Age differences in motivations, barriers, and facilitators of wearable and mobile app use in a government-led digital health initiative: a qualitative study

Chronic diseases have long been major public health concerns worldwide, and government-led digital health initiatives, such as the use of wearable activity trackers, have emerged as promising approaches to promote continuous self-care and patient empowerment. As their adoption expands, understanding the factors influencing sustained engagement is essential to maximize their contribution to population health. This qualitative study explored participants’ experiences in a community-based, government-led digital health promotion program to identify key motivators, facilitators, barriers, and areas for improvement, with particular attention to age-related differences. We conducted a qualitative focus group study to examine user experiences with a government-led digital health initiative in Seoul, Republic of Korea, from November 2021 to August 2022. The program offered wearable activity trackers and a mobile app that enabled step monitoring, personal goal setting, and point-based rewards for health-related products. Participants were purposively recruited across engagement levels to capture diverse experiences, and age-related differences were analyzed. Data were thematically analyzed using an inductive approach, with credibility ensured through double coding, peer debriefing, and triangulation. Fifty participants were included in the focus group study (mean age = 40.1 years; 44% men). Age-stratified analysis (19–39 vs. 40–64 years) revealed that younger adults were motivated by appearance, fitness, and technology exploration, whereas middle-aged adults emphasized health maintenance and practical rewards. Engagement was facilitated by ease of use, real-time feedback, and trust in the public program, while barriers included technical issues, limited personalization, and administrative inconvenience. Participants recommended more personalized feedback, automatic data synchronization, and broader reward usability to enhance sustained participation. This study identified key factors influencing the use of wearable activity trackers in a government-led digital health program. Enhancing technical reliability, personalization, and age-sensitive design is essential for sustaining engagement and maximizing public health impact.