JMIR Publications

Background:

Wearable technologies, such as the Apple Watch, are rapidly transforming the healthcare landscape by enabling the tracking of real-time physiological and behavioral data used in healthy lifestyle interventions. Despite their widespread adoption in the consumer market, scientific validation of their impact on the brain remains limited, and factors influencing effects on cognition and adherence are not fully understood. This gap is critical as consumers, healthcare providers, and researchers depend on this data to unlock the potential of wearables for cognitive support.

Objective:

In this study, we aim to assess the effectiveness, engagement, and acceptability of a commercially available smartwatch healthy lifestyle intervention on cognitive enhancement in healthy adults. Effectiveness (intervention’s impact) will be evaluated through cognitive function as the primary outcome (executive function), along with secondary outcomes including resting-state brain activity, behavioral performance and perceived health. Effectiveness, engagement (participants’ interactions and commitment to the intervention) and acceptability (participants’ perceptions and satisfaction with the intervention) will be assessed through quantitative and qualitative assessments using a convergent parallel mixed-methods design. Finally, we seek to provide a comprehensive, replicable methodological framework to evaluate wearable technology interventions targeting cognitive enhancement in healthy adults.

Methods:

Healthy adults aged 18-40 with a sedentary lifestyle (n=72) interested in participating in a healthy lifestyle intervention will be recruited in the Vancouver Metropolitan Area, BC, Canada. Participants will be randomized into an intervention group using an Apple Watch or a control group following standard physical activity guidelines without an Apple Watch over a period of four weeks. We will employ a convergent parallel-mixed methods design to assess effectiveness, engagement, and acceptability. Effectiveness will be evaluated through: 1) cognitive function (primary outcome): executive function, specifically inhibitory control via EEG-based event-related potentials (N2/P3) during a Go/No-Go task; 2) resting-state brain activity via EEG spectral power; 3) behavioral performance (reaction time and accuracy); 4) perceived health (SF-36); and 5) qualitative analysis of factors affecting the intervention’s effectiveness. Engagement will be assessed through goal completion metrics and qualitative analysis of barriers, facilitators, and usage patterns. Acceptability will be assessed through usability scores (System Usability Scale) and qualitative analysis of factors affecting usability, satisfaction and user preferences. This design integrates pre-, during, and post-intervention assessments. Qualitative assessments will include weekly check-ins and semi-structured interviews to provide a comprehensive understanding of factors influencing the effectiveness, engagement, and acceptability of the intervention. Exploratory outcomes include descriptions of possible interactions between the three constructs and comparison of smartwatch-tracked vs. self-reported goal completion.

Results:

The study received funding by the AGE-WELL Network Centres of Excellence (April 2020–March 2023) and was approved by Simon Fraser University’s Research Ethics Board. Enrollment for the study is ongoing. The data collected from participants who have successfully completed the intervention is currently being processed and analyzed. The first results are expected to be published in 2026.

Conclusions:

This study outlines a foundational framework for evaluating the effectiveness, engagement, and acceptability of wearable health interventions targeting cognitive enhancement in healthy adults. Further, we hope our mixed-methods approach with randomized controlled comparison will inform the design and development of effective, engaging, and friendly wearable brain health technologies.

International Registered Report:

DERR1-10.2196/81490