Digital Health Engagement: Use of Wearable Monitoring Devices among Adults in Saudi Arabia

Background Wearable health monitoring devices (WHMDs) are increasingly incorporated into digital health ecosystems, enabling continuous monitoring of health indicators and encouraging preventive health behaviors. Despite Saudi Arabia’s rapid digital transformation under Vision 2030, evidence on public engagement with wearable technologies remains limited. This study assessed knowledge, attitudes, and practices (KAP) related to WHMDs among adults in Saudi Arabia and identified factors associated with their adoption and use. Methods A cross-sectional online survey was conducted among 385 adults aged 18–60 years residing in Saudi Arabia. A validated self-administered questionnaire (Cronbach’s α = 0.896) assessed sociodemographic characteristics, knowledge of WHMDs, Technology Acceptance Model constructs (perceived usefulness and ease of use), attitudes, preventive health practices, barriers, and facilitators. Descriptive statistics, chi-square tests, independent t-tests, and multivariable logistic regression analyses were performed using SPSS version 28. Acceptable KAP was defined as a score ≥ 60%. Results 45.2% of participants reported current WHMDs use. Users were significantly younger, more likely to be male, employed, university educated, of higher socioeconomic status, and free from chronic diseases (all p < 0.05). Compared with non-users, users demonstrated significantly higher knowledge (87.6 ± 13.9 vs. 80.6 ± 14.2), attitude (73.0 ± 10.1 vs. 65.5 ± 13.1), and preventive practice scores (49.1 ± 10.3 vs. 40.1 ± 11.9) (all p < 0.001). Smartwatches were most commonly used devices (67.8%), and daily use was reported by 54.6% of users. Sleep monitoring was predominant reason for use (31.0%). Logistic regression identified male sex, younger age, university education, employment, and higher socioeconomic status as significant predictors of acceptable KAP, whereas chronic disease was negatively associated with all KAP domains (aOR range: 0.38–0.45; p < 0.001). Conclusions WHMD adoption is associated with greater health knowledge, favorable attitudes toward digital health, and stronger preventive health practices. Targeted efforts to improve digital health literacy, address privacy concerns, and enhance accessibility for individuals with chronic diseases may facilitate broader, more equitable adoption of wearable health technologies.