information National Trends Survey (HINTS), a nationally representative, population-based survey of community-dwelling US adults, from 2020, 2022, and 2024. Main Outcomes and Measures: The primary outcomes were use of a wearable device to track health, daily wearable utilization, willingness to share wearable data with clinicians, and actual sharing of personal health information with clinicians among users. Longitudinal trends were evaluated in the overall US adult population, among individuals with cardiovascular disease (CVD) or major CVD risk factors, and across sociodemographic subgroups using the Rao-Scott χ2 test. Survey analyses evaluated contemporary drivers of wearable use and data-sharing behaviors. Results: There were 3865, 6252, and 7278 HINTS participants across the 3 survey cycles, representing 254 million US adults in 2020, 258 million in 2022, and 262 million in 2024. The weighted mean (SD) age of wearable users was 48.7 (18.1) years, 55.3% (95% CI, 52.3%-58.2%) were women, and 62.3% (95% CI, 60.9%-63.7%) had CVD or risk factors. Wearable use increased from 30.2% (95% CI, 27.6%-32.7%) in 2020 to 41.1% (95% CI, 39.0%-43.2%) in 2024, with similar upward trends among adults with CVD or risk factors. Among users, daily use remained low, with approximately one-half of users reporting daily use, and did not increase over time. Willingness to share wearable data was high but declined from 81.3% (95% CI, 77.1%-85.5%) to 73.4% (95% CI, 70.7%-76.2%), whereas actual sharing remained low across cycles (from 14.2% [95% CI, 12.4%-16.0%] in 2020 to 19.2% [95% CI, 17.7%-20.6%] in 2024). In adjusted analyses, wearable use increased by 30% per 2-year interval (adjusted odds ratio, 1.30; 95% CI, 1.19-1.41), but daily use, willingness to share data, or actual data sharing showed no meaningful change. Temporal trends were consistent across sociodemographic subgroups of age, sex, race and ethnicity, and income. In 2024, higher digital literacy was associated with greater willingness to share, but not with actual data sharing. Conclusions and Relevance: In this serial survey study, wearable device use increased among US adults, but daily use and clinician-directed data sharing remained limited. These findings suggest that there is a need for approaches to help realize the potential of wearable devices as health care tools, both by broadening uptake and promoting consistent use.