From perception to continuance usage: How smartwatch health features influence consumer attitudes, health improvement expectancy, and well-being

The increasing integration of advanced health-tracking features in smartwatches (e.g., heart rate monitoring, blood pressure tracking, and electrocardiograms) has positioned them as key tools in personal healthcare management. However, despite their growing adoption, little research has examined how consumers' expectations for health improvement and attitude influence their long-term usage behaviors and meaningful outcomes. Existing studies mainly focus on smartwatch adoption and initial use, neglecting the roles of health improvement expectancy and health anxiety in shaping continued use and well-being outcomes. To address this gap, this research investigates how consumers' perceptions of smartwatch health attributes shape their attitudes toward smartwatch health usage (ASWH) and health improvement expectancy, and how these affect continuance usage and well-being. Furthermore, this research examines health anxiety as a moderator of this relationship. This research employs a mixed-methods approach, combining qualitative online content analysis with quantitative questionnaires. The qualitative phase explores consumers’ perceptions of smartwatch health-monitoring features, their ASWH, and their expectations. Insights from this phase inform the quantitative study by refining the proposed conceptual model and hypotheses. The findings offer valuable insights that contribute to the growing discourse on wearable technologies by shifting the focus from adoption to sustained use and well-being improvement. The research provides practical implications for smartwatch developers and marketers by identifying key technological, psychological, and perceptual drivers that can inform feature design, consumer experience, and targeted marketing strategies for health-conscious consumers.