Knowledge, Perception, Attitude, and Adoption of Consumer Wearables Among African Americans in Mississippi: A Public Health Analysis

African American communities in Mississippi face disproportionately high rates of chronic disease, yet the adoption of wearable health technologies, tools with the potential to improve health outcomes, remains limited. This study is the first systematic investigation of wearable devices use among African Americans in Mississippi, offering critical insights to inform public health strategies and interventions aimed at promoting health equity in minority communities. The primary objective of this study was to explore the difference/similar perceptions of African American church leaders regarding the use of wearable health devices compared to students, and to identify the cultural, economic, mistrust, cost, and technological barriers that impact adoption within their communities. A qualitative research design was used, involving 89 focus groups discussions with African American church leaders from Northern, Central, and Southern Mississippi. Sessions were conducted both in-person and virtually via Zoom. Data were analyzed using thematic analysis, guided by the Social-Ecological Model (SEM) and the Transtheoretical Model of Behavior Change (TTM), to understand individual and contextual factors influencing wearable devices adoption. Participants, primarily African American clergy and students aged 18 and older from 89 Christian denominations, expressed strong interest in wearable devices but cited several barriers to adoption. These included concerns over data privacy, cost, limited technological literacy, generational divides, and mistrust in healthcare systems. Older adults, in particular, viewed wearables as tools for younger people and lacked awareness of their health benefits. The study also found that African American clergy, as trusted community figures, who can play a pivotal role in influencing health behavior and could be instrumental in promoting wearable devices use through trust-building, education/preaching, and modeling as exemplary leaders by utilizing wearable devices. The broader dataset included 548 participants, allowing for robust demographic analysis. Results showed a health-conscious yet cautious population, highlighting the need for targeted culturally sensitive interventions. These should include educational outreach, financial assistance, and transparent communication about data use. Wearable devices have the potential to improve health outcomes and reduce disparities in underserved African American communities. To unlock this potential, public health strategies must address key barriers, particularly those related to cost, trust, technological comfort, and awareness. By engaging faith leaders and community organizations in culturally aligned efforts, wearables can become effective tools for chronic disease management and health promotion. The study proposes the "Mississippi Model of Wearable Adoption," emphasizing collaboration among clergy, policymakers, and technology providers to drive equitable adoption and foster community trust.