Investigating Changes in the Brain After Using a Wearable Healthy Lifestyle Intervention: A Mixed-Methods Protocol (Preprint)

<sec> <title>BACKGROUND</title> 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 adherence and effects on cognition 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. </sec> <sec> <title>OBJECTIVE</title> In this study, we aim to assess the cognitive and behavioral effect of a commercially available wearable technology, the Apple Watch, on the brain, while exploring user experience (UX) factors influencing adherence, engagement, and acceptability of wearable healthy lifestyle interventions. Our goal is to provide comprehensive guidelines to evaluate the effect of wearable technologies on the brain, which could potentially shape the future of brain health interventions. </sec> <sec> <title>METHODS</title> Healthy adults aged 18-40 with a sedentary lifestyle (n=72) will be recruited in the Vancouver Metropolitan Area, BC, Canada. Participants will be randomized into an intervention group following a healthy lifestyle intervention 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 investigate three constructs of a wearable healthy lifestyle intervention: effectiveness, engagement, and acceptability. This design integrates pre-, during, and post-intervention assessments combining quantitative and qualitative approaches. Effectiveness will be evaluated with quantitative assessments including perceived health (SF-36), behavioral performance (Go/No-Go task) and cognitive activity (EEG-based ERPs and resting-state activity). Engagement and acceptability will be assessed using questionnaires (goals completion and System Usability Scale, respectively). Qualitative assessments will include weekly check-ins and semi-structured interviews to capture UX factors influencing the acceptability of the intervention. Secondary outcomes include descriptions of possible interactions between the three constructs. </sec> <sec> <title>RESULTS</title> The study received funding by the AGE-WELL Network Centres of Excellence (April 2020–March 2023) and the Pacific Economic Development Agency of Canada (April 2022–March 2025) 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 by the end of 2025. </sec> <sec> <title>CONCLUSIONS</title> This study outlines a foundational framework for evaluating the effect of wearable health interventions on the brain. Further, we hope our mixed methods approach will inform the design and development of effective, engaging, and friendly wearable brain health technologies. </sec>