A case study approach to understand Black adults’ engagement with a smartwatch

As Black adults age, addressing potential hindrances to healthy aging becomes increasingly important—especially given that Black middle-aged adults often develop chronic conditions and multimorbidity earlier than their White counterparts. Smartwatches can collect vital health metrics (e.g., heart rate, sleep, oxygen saturation) and represent a promising technology for promoting proactive health self-management. To develop equitable and effective smartwatches, involving diverse populations to consider their needs and experiences is critical. We conducted a case study with six Black adults (50+) to investigate their engagement with a smartwatch for health self-monitoring over one month. Data were gathered through surveys and questionnaires to capture rich, real-time insights into participants' evolving behaviors, perceptions, and challenges. Participants noted their smartwatch was a potentially empowering tool that offered feedback on health indicators (e.g., heart rate and steps). The ability to access this readily available information motivated some participants to establish goals and consider lifestyle adjustments. Participants noted facilitators and barriers that influenced their sustained engagement with the smartwatch. Facilitators included perceived usefulness, relevance to personal health goals, and the prospect of integrating the device into daily routines. At the same time, participants expressed uncertainty about interpreting complex data and the absence of straightforward instructions as critical barriers to long-term adoption. Our findings guide the development of user-centered wearable activity monitors (WAMs) and supportive infrastructures that effectively help Black older adults manage chronic conditions.