Wearable device adherence and engagement in health research: a scoping review

As wearable devices become more widely used in health research, adherence to device wear or use is essential for generating meaningful and reliable data. We conducted a scoping review following JBI methodology and PRISMA-ScR guidelines, searching PubMed, Cochrane Library, and Web of Science. Two reviewers independently screened and extracted data using a standardised form. The protocol was preregistered on OSF. Only studies explicitly reporting adherence or engagement as an outcome were included, resulting in 70 studies ( n = 9908 participants; median duration = 84 days), mostly pilot and feasibility studies. Most studies (61%) provided no definition or justification for adherence or adherence thresholds. Adherence thresholds varied widely and included temporal, activity-based, and percentage-based thresholds. Common adherence thresholds included 10 h/day, 4/5 days/week, or 70–80% of the study period. Across studies reporting quantifiable adherence metrics (using heterogeneously defined measures rather than pooled estimates), median percentage wear time across studies was 80%, and median reported daily wear time was 17 h. Barriers and facilitators operated across three levels: device (e.g., comfort, reliability), user (e.g., health status, privacy), and study context (e.g., study burden). There is substantial diversity in how adherence is conceptualised and reported, highlighting the urgent need for standardised guidelines. We propose a Minimum Adherence Reporting Set (MARS) covering device specifications, adherence definitions and thresholds, adherence results, and implementation context.