JMIR Publications

ABSTRACT

Background:

Wearables like smartwatches can enhance older adults' health management at point-of-care while reducing strain on healthcare systems amid a growing aging population. Though there are many studies comparing technical accuracies of smartwatches, there is a major gap of user-centric studies to understand human-computer interaction (HCI) factors that influence their adoption by older adults, especially in Low-and middle-income countries (LMICs) like Bangladesh.

Objective:

The primary objective of this study is to assess the real-world usability and adoption of smartwatches among socioeconomically diverse elderly communities (>60 years) in an LMIC like Bangladesh. It explores how HCI factors like age, background, education, and lifestyle may influence user experience, highlighting key barriers and facilitators to adoption, comfort, and long-term engagement with a smartwatch.

Methods:

The first step was to identify and engage with communities of elderly individuals to evaluate this study's general interest level and feasibility. Then, a three-phase survey was conducted with the recruited individuals from different socioeconomic and educational backgrounds. The study cycle includes: i) a short-term survey, ii) a long-term survey with three data points, and iii) focus group interview. Statistical data analysis, reliability analysis, comfortability analysis, adaptability analysis, and usability analysis were performed.

Results:

The study reveals significant findings regarding smartwatch adoption among senior citizens across diverse socioeconomic backgrounds. Participants demonstrated remarkable improvement in comfort perception (26.31% to 88.88%) over time, challenging assumptions as users from the lower socioeconomic stratum adapted more readily to the technology. Among health metrics, heart rate monitoring consistently emerged as the preferred feature (68.42% to 79.53% usage), while privacy preferences revealed a notable divide: higher socioeconomic participants favored continuous data sharing, while lower socioeconomic groups preferred emergency-only sharing. Most participants ultimately reported high perceived accuracy of health metrics, with aesthetic preferences inclining towards traditional watch designs.

Conclusions:

This study reveals significant insights into smartwatch adoption among diverse elderly populations in LMICs, challenging conventional assumptions about technological adoption across socioeconomic divides. Our findings demonstrate that older adults can successfully integrate wearable technology into their daily routines when given adequate time and support, regardless of educational background. The marked preference for fewer and focused health monitoring features and the unexpected faster adoption among less educated participants highlight the importance of more streamlined design. These insights guide the development of age-appropriate wearable health technologies that balance functionality, comfort, and familiarity, enhancing healthcare accessibility for elderly populations in resource-limited settings. Clinical Trial: An IRB approval (2023/OR-NSU/IRB/1231) was obtained from the North South University, Bangladesh, through rigorous reviews from their Scientific Regulatory Committee. The study involved non-invasive use of commercially available smartwatches and follow up surveys on user feedback with appropriate consent prior participant recruitment. No new drug or device was tried in this study.