Investigation of long-term effects of wearables on healthy lifestyle behaviours

Investigation of long-term effects of wearables on healthy lifestyle behaviours

2.0 LITERATURE REVIEW

2.1 Chapter Introduction

The researcher reviewed the documented academic literature on the topic to find the theoretical and current study through the analysis of past studies by examining the existing empirical evidence established during the previous studies. The literature review focuses on highlighting the already documented information about the research topic and establishing its tentative theoretical answers about the research questions. The researcher reviewed data and information from scholarly sources that are genuine and authoritative such as journals, peer-reviewed articles, and other publications. The literature review involved several steps, such as; The first step discussing the theoretical background, followed by a description of empirical evidence about the topic, the next step was mentioning the research gap, and, lastly, outlining the conceptual framework.

2.2 Theoretical Background

2.2.1 Wearables as (Technology) Gadgets

Wearables are electronic devices that are smart because they can be used to record and analyze individual body signals (Lunney et al. 2016). According to Kerner and Goodyear (2017), wearables are an electronic device that can be incorporated as a part clothing item and accessories which are comfortable to wear on the body. Wearables are simply gadgets with communication ability that allow the wearer to access real data on time. The devices are sophisticated, hands-free, powered by microprocessors with the ability to send and receive data through the internet. The gadgets exist in various forms, which are often re-inventing the already existing gadgets like watches, glasses, and bracelets. The devices are trendy among the current generation, a study by Ledger and McCaffrey (2016). found that one in ten people among the adults in America own at least one wearable device. The use of wearables is expected to grow from 33 million devices in 2015 to 148 million devices by 2019, according to Spill and others (2017).

The gadgets are worn close or on the skin to record the vital signs that originate from the body. Some wearables are also embedded in the clothes for the devices to touch the skin surface efficiently (Dehghani, 2018). Sensory and scanning features of the device make them sophisticated than any other device in the market. Standard functions of the wearables include step counting, tracking speed and distance, and heart rate monitoring (Kulick 2017). Wearable devices are broad because they can influence the field of fitness, gaming, transportation, music, education, health, and medicine. Data gathered by wearables devices are presented in the form of visual purposely for analysis to be easy and quick ( Ledger and McCaffrey 2016). The devices are manufactured by different business entities that offer a wide range of products to choose from according to their preferences. Some of the companies that developed devices for their customers are Apple and Samsung.

2.2.2 Lifestyle Behaviour Changes

Change in lifestyle behavior involves a complex process of changing the psychological perspective of an individual over a specific matter or issue that can be manipulated to fit different standards (Kononova et al. 2017). Behaviour change is only possible when a person decides to change the psychological perspective of specific behaviours that affect their daily lives. The psychological changes can be attitude, self-efficacy, and the living style of an individual (Rieder et al. 2019). Several factors trigger the change in lifestyle behaviour, which are vital as they determine how someone lives and whether they will maintain the lifestyle, behaviour or will change in the future. Motivation is one of the crucial factors that can encourage people to change their lifestyle behaviour ( Hagger et al. 2014). Another factor is an experience one went through that may affect their perceptions of behaviour and lastly, the emerging health issues that are rampant nowadays (Wieneke et al. 2016).

Change in behaviour can lead to positive or negative outcomes depending on how an individual changes. About health matters, lifestyle behaviour changes are an individual effort that aims at the change of personal habits and attitudes to ensure that they live a healthy lifestyle through the prevention of chronic diseases ( Ledger and McCaffrey 2016). The changes are essential to ensure that an individual reduces the chance of suffering from certain diseases that may develop due to their living style (Kulick,2017).  Most behaviour changes are practiced to improve the health status of a person. An excellent example of a healthy lifestyle style change is the change of food type that one takes to improve their immunity. Another change in behaviour is weight loss that happens a lot when someone feels their weight affects their health status (Voils and Shaw 2017). Wearable devices have been assisting people in changing their lifestyle behaviours because they can comfortably record, analyze, and adjust their daily activities to fit the recommended living standard.

2.2.3 Technology Acceptance Model (TAM)

The technology acceptance model is (TAM) is a theory established to define the factors that influence IT usage use among people. It shows how various users accept and use new technology devices and systems at their disposal (Chang et al. 2016). For people to accept the new technology system and devices, a behavioural intention must be established to attract people to use the technology. The behavioural intention largely relies on the attitude influenced by the perception technology creates on people’s minds (Yang et al. 2016). The technology advance model suggests that technology users are influenced by two factors on when and how they will use the innovations. The first factor is the perceived usefulness (PU), which means the level of belief an individual has on the particular technology, especially if that technology is beneficial to them or not. The second factor is perceived ease-of-use (PEOU), which means the belief of an individual about technology simplicity or the ease of using the technology (Jeong et al. 2016).

Wearables are a new technology that is penetrating the market currently as most people have not experienced how the devices function. This has made the wearables manufacturers develop devices that are acceptable to the public, as mentioned by Yang and others (2016). The devices have to be easy to handle, and they are considered useful for the daily operation of a person. Usefulness is achieved due to a wide range of functions that the devices perform, such as monitoring the heart rate, calculating distance one covers, and many other vital functions (Jeong et al. 2017). Wearable devices are easy because the data are generated and analyzed automatically by gadgets (Chang et al. 2016). Users are only able to read and analyze the generated data. The ease of using the wearable and the associated benefits have made it possible for most people to accept the new technology.

2.3 Empirical Evidence

2.3.1 What motivates people to start using wearables

Motivational factor of the wearable device is one of the ways that people are motivated to use gadgets. People are always pushed to complete behaviours that they deem fit for their goals and needs (Rupp et al. 2018). A motivational theory, self-determination theory, is a popular theoretical aspect of understanding the motivation effect on a particular action. The theory shows an understanding between the start and continuous use of the wearables by an individual. For the users to continue using the devices, they must be motivated, which is possible through developing interest in using the wearable (Kerner and Goodyear 2017). The theory states that people have three basic psychological needs: autonomy, which entails being in control and making good choices, a competence that involves being skillful and effective, and achieving goals and relatedness where one feels connected to others and receives social support. Actions that fulfill the three psychological needs are considered rewarding, which means they motivate individuals to engage in the activities for a long time, according to a study conducted by Kulick (2017).

Technology Trust is the belief of a person on the support it contributes to achieving goals and objectives. In cases where the user does not have full knowledge of the event or process, the use of technology is crucial for such situations (Rieder et al. 2019).   When using the wearables, people access the trust by monitoring the devices’ performance, the process of functioning, and the primary purpose the device was designed. People trust devices they consider to be accurate, reliable, and secure with the personal information they receive, which are qualities that wearable possess as users can easily judge the device capability personally (Kononova et al. 2017). The wearables support people as they provide real data about their body vitals and other use cases as weather changes. The fitness wearables are mostly affected by the technology trust because users depend on the data generated and analyzed by the devices to depict their health and fitness status (Rupp et al. 2018).

Technology acceptance is a vital aspect of long term adoption of the wearables by the users. The technology acceptance model highlighted the usefulness and ease of using technology to be the force behind interest in using new devices by people. Usefulness is the ability of a device to help achieve objectives and goals (Kerner and Goodyear, 2017). The ease of use is the simple standard of using the device without experiencing any complication. The acceptance of using the goods depends on both the user and technological devices available. In this case, the wearables are easy to use because data are generated and analyzed effectively for the users to refer (Rupp et al. 2018). The users can also use the data to decide on their daily lifestyle behaviour to improve their health and fitness standards if the fitness wearables are involved. Technology acceptance influences the attitude and the behavioural intentions using a particular device (Wieneke et al. 2016).

The wearables’ usability is also a motivator for people using wearables because the devices have better design and usability. People easily wear wearables through several means, such as sticking to clothes, next skin (Voils and Shaw 2017). The wearables are also available in different forms, which already existed, making it easy to wear the devices. Using already existing devices such as glasses, wristbands, and watches makes wearables easy (Rupp et al. 2018). The existence of devices in different forms is an opportunity for the users to choose the best design according to their preference and taste, which motivates them to purchase the devices. According to Kerner and Goodyear (2017), wearables’ usability requires further studies because some people consider the data presentation to be inconvenient, and the devices can easily get lost.

2.3.2 The role technology plays in the adoption of wearables

Technology is the main base and influence on the establishment of the wearables that are accepted and purchased by the users ( Hagger et al. 2014). Consumer perception is vital for the purchase of wearables, which means the role of technology plays for adoption is essential. The perception of users mostly depends on the manufacturer’s brand image. Rauschnabel and Ro (2016) investigated and found a significant influence of brand attitudes on consumer’s perception of adoption of smart glasses. Technology quality has a significant influence on the consumer’s attitude towards wearable adoption. Good technology innovation has a positive influence on wearable user adoption (Yang et al. 2016). User social image is also enhanced by brand images that are considered to innovate some of the best devices. The quality of information generated and presented by these devices may vary according to manufacturer design of functionality (Dehghani, 2018). This makes it easy for users to adopt wearables because they can choose the right device.

Aesthetic attributions of the technology have a significant effect on the adoption of wearable devices by consumers. Technology innovation is, most of the time, considered fashionable, so the consumers are ready to purchase and use the new devices available. They consider aspects such as design, color, form, and texture due to the devices’ visual appearance. The aesthetic attributes are useful when the customers decide because the cognitive attention and emotions of the consumer rely on the attributes that eventually affect the consumption pattern. Hwang et al. ( 2016), analyzed the aesthetic attribute of the clothes powered by solar and determined a significant effect that the attributes have on the consumer attitude towards the clothes. Yang et al. (2016) mentioned that wearable devices’ attractive nature greatly influences the user’s perception of enjoyment and social image. The aesthetic attributes of the technology make it easy for people to adopt the wearables as per the reasons mentioned (Dehghani, 2018).

The compatibility of technology is the extent to which it is assumed to be consistent with the experience, values, and needs of adoption requirements. The compatibility of the technology has enhanced the wearables’ adoption rate because the gadgets fit into the consumer lifestyle (Wu et al. 2016). The existence of other technological devices that collectively function with a wearable is a boost to the adoption process. Such devices are smartphones and computers connected to the wearables, making it easy for users to handle and interpret the generated data (Rauschnabel and Ro 2016). The devices are used by people daily, making it easy to connect with a wearable device. The functionality of both the wearable devices and other gadgets affects the consumer attitude and perception hence they adopt to the devices efficiently. The compatibility of a wearable device to other technological innovations has positively influenced the user perception and attitude toward adopting the wearable (Hwang et al. 2016).

2.3.3 Effects of Wearables on lifestyle and behaviour changes

Wearables have been used in different industries to improve on several factors that depend on technology. Wearables have been used in clinical applications and healthcare by different institutions and individuals (Mercer et al. 2016). The existence of wearables has helped in monitoring the blood pressure, blood oxygen circulation, heart rate, among others. The measurement and monitoring of the parameters are essential for diagnosing different diseases, according to Lou and others (2020). A study conducted by Piwek (2016) also proved that wearables’ use is useful for patients due to the ability to record accurate health information that can be used to manage possible health complications. The use of wearable to determine the future health status of an individual is vital for medical practitioners. More research should be conducted to determine the exact variable or vital signs that may lead to a particular health issue (Canhoto and Arp, 2017). Most patients are also not aware of wearables, which means the functionality and suitability should be the priority when designing the gadget.

In modern society, people pay attention to their health before any signs and symptoms, which is different from the past years, where one had to experience it. People use a wearable to maintain a healthy lifestyle, and manufacturers are also encouraging people to participate in such activities (Piwek et al. 2016). People use wearables to monitor and create better interventions when managing weight (Kulick, 2017).  Voils and Shaw (2017) mentioned that increase in physical exercise and diet management are two primary methods that wearable can assist people in getting rid of obesity after careful study of the wearable effect on weight. In a study conducted by Rupp and others (2018), earlier findings mentioned that wearable devices capable of measuring physical activity and presenting analyzed feedback could increase the exercise and reduce the user’s body weight. Managing health does not rely on the use of devices only, but if the users can effectively use them for their benefit.

Effective diet control is also achievable when using the wearables because the data are generated and analyzed in real-time. A previous study conducted by Luo and others (2020) established that using wearable devices effectively helps people monitor their dietary behaviors.  Maintaining a healthy diet requires strict guidelines and conditions that are not easy to follow, especially when one cannot monitor their behavior. According to Piwek and others (2016), wearables are the best devices that exist for monitoring dietary behavior because of their usability and ease movement. Using wearables to monitor dietary behavior is good, but one must strive to maintain a healthy lifestyle and avoid any temptations. Healthy dietary is beneficial if the wearable user considers other existing health factors that also contribute to poor health hence need to monitor other health-related issues (Canhoto and Arp 2017).

Sedentary behaviour among people that last for an extended period is associated with various harmful health outcomes. Frank and others (2017) researched the use of wearables to help change the subject’s physical behaviour, and the outcome showed a positive correlation and healthy behaviour. The use of wearable has been identified to help increase physical activities among people through monitoring the progress of activity continuously (Piwek et al. 2016). The availability of wearable for fitness activities is popular among the young population compared to the older generation whose health issues and conditions require constant use of the wearable to manage fitness (Rupp et al. 2018). The use of wearable has improved the fitness of many people, especially the young generation, while the old generation is experiencing several issues using the devices. The issues are lack of proper knowledge on how to use the devices, low adoption rate, and the price of devices is high.

Monitoring mental conditions of people using wearable devices are quite a new phenomenon but have been effective. Some wearable contains sensors that monitor the physiology status of a person such as blood pressure, heartbeat, and other vital signs which are used to detect stress. Akbulut and others (2020) Studied stress detection by monitoring the audio and heart rate signals among the research subject through the use of wearable devices. It was possible to detect stress among people using wearable devices. Another study by Setz and others (2010) Proved that electrodermal activity (EDA) sensors also are capable of identifying the stress level in a person through the use of wearable on the skin. Stress detection by the devices is an essential factor for most people’s wellbeing as they can manage their stress levels effectively to avoid health conditions that arise from stress ( Stephenson et al. 2017).

Sports have nowadays evolved rapidly to incorporate the use of technology as part of sports medicine and physical activity monitoring. Wearable devices assist the athletes and coaches in managing and controlling the training and matches effectively. A study by Skazalski and others (2018), applied the commercial wearable equipment as an effective and capable method to track the jump load of volleyball players and monitor jump-specific training. The study showed that devices could effectively detect jump height capacities. Another study by Chen and others (2018) developed a system to measure and detect heat stroke, which is harmful to people’s health, especially when doing exercise when the temperature is high. It was possible to detect, monitor, and alert the users about the heatstroke. The wearable devices can monitor the heart rate, workload, a functional movement that makes it practical to use is sports medicine as a performance maximize, and lowering the injury (Konova et al. 2019).

Fall identification and prevention are among the significant effects of wearables because of the ability to detect and alert users about fall. The majority of fall victims are older adults who face various health conditions that need constant monitoring, according to a study done by Gibson and others (2017), which was developed to monitor walking patterns that may cause a fall or seizure by using wearable devices. Research by Piwek and others (2016) showed a method of detecting a fall at different stages using the wearable devices. Panurat and others (2017) also generated fall detection through the analysis of daily activities, which may trigger the fall of a person. A study performed by Awais (2016) compares and evaluates the functionality of the wearable in a laboratory set up and real-life situation. The study showed that systems that are established in a laboratory might not function according to real-life conditions. This means a new system is supposed to be tested in a real-life situation.

The workplace is another vital part of people’s lives that they spend most of their time, which means wearable devices have become part of the daily operation (Jeong et al. 2017). The devices have been used to assist people in working effectively and efficiently while monitoring and maintaining the workers’ physical and mental status to ensure the safety standards are met. The wearables are used to monitor employee physical and psychological conditions like stress and joint angles that may be inappropriate, leading to disorder (Alyazed et al. 2018). Wearables technologies are used as personal protective garments at the workplace to prevent any physical injuries prone to workplaces.  According to Xue (2019), issues and risks exist among people that they try to consider before adopting the wearable devices. The issues are the privacy of employees, compliance from the employees, the time-lapse of the sensor, and the cost associated with sensors’ use.

Human senses are limited and not capable of functioning perfectly, making the use of wearable as sense enhancement effective in everyday activity. The wearables are capable of detecting the surrounding environment and apply the acquired data to increase human capabilities. Rieder and others ( 2019), conducted a study to evaluate the effectiveness of using wearable devices to monitor language patterns. According to the study, the use of language tracking wearable is beneficial as it improves communication between people. Other wearables have been used to improve the information presentation, control, and exchange and the operation standards of people (Jakicic et al. 2016). A good example is the use of head-mounted devices as smart glasses that are used to guide an individual remotely. Enhancement of the human senses to perform optimally is essential for better processing and production efficiency (Voils and Shaw 2017).

Wearable technology has changed the perception, lifestyle, and behaviour of people in different ways as they look to maximize the device use for their benefit ( Lunney et al. 2016).  Wearable devices as a motivator for lifestyle behaviour change, such as an increase in physical activity, require some promotion (Ledger and McCaffrey 2016). Some of the techniques are cognitive behaviour therapy that helps a person determine the link between their thoughts and exercise traits (Spil et al. 2016). They assist in improving the health status of a person and enhance physical activity. The changes in thinking can also motivate a person, although most fitness technology rarely includes the use of cognitive factors in their program.

New technologies are established to help solve the existing problems in society while benefiting users. Wearable improves people’s lives personally and professionally, which makes them fit for most purposes (Wieneke et al. 2016). The devices monitor physical activities, diet monitoring, among others. The technology is also prone to risk, which depends on the functionality of the devices and usability, which is the interaction of humans and technology. Some of the risks associated with wearable are privacy risk, safety risk, performance risk, and social and psychological risks (Jeong et al. 2017).

2.4 Research Gaps

The existing empirical studies and literature have discussed the detailed research topic of discussion that is the long effect the wearable has on the user. Some gaps still exist that need is supposed to be addressed. First, a study should be conducted to determine if the long term users of wearables need to continue to wear the devices so that they can stick to the healthy lifestyle they developed. Very few studies exist that mention the lifestyle of users after they stop using the wearables. The available studies do not consider the significance of not using the wearable after long time adoption by an individual.

Another gap that requires attention is that the empirical studies and literature have less information about it to identify the long term effect that wearables have on healthy lifestyle behaviours among the users. Past studies have mostly covered the short-term effect that wearables have on the healthy lifestyle behaviour of users, not considering the long-term effects. Also, the use of current information concerning this topic is vital due to its connection to changing factors in technology should be considered. Which simply means the information gathered should be current.

The last gap that exists is the role technology plays in the adoption of wearables across the globe. The existing empirical studies mostly cover the wearables’ technological aspect and less information about the technology role in the adoption of wearables by users. Data about the adoption should cover all ages from young and older people considering both genders equally to help get the right information for the study. This study’s main focus was to address the long term effect that wearables have on a healthy lifestyle, investigate the role technology plays in the adoption of wearables, and lastly, to find out if long term users of wearable need to use the devices for them to live a healthy lifestyle.

2.5 Conceptual Framework

The conceptual framework was established to determine the long term effect of wearable on the user lifestyle. The core drivers for the ideology of using the wearables are; first is the existence of wearable as gadgets in the form of physical existence and technology which make them available for use, the second factor is the lifestyle behavior change that a person may experience that may trigger the usage of the wearable or discourage the possibility of using the devices; some of the changes may include health issues, the fitness standard, and social influence depending on user determiner, the last factor is the acceptance of the technology by the users (TAM); acceptance of the technology is vital for the usage and adoption of the wearables due to the factors involved such as the user perception about the technology; the device has to be modeled to attract users by defining the function it is intended for and the ease of using the device which means if it can be handled easily.

The framework also establishes the driving factors that encourage usage after developing interest. Some of the factors that were mentioned that contribute to continued use of wearables are adoption among the users, which is influenced by the role of technology in the adoption of wearable devices. The adoption is vital because it determines the user’s possible duration of using a wearable. The technology feature such as aesthetics, acceptance, and usability are the primary influence on adoption. Another factor that determines the duration of use is the motivation factor behind wearable usage, which is different depending on various factors such as functionality, usability, pricing of the devices, among others. All the factors, as mentioned above, will directly determine the long term effect of using a wearable.

2.5 Chapter Conclusion

The chapter has discussed the varied aspect of the wearable devices even though the information about the long term effect of wearables is on users are not enough. The use of wearable devices has been found to have serious health effects on the majority of users being young or old, which has significantly affected users’ perspective. The use has been established to rely on several aspects such as the technology acceptance model (TAM), connection with other technology gadgets, among others. It’s used also relies on its usability and functionality that most consumers consider. Another vital aspect of using wearable is the adoption among the users, which significantly varies according to age.  The next chapter will discuss the methodology that will be applied to find out the answers to research questions and discuss the objectives.

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