JMIR Publications

ABSTRACT

Background:

Consumer wearable devices offer scalable opportunities to monitor real-world behavior and support health in cancer survivorship. However, adoption and sustained use outside structured research settings remain incompletely characterized, limiting their integration into survivorship care.

Objective:

The primary objectives were to describe the prevalence of fitness tracker ownership and use patterns among cancer survivors, and to identify sociodemographic, psychosocial, and usability-related determinants of device ownership and frequent use.

Methods:

We conducted a cross-sectional survey of 893 cancer survivors enrolled in the Total Cancer Care protocol at a comprehensive cancer center. Participants completed an adapted online questionnaire assessing fitness-tracker ownership, frequency of use, and perceived barriers and facilitators. Multivariable logistic regression models were used to identify sociodemographic, psychosocial, and usability-related correlates of device ownership and frequent use.

Results:

More than half of participants (56.7%; 506/893) reported owning a fitness tracker, and among owners, 71.3% (361/506) reported daily use. The most commonly used devices were the Apple Watch (53.8%; 272/506) and Fitbit (29.1%; 147/506). Higher perceived stress was independently associated with lower odds of device ownership (adjusted odds ratio 0.61; 95% CI 0.38–0.98). Among owners, frequent use was significantly less likely among those reporting device discomfort (P<.001), low motivation (P<.001), information overload (P=.04), or limited app integration (P=.007). Demographic characteristics were not independently associated with ownership or sustained use.

Conclusions:

In this large, real-world sample of cancer survivors, wearable ownership was common, but sustained engagement was primarily shaped by psychosocial and usability factors rather than demographic characteristics. These findings suggest that scalable, wearable-enabled survivorship care will require strategies that address behavioral readiness and user experience, not access alone, to ensure equitable and clinically meaningful implementation.