Wearables and Their Potential to Transform Health Management: A Step towards Sustainable Development Goal 3

Abstract

In the era of rapid technological advancement, wearables have emerged as a promising tool for enhancing health and well-being. The convergence of health and technology drives an unprecedented change in the approach to health and well-being management. This paper aims to provide a comprehensive understanding of the potential role of wearables in actualising health and well-being, thereby paving the way for a healthier and more sustainable future. Using the Affordance Theory lens, this paper delves into the transformative potential of wearables in health and well-being management, thereby promoting Sustainable Development Goal 3 to ensure healthy lives and well-being for all at all ages. The thematic analysis of online reviews on wearable devices captured through web scraping was carried out to explore the potential of these devices in the management of health and well-being. The paper explored how wearables, often integrated into everyday life, can monitor vital signs, track fitness metrics, and even provide therapeutic benefits for health and well-being. The findings reveal that wearables can empower individuals to take charge of their health by leveraging real-time data and personalised feedback, promoting a proactive and preventive approach to health management and resource-effective healthcare. Furthermore, the paper highlights how wearables can contribute to long-term health outcomes for the present generation without exerting excessive strain on the resources for future generations.

1. Introduction

In an age where technology has become an inseparable part of daily living, wearables have emerged as a groundbreaking paradigm for managing health and well-being. The interactive features and low-cost data-driven insights of wearables provide a unique perspective on how health, technology, and sustainability are intertwined [1,2]. Sustainability is defined as the ability or capacity of something to be maintained or to sustain itself without jeopardising the potential for people in the future to meet their needs [3]. The United Nations (UN) 17 Sustainable Development Goals (SDGs) are aimed towards achieving global sustainability for people, prosperity, and the planet [4]. Sustainable development is “development that meets the needs of the present without compromising the ability of future generations to meet their own needs” [3].

Goal 3 of the SDG (SDG-3) aims to ensure healthy lives and promote well-being for all ages while targeting 13 broad health aspects [4]. SDG-3 targets, among others, the reduction in premature mortality from non-communicable diseases through the prevention, treatment, and promotion of mental health and well-being [4]. SDG-3 also targets universal health coverage and access to quality services aimed at essential healthcare. The concept of health has transitioned from the absence of illness to a better and healthier life for oneself and future generations [5]. Health and well-being are associated with people, so SDG-3 is classified under social sustainability. SDG-3 targets have also been linked to the planet, which is the environmental dimension of sustainability [6,7].

Globally, the achievement of the SDGs, including SDG-3, has been derailed, and calls have been made for urgent, intensified efforts towards the timely realisation of SDGs [8,9]. The UN 2023 Report on SDGs’ progress laments the slow progress and, in most cases, regression in achieving SDG-3 across the globe [9]. As the world grapples with mounting health challenges and lags behind the achievement of SDG-3, there is a growing need to deliver innovative and sustainable solutions, aligning personal health objectives with global imperatives for a healthier society. To this end, the immense contribution of technology to achieving SDGs has been lauded [9]. Specifically, as health and technology converge, the resultant effect is an unparalleled change in how healthcare and well-being are managed [10], which positively impacts the achievement of SDG-3 [11]. Thus, exploring the synergies between these two vital fields of health and technology is essential, given the complexity of healthcare and sustainability [1,12].

The wearable revolution has the potential to revolutionise health and well-being management and, by extension, reshape global commitment to a sustainable future [1]. Wearables also play an important role in enabling the implementation and development of smart cities globally, as they promote smart health, which is an essential component of the smart living dimension of smart cities [13,14]. The smart living dimension is concerned with the quality of life in the city and includes factors such as culture, tourism, health, and housing [13]. Wearables are an example of the Internet of Things (IoT), which has been identified as a significant technology for the infrastructure development of smart cities [15]. Wearables are AI-empowered and sensor-embedded advanced digital technologies that collect and analyse essential data [16,17]. They encompass smart digital devices worn by individuals, such as clothing, shoes, eyewear, or jewellery, which can aid in detecting and tracking human performance, activities, and health [18,19].

Beyond particular health-related cases or scenarios, wearables can offer sustainable solutions for managing health and well-being, providing a broader sustainability contribution [20]. The sustainable contribution of wearables to health and well-being is considered complex, encompassing resource efficiency, reduced health and well-being management costs, and more responsible health choices [21]. These portable and fashionable devices have transcended their initial role as mere accessories and are becoming essential tools empowering people to monitor and enhance their mental, emotional, and physical health [12]. By harnessing the potential of wearables, people can improve their health and achieve the objective of successful sustainable development while building a more sustainable world [1,2,22]. Wearables can assist in shifting the global emphasis from treatment to leading and maintaining healthy lives.

The challenge, therefore, is not whether but how advanced technologies like wearables can help shift the attention from treatments to improving health and well-being and contribute to achieving SDG-3. Hence, the purpose of this paper was to answer two research questions: 1. How are wearables currently used to manage health and well-being? 2. What are the potential contributions of wearables to promoting SDG 3? To answer the research questions, this paper investigated the transformative potential of wearables in promoting health and well-being and contributing to the larger goal of achieving SDG-3. Through the theoretical lens of the Affordance Theory (AT), it highlights wearables’ role not only as tools for personal health management but also as catalysts for the broader goal of SDG-3 and advancing sustainability.

The paper is structured as follows: Section 2 provides a review of the application of wearables in health management and SDG-3. Section 3 and Section 4 explain the Affordance Theory and the research methodology. Section 5, Section 6 and Section 7 present the findings, discuss them, and highlight the implications of the findings for SDG-3. Section 8 highlights the study’s limitations and recommendations for future research. Finally, Section 8 concludes the paper.

2. Literature Review

2.1. Wearables for Health and Well-Being Management

Wearables, wearable technology, or wearable devices are used interchangeably to describe small electronic and mobile devices or computers with wireless communication capability embedded in gadgets, accessories, or clothing and can be worn on the human body [16,23]. This paper adopts the wearable definition by [16,23] and shares the view that one of the primary characteristics of wearable devices is that they are worn on the body (wearability). Wearability ensures that wearers can carry the device throughout the day without burdening daily routines and mobility [18,24]. Whether it is a smartwatch, fitness tracker, or another type of wearable, the device should be comfortable, lightweight, and designed to integrate seamlessly into the wearer’s daily life. Wearables can be integrated into personal items such as wristbands, eyeglasses, hats, shoes, socks, belts, headphones, hearing aids (“hearables”), and clothing [16,23,24,25]. The more intrusive versions are embedded in microchips or smart tattoos [16,23,24]. Thus, wearables are classified according to their on-body location as head-mounted, wrist-worn or hand-held, body-worn (upper body and lower body), or ingestible [16,23,25]. However, wrist-worn wearables like smartwatches and wristbands are the most commonly used wearables [23,26]. Smartwatches make up 30.5% of the wearables shipped globally in 2021, amounting to 142 million units [23,26].

Traditionally, wearables such as smartwatches were primarily concerned with monitoring fitness and physical activities like running [19,27]. However, new hardware, software, and applications have transformed smartwatches and other wearables into personalised health clinics, where users are increasingly utilising them to check their health, not simply their jogging or running pace [19,28]. Smartwatches, such as the new Apple Watch Series 8, with the primary purpose of fitness and activity tracking, have biosensors that record both high and low heart rates, body temperature, factors relating to women’s health such as retrospective ovulation estimates, and fall and crash detection [29,30]. Most smartwatches now have heart rate sensors, and some (for example, Apple Watch 7, Apple Watch Series 8, Fitbit Sense, and Samsung Galaxy Watch 4) have been approved by the United States of America’s (USA) Food and Drug Administration (FDA) for identifying irregularities such as atrial fibrillation (AFib), which is a major risk factor for strokes [28,31].

Due to the potential benefits of wearables in health and well-being, the demand and use for wearables are expanding [17,24,32]. This expansion is evident in the growing number of individuals anticipated to adopt wearables for health management. In 2019, the Harvard Medical School [33] predicted that over 160 million individuals worldwide will actively monitor their health and fitness through wearables by 2022. Deloitte Global’s projections for 2022 indicate that a substantial 320 million consumer health and wellness wearable devices will be shipped globally [34]. This figure is projected to increase to approximately 440 million units in 2024, driven by the introduction of new solutions to the market and increasing familiarity and comfortability among healthcare providers with these technologies [34]. Specifically, the Smartwatch, which is popular among users for health monitoring, is expected to continue its popularity throughout 2023–2028, reaching 230 million users worldwide by 2028 [35].

Appendix A provides examples of some wearables applicable in health and well-being management and the data they collect as reported in the literature [16,17,19,23,24,28,29,30,36,37,38,39,40,41]. Among these wearables, smartwatches are the most popular for use in relation to health and well-being [23,24,25,26]. The popularity of smartwatches for health data collection and analysis can be due to their aesthetic design and ability to fit well into regular fashion without drawing much attention as a health monitoring device. According to [42], smartwatches are unique wearables because of their shape and design, which resembles those of the agelong wrist fashion items. The new Amazon Halo, Fitbit Sense, Xiaomi Mi and Apple Watch Series are examples of fashionable wrist-worn wearables that aim to provide users with real-time health feedback [43]. Other wearables for managing health and well-being include headbands, armbands, motion trackers, activity trackers, smart clothing, smart glasses, smart jewellery, smart patches, smart tattoos, smart implants and ingestible [17,19,24].

The role of wearables in health and well-being management is actualised through their key function of collecting diverse health data in real time [19,44]. Equipped with advanced sensors, wearables collect real-time health data on attributes such as blood pressure, heart rate, respiratory rate, oxygen saturation, skin reaction, body temperature, body posture, calorie intake and expenditure, and more recently, COVID-19 symptoms [17,19,23,25]. Wearables use sensors to track and collect data for monitoring and then process and analyse the data collected to provide useful health information using context-aware technologies such as actuators and control units [23,44]. Through synchronisation with computer-based or mobile-based health applications, these wearables also offer data summaries and visualisations as well as ways to connect to social media [17,43].

Modern wearables use electrocardiogram (ECG), photoplethysmography (PPG), electroencephalography (EEG), and accelerometer sensors in their data collection and analysis [23,32,37,45]. ECG-enhanced sensors measure data relating to vital signals concerning the heart, such as the heart’s electrical activity, to check for heart conditions [32,37,45]. PPG-enhanced sensors are useful for measuring volumetric variation in blood circulation [37,45]. EEG-enhanced sensors are relevant for measuring attributes relating to the brain, such as the brain’s electrical activities [24,37]. Other sensors, like the accelerometer-enhanced sensors, are relevant for collecting attributes relating to the body’s movement, for example, steps taken and fall detection [32,37].

The health data collected by wearables are essential in preventive health, disease management and monitoring, health maintenance, clinical decision-making, medical consultation, and medication management [23,25,32,46]. Lifestyle concerns, obesity, and diseases such as diabetes, hypertension, pulmonary conditions, and cardiovascular disease can be monitored and managed using wearable health data [17,37]. Thus, [23,32,38] further allude to the relevance of wearables in preventing, monitoring, and managing serious medical conditions such as autism, mental health, Parkinson’s disease, depression, blood disorders, and heart and brain disorders.

The most common health data measured by modern wearables, as reported in the literature, are those with attributes relating to the ECG (see Appendix A). The use of wearables to collect ECG-related data is common and valuable because of the usefulness of this data in the clinical investigation and detection of health problems [19,45]. Specifically, wearable health data relating to the measurement of ECG and EEG are relevant for the timely and cost-effective monitoring and management of severe heart diseases and brain conditions, respectively [17,23,28]. For example, using wearables, cardiologists can measure the length of time it takes for electrical signals to travel and their intensity (ECG test) to determine heart conditions and heart health [28]. The implication of this for day-to-day clinical management is a paradigm shift in which asymptomatic patients are now visiting hospitals and clinics with health data rather than symptomatic patients being referred for cardiac assessment to obtain health [47]. Although this new paradigm is perceived as a challenge for health professionals regarding what steps to take when patients visit with health data [47], wearable health data can alarm an impending health condition and encourage proactive measures.

The possibility of proactive healthcare offered by wearables through continuous health monitoring is important for chronic disease prevention, detection, and management [19]. Usually, most people tend to deal with potential health issues reactively, only seeking medical assistance and scheduling doctor’s appointments when sick or in pain. However, the use of a wearable could potentially forecast disease or an ailment through ongoing health monitoring and even automatically alert the doctor and emergency providers to initiate and take proactive preventative measures against incipient threats [16,46]. Wearables are able to detect the onset and progression of serious diseases, such as heart and blood vessel diseases, and provide the opportunity to monitor and manage such health conditions closely [46]. Thus, rather than passively waiting for a chronic disease to progress quietly, wearables are useful for sounding the alarm and potentially saving lives. Medical insurance providers are also taking advantage of wearables to promote proactive healthy living by integrating wearables such as smartwatches into their incentive programs. These programs include the Vitality Active Reward in South Africa, the United States, Australia, and the United Kingdom; Paceline in the United States; and LumiHealth in Singapore [30] (p. 38).

More recently, wearables have been integrated into the monitoring and management of Parkinson’s disease (PD) in patients using the Global Kinetic’s PKG (personal kinetigraph) watch [38,39,40]. When worn, this device continuously collects objective data during daily activities and reports to healthcare providers [38,39,41]. The collected data include attributes relating to the movement of the wearer [38,40]. These data provide information to their doctors concerning the wearer’s Parkinson’s motor symptoms like immobility, tremors, involuntary movements (Dyskinesia) or slow movements (Bradykinesia), and fluctuations in motor skills [38,40]. The information gained through the PKG watch data aids in the pharmacological therapy and monitoring of medication adherence of PD patients [23,38,41]. The integration of the PKG watch in PD management to support medication management is beneficial, as PD patients usually require their medication to be adjusted according to their current condition [38,39,41].

Apart from physical illnesses, wearables have been integrated into managing mental health conditions such as anxiety. Wearables have become a popular tool for automatically, objectively, and more effectively predicting and detecting anxiety disorders [48]. According to the American Psychiatric Association (APA) [49] and the Global Burden of Disease (GBD) [50], anxiety disorders are among the most common mental illnesses in the world, with 4% of the world population suffering from the condition. Usually, physicians use self-assessment questionnaires or interview-based evaluation techniques to measure anxiety symptoms [48]. These procedures can be subjective, time-consuming, and difficult to replicate. Wearables can help improve these procedures by continuously collecting biosignals relating to anxiety symptoms, such as heart rate variability, pulse rate, skin temperature, and sleep patterns, quickly and in real time [20,51]. These data can then be combined with other contextual data (e.g., automated self-administered questionnaire) to monitor, detect, and manage anxiety [51]. As a result, there is a growing need to use technology that can provide early and objective anxiety detection.

Wearables are useful in clinical decision-making because these technologies can significantly improve the accuracy of a diagnosis due to the ability to obtain information about a patient’s health quickly [32,44,52]. Monitoring patients’ health attributes in their relaxed states and in real time presents the prospect of higher accuracy in diagnosis and treatment [52]. While improving diagnosis accuracy, wearables also provide the opportunity for constant monitoring of patients, which was previously only possible in a hospital setting [44] (p. 10). The continuous monitoring of vital signals such as heart rate and blood pressure is crucial for all individuals with varied medical conditions and the aged [19] (p. 6). In addition to efficient clinical decision-making and constant monitoring, wearables play a huge role in responsible self-health monitoring and out-of-hospital health management through personalised data collection and analysis [17,24,36,44].

However, the integration of wearables in healthcare settings is still in the infancy stage despite the rapid growth in personal health and well-being management [16]. The factors affecting the practical applications of wearables in healthcare are multi-faceted, ranging from the lack of awareness of their potential in health management to the challenges of wearable data quality, privacy, security, and accessibility [24,28,34,47,53]. Moreover, apart from addressing the lack of awareness of wearable potentials in healthcare, for wearables to be widely integrated into clinical healthcare, the data it collects must be trustworthy, and the process for collecting such data should be considered ethical by all stakeholders, including health professionals [28,46,47]. As a result, considerations of wearable potentials do not negate the challenges of their applications in the management of health and well-being.

2.2. Health and Well-Being as SDG: Significance and Progress

SDG-3 is concerned with ensuring a healthy life and promoting well-being for all people of all ages at every stage [4]. It comprises 13 targets that address major health aspects, which relate to maternal mortality, neonatal and child mortality, infectious diseases, non-communicable diseases, substance abuse, road traffic accidents, sexual and reproductive health, universal health coverage, environmental health, tobacco control, health research and development, health financing and support for the health workforce, early warning, risk reduction, and management of global health issues [4].

SDG-3 sets important targets for improving the general health of a nation’s population to stop needless suffering from avoidable diseases and early mortality. The crucial importance of SDG-3 to achieving other SDGs has been expressed in the literature. The theory is that health can contribute to achieving sustainable development, be one of its beneficiaries, and serve as a gauge for its success [8,54]. Health and well-being metrics can be used to gauge how well the SDGs are being implemented because SDG-3 is vital and interconnected in achieving other SDGs [55]. The crucial role of SDG-3 is seen in the relevance of health and well-being to human existence. Better health and well-being are not only viewed as a single goal for sustainable development but as essential for achieving all three pillars of sustainable development [54]. According to the first principle of the UN Rio Declaration, human beings are at the centre of concerns for sustainable development and are entitled to a healthy and productive life in harmony with nature [56]. This implies that human health is critical to achieving sustainable development, and the intricacy and connection between these two concepts are reflected in the 2030 Agenda [57].

The WHO contends that within a comprehensive strategy towards achieving SDGs, health and well-being are key indicators of success towards accomplishing the SDGs [54]. The progress on SDG-3 is deemed to promote progress on the other SDGs, and this is a reciprocated effect [58]. More specifically, there are high to moderate positive correlations between SDG-3 and other SDGs relating to economic development, including human capital development, infrastructure development, and equitable society [6,59,60]. The achievement of sustainable development faces a huge setback with a high prevalence of incapacitating ill health resulting from communicable and non-communicable diseases. A healthy generation forms part of capable human resources and is imperative for sustainable development [8,54]. A society where infants and children under five years old have fewer survival chances cannot guarantee human capital, which is tied to economic development. Similarly, SDG-3 can serve as an indicator of an equal society and economically balanced society [61]. A fairly healthy society reflects a fairly equal society resulting from equality in resource distribution. Furthermore, SDG-3 can be a resource for human capital development, human emancipation, and poverty eradication [6]. Thus, all countries stand to benefit from maintaining a healthy society, which translates to a healthy workforce necessary to be productive and participate fully in the economy [4]

The significance of SDG-3 also means that failure to make substantial progress in its achievement can set back the achievement of other SDGs [62]. At over the halfway point of 2030, a reality check of the progress made in achieving SDG-3 indicates major challenges that could jeopardise the accomplishment of other SDGs [9,61]. Generally, the world is failing in achieving the SDGs, with progress towards all their attainment being at 15% on track, 48% moderately or severely off track and 37% stagnation or regression [9]. Half of the approximately 140 targets analysed in the UN 2023 global-level statistics and assessment revealed moderate to severe deviations from the intended trajectory [9]. Moreover, over 30% of these targets have either shown no progress at all or, even worse, have regressed below the baseline of 2015. This presents a bleak picture of the sustainability promises aimed at people, prosperity, and the planet and the achievement of SDGs. Although certain aspects of the SDGs have witnessed progress, a concerning proportion of targets are progressing too slowly or even facing regression [9].

More concerning is that SDG-3 is less than 10% on track to meeting its targets [9]. While progress is being made on SDG-3 targets for the reduction of mortality for children under five and from AIDS and neglected tropical diseases (NTD), progress on access to quality essential healthcare services, reduction in death from non-communicable diseases through prevention and treatment, and mental health and well-being has witnessed regression [9]. The UN 2023 report further reported that the prevalence of depression, anxiety, and other mental health challenges is rising, and many individuals are still unable to access the care and support they require for new and pre-existing mental health illnesses. This evaluation emphasises how urgently more work must be done to keep the SDGs on track to achieving a sustainable future for all [9]. In particular, swift and coordinated action is required to get back on track towards achieving SDG-3 globally [9].

3. Theoretical Background: Affordance Theory (AT)

This study employed the Affordance Theory (AT) in exploring the potential role of wearables in promoting health and well-being and contributing to the achievement of SDG-3. Gibson [63] coined “affordance” to describe the action possibilities in the relation between an animal and the environment (object and subject). The affordances of the environment are what it affords or furnishes the animal, whether good or bad, thus indicating the animal’s and the environment’s complementarity [63]. Affordances exist relative to the action capabilities of an individual but exist irrespective of whether it is perceived or not [63] (p. 127). Furthermore, an individual’s perception of an object is not determined entirely by its physical properties but also by the opportunities for action that it provides the individual based on their action capabilities [63]. Hence, affordances are closely linked to the individual’s capabilities for taking needed actions and their goals, intentions, and past experiences towards the actions [63,64]. AT is, therefore, a theory based on action and perception, and affordance is a concept that defines the possibilities of actions that could emerge when a person and an object interact and is relational to the individual’s action capabilities (physical and cognitive).

The application of AT in CS and IS research focuses on the relationship and interaction between technology and individuals or organisations [64], technology use and perception [65,66], technological features, technological capabilities or functions [18], and the value of technology [67]. The focus of AT in IS and CS research is on affordance actualisation, resulting in the emergence of the AT Framework in Figure 1, which is centred on perceived, actualised, and affordance effects [63,68,69,70,71]. AT serves as a useful theory in exploring socio-technical issues and relations between technology users and technology, as well as the implications of the technology on the users [68]. Technology affordances emerge from the “mutuality” between technology users, the materiality of the technology features, and the nature of use [72]. The nature of use indicates the technology user’s capabilities, the set goal around the technology and the situation in which the technology is being employed [64,73]. As a result, technology affordances are action possibilities relational to goal-oriented technology use and action capabilities [68], that is, what a person or organisation with a specific purpose can do with a technology or information system [73]. Technology affordance exists independently in all technologies, irrespective of whether it is perceived or not [69]. Thus, to comprehend the uses and effects of technology, one must study the dynamic interactions between people, organisations, and the technology they employ [73].

Perceived affordances are action potentials observed by actors (technology users) [63,69]. Actualised affordances are actions arising from a technology user interacting with technology [63,70]. The affordance effects are the implications or outcomes of actualised affordances [63,70,71]. The framework for the affordance actualisation process, which emerged from the IS and CS research application of AT, has continued to generate a lot of interest in IS and CS research [68,69,70]. The focus on the affordance actualisation process is relevant for research that seeks to investigate how individuals and organisations utilise technology and how technology use impacts individuals, organisations, and their performance [67,71]. Individuals might use technologies for purposes not initially intended by manufacturers. Equally, people might not always realise the apparent use of technologies they use. Affordance actualisation processes aid in the investigation of how what an individual or organisation with certain skills and aims can or cannot achieve with technology may differ greatly from what another individual or organisation may do with the same technology.

Drawing from the AT, this paper proposed working definitions for wearable affordances and wearable affordances in health management as follows: Wearable affordances are action possibilities that can be or are derived or achieved using wearables in relation to set goals and action capabilities. Therefore, wearable affordances in health management are the action possibilities that individuals can derive or achieve using wearables in managing their health or, more specifically, towards accomplishing their health goals. These definitions guided the investigation of wearables’ potential role in health and well-being management and in promoting SDG-3.

4. Methodology

A qualitative approach was employed in this study, and data collection was done using web scraping of user-generated data in the form of online reviews. Web scraping (web harvesting or data extraction) is an automated process of obtaining structured data or information from a webpage or website for specific purposes using relevant computer software [74]. It is an emerging and valuable data collection technique for academic research because of its speedy, convenient, and cost-effective characteristics [18,74,75]. Through the AT lens, thematic analysis of the online reviews on specific wearables was conducted to collect experiential data from wearable users. Online reviews are an invaluable data source in research aiming at experiential data [18,74,76]. Online reviews provide information on various human experiences with products and services [76]. These experiences include objective descriptions of a product’s features, subjective qualitative evaluations of product use and values, and special use or failure scenarios [18,76].

The web scraping was carried out using two Python libraries, Request and Beautiful Soup, to scrape reviews from the Amazon.com (accessed on 24 May 2023) website on the purposively sampled Apple Watch Series 7 (Watch 7) and Apple Watch Series 8 (Watch 8). Watch 7 and 8 were selected because they are popular [26] and have embedded ECG sensors that are useful in obtaining health data on vital signs. The Watch 7 and 8 have also received FDA approval for their ECG sensing capabilities [17]. The Request library was used to request the Hypertext Transfer Protocol (HTTP) for the Watch 7 and 8 review web pages from Amazon.com. The Beautiful Soup library was used to filter and obtain the relevant HyperText Markup Language (HTML) tags from each review page to retrieve data, such as country, date, title, and body (review texts). The retrieved data were added to a Python dataframe using the Pandas library.

The texts of the online reviews were deductively analysed in Microsoft Excel following the process of thematic analysis highlighted by [77]. Due to the language barrier, the analysis focused only on the reviews with English texts. After an initial reading, the reviews were sorted and cleaned, and online reviews without review texts (RT), that is, reviews without a body of text describing a user experience and those with RT written in non-English languages, were deleted. Drawing from the working definition of wearable affordance provided in the study, each review text was coded according to related predefined affordance themes to map the wearable affordances in the online review texts. This coding process involved using a keyword search utilising the predefined affordance themes. The themes were monitoring, screening, detecting, predicting, treatment and medication management, and collaborative healthcare. Further keywords were drawn from the review texts during the data analysis. All keywords were used independently and combined, where necessary, throughout the analysis.

5. Findings

The online reviews retrieved were 5,478, of which 4,911 were for the Watch 7 and 567 were for the Watch 8, with 5340 of these reviews containing RTs. About 90.5% (f = 4833) of the text reviews were written in English; thus, only these were included in the thematic analysis. A total of 228 relevant RTs were found and analysed to the point of saturation. From the analysis, seven affordances were identified. These affordances were health monitoring, screening, detection, prediction, treatment and medication management, collaborative health management, and stress management.

Table 1. Findings on wearable affordances.

Affordances	Examples of Related RTs
Health Monitoring (f = 126)	RT1: “I’ve been doing research on my health condition about congestive heart failure… I suffered a cardiac arrest last year and comatose for 5 days and recovering, but I needed a device that will monitor my daily routine so I watched video of people who experienced sudden heart attack. This watch is perfect for me…” RT2: “Being that I have sleep apnea I want to track everything and get written reports” RT3: “… it’s about what you would expect with it constantly monitoring your vitals and anything else you set it up to keep track of”. RT4: “Got it for Heart monitoring…Works great. It must pair with your iPhone, confusing which is dominant on various apps. Helpful to have an Apple store nearby or a teenager”.
Health Screening (f = 27)	RT1: “…The reason I did this was to try to make sure that I didn’t have any sleep apnea issues as I’ve been accused of snoring and wanted to make sure that that didn’t indicate any potential problems. So far the watch seems to indicate that I’m OK”. RT2: “I upgraded because I felt suspicious about my heartbeat. Sure enough, it was messaging me like crazy! I sent the results to my doctor who ordered more tests and now I’m on medication and feeling so much better”. RT3: “I used my Apple Watch to screen for heart arrhythmias and blood oxygen saturation levels. It works great for this purpose.” RT4: “As someone conscious of COVID hazards, I find having the oximeter App built in has me screening my blood O2 every day vs. a few times a week”.
Health Detection (f = 31)	RT1: “I got the Apple Watch because, honestly, I’m getting older and I wanted the fall detection and health features” RT2: “…it helps me with my low blood pressure, it alerts me every time I’m in my anxieties and it tells me how much my heart rate is!!” RT3: “I’m 80 and was paying a monthly fee for a medical device w/fall detection & my Fitbit wasn’t syncing with my iPhone. So happy to find this Watch at such a great price that not only tracks my steps but has fall detection, and it fits on my wrist.” RT4: “First off this watch saved my life!! I have never been diagnosed with Afib. This past Friday night my watch told me I was in Afib and I went to the ER. My heart rate was 147 beats a minute. Had I not had this watch I would have just thought I was having an anxiety attack”.
Health Prediction (f = 9)	RT1: “I live in a senior gated community and tell all seniors to buy one because this watch will sense if you are in trouble and you can hit the button for help. My neighbour came over and thanked me for recommending this watch to her it saved her life because it will monitor her heart, she told me the watch sent her a SOS about her heart being in trouble, she went to the hospital and it saved her from a heart attack, because of the early warning with this watch”. RT2: “This gives you an accurate Lead I (RA-LA) ECG waveform. You can print strips on your iPhone and bring them to your Cardiologist if needed, the SpO2 has been accurate as well. I compared all values to an acute care patient monitor for reference”. RT3: “The oxygen is another plus for since I have asthma I can keep a track when I’m sick”.
Collaborative Health Management (f = 23)	RT1: “My heart doctor suggested I buy an Apple Watch after having a couple of procedures. Said heart apps were great way to monitor heart activity. He was right. The blood oxygen and ECG apps are easy to use and accurate. Heart Rate app keeps me updated on what my heart is doing and gives me the option to send results to my doctor”. RT2: “Due to health issues, my wife convinced me to get the cellular capability. In an emergency, these will call 911, even when your phone is not around, and even when you don’t subscribe for service. That’s important”. RT3: “ECG, sleep info, hard fall info being sent to emergency services are quality features for all of us and certainly important for octogenarians like my mom”
Health Treatment and Medication Management (f = 13)	RT1: “…I had a cardioversion and was put on a beta blocker which worked well for about 6 days. Then my heart would kick back into AFIB for a little while, then the beta blocker would try to convert back to sinus rhythm, in doing so, my heart would do what they call ‘conversion pauses’, only mine would pause to the point of nearly passing out. I happened to catch one of the worst pauses that lasted 8.7 s. I was using my Apple Watch in the ECG mode to check AFIB, at the time. My heart was pausing multiple times. Sent the recordings to my heart Dr. and he took me off the beta blocker for now. I will go back on those after I get my pacemaker the end of the month. If it had not been for the watch and the ability to do the ECGs, I would have not known what was going on and would have thought it to be common under the circumstances. So, I think the watch may have saved my life, by helping to figure out the pauses, which kept getting worse”. RT2: “A few months back, I was diagnosed with a decrease in heart function. The most likely cause, tests revealed, was a sedentary lifestyle. So, in order to help me get moving, track my activity, and monitor my heart, I purchased this Apple Watch. I wear it everywhere except in the shower and when it is charging. It is helping me track longitudinal data about my movement habits…”
Stress Management (f = 10)	RT1: …“In addition to indicating when you should take breaks to stop because you have been sitting for more than an hour and also control your breathing to relax and lower stress levels”. RT2: “I’m 37 have had 2 open heart surgery and brain surgery back in 2020 and its perfect for monitoring my stress my heart rate” RT3: “In terms of feature benefits, my main interest are the heart health functions including the Mindfulness/Breath app”.

presents the identified affordances, the frequency distribution of analysed RTs for each affordance, and some examples of RTs.

Out of the 228 online RTs analysed, 126 were related to health monitoring, 31 to health detection, 27 to health screening, 23 to collaborative health management, 13 to treatment and medication management, 10 to stress management, and 9 to health prediction.

6. Discussion

Figure 2 depicts the seven affordances identified through the findings while illustrating AT’s theoretical position adopted in the study. Discussion on each of these affordances, which stems from the findings and literature, is presented in the subsequent subsections. The purpose is to highlight the potential of wearables in health management, which is a prerequisite for determining their contribution to the achievement of SDG-3.

6.1. Health Monitoring Affordance (HMA)

The findings from the data analysis revealed that health monitoring is a crucial affordance of wearables because of their ability to collect data when worn constantly and ideally by wearers continuously. Depending on the embedded sensor, wearables can continuously collect data attributes necessary to monitor biomedical processes [78]. As shown in the literature and the findings, wearables can sense and transmit data attributes relating to heart rate, blood pressure, body temperature, respiratory rate, chest sounds, ECG, sleep patterns, and calorie intake [17,19,23,32]. Wearers commonly perceive monitoring vital signs as a wearable affordance, and their varied health goals shape this perception. Furthermore, the findings indicate that the wearers of the Watch 7 and 8 have actualised the HMA in different health scenarios, depending on their health goals. The HMA is commonly actualised around cardiological health by wearers with heart conditions who aim to manage these conditions and wearers without heart conditions interested in taking preventive measures against developing such conditions.

Watch 7 and 8 commonly collect wearers’ health data attributes relating to ECG, blood oxygen levels, and heart rate to provide the HMA. However, to actualise HMA, the collected data must be analysed, understood, and interpreted in relation to the health goal and focus of the wearer. The understanding and interpretation of the collected data are hinged on the cognitive and physical capability of the wearer or their physician; hence, health monitoring is a wearable affordance and not a feature [72]. For example, wearers need to be able to set up the Watch 7 and 8 based on their health goals, which can be cumbersome. Also, wearers need to be able to integrate their wearables with related mobile or computer applications (e.g., Apple Health App or ECG App) and enable data sharing in certain instances to actualise HMA [30].

The above interpretations and assertions align with AT’s view that the perception and actualisation of affordances are linked to users’ goals and action capability. The desire and necessity to accurately monitor disease-related attributes and metrics for people with chronic conditions can be met through the possibility of wearing a smartwatch and being capable of understanding and interpreting the collected data to form an informed judgement about the condition. AFib is a good example of a relapsing health condition requiring constant monitoring to assess treatment efficacy and prepare for future interventions [79], and the findings of this study revealed that the HMA of Watch 7 and 8 can be useful in this regard. The accuracy of wearables in monitoring AFib has been established in previous studies [31,80], giving more credit to wearable HMA.

Moreover, monitoring cardiovascular signals such as heart rate and blood pressure is crucial for all individuals with varied medical conditions and the aged to prevent worsened health conditions and, ultimately, mortality [19] (p. 6). This study’s findings also support the view shared in [19]. Additionally, the actualisation of HMA by Watch 7 and 8 wearers can lead to proactive health management by promoting health consciousness in people who may ordinarily be passive about their health needs. This outcome is corroborated by [16,19,46]. Thus, wearables have been appraised for the possibility of monitoring people’s health, including healthy individuals, sick patients, and patients who are recuperating in and out of the hospital [19,23,32].

6.2. Health Screening Affordance (HSA)

Health screening affordance (HSA) involves using wearable health data metrics to identify certain health conditions and diseases in wearers using the data sensed and transmitted by wearables [78]. Actualising this affordance requires wearers to wear the relevant wearable to allow passive sensors to take measurements of motion, steps, pressure, sound, and light. The wearers of Watch 7 and 8 have perceived and actualised the HSA in their desire to screen for various health conditions, as indicated in the findings. These include respiratory and cardiovascular conditions and diseases, as well as symptoms that serve as markers to detect and diagnose similar health conditions and diseases.

Other instances where the HSA has been actualised are using smartwatches and smart garments equipped with PPG sensors to track sleep and screen for symptoms of sleep apnea. Sleep apnea screening is possible because wearables measure real-time physiological parameters such as blood pressure, oxygen saturation (spo2), and heart rate [81]. Watch 7 and 8 wearers have collected important spo2 and heart rate metrics to screen for sleep apnea. This outcome supports the report in [82] that wearables embedded with PPG sensors can provide a cost-effective alternative approach to screening for sleep apnea with high accuracy.

The early screening and detection of sleep apnea are important to avoid fatal complications [83]. Sleep apnea is a potentially fatal sleep disease in which breathing stops and repeatedly begins because of a blockage to the upper airways; it can lead to neurocognitive dysfunction and cardiovascular disease as a result of oxygen desaturation, changes in blood pressure and heart rate, and sleep fragmentation [81]. The commonly used screening approach for sleep apnea symptoms is mainly reliant on the adequacy of one’s bedpartner’s observations on sleep patterns, home sleep apnea test (HSAT), or medical tools (polysomnography machine) within hospitals [81]. The effect of the wearable HSA in this regard is the elimination of complex procedures and the provision of continuous tracking of sleep apnea conditions. Thus, the HSA is especially of transformative importance for screening sleep apnea since it can facilitate early screening, detection, and intervention. Moreover, the findings reveal that HSA is crucial and closely linked to the detection of health conditions other than sleep apnea. Hence, HSA can be important to the management of vast health conditions within various contexts and scenarios.

6.3. Health Detection Affordance (HDA)

Detection is the investigation of probable patterns and characteristics in wearable health data obtained through monitoring and screening that may be interpreted as indications and markers of certain biological problems [78]. Wearable HDA entails detecting the occurrence of serious health events like a fall or crash, chronic and acute diseases, adverse health conditions and minor health anomalies, as well as health improvement. Wearers of the Watch 7 and 8 perceive the devices as able to detect falls and other serious health conditions. As indicated in the findings, wearers of Watch 7 and 8 have gone beyond their perceptions of HDA to its actualisation. In some cases, HDA has helped in averting impeding critical health conditions. More specific to fall detection, the HDA has been actualised and is crucial to routine health management for the aged who need care support. In this regard, the findings reveal that the wearable HDA supports a cost-effective alternative for providing care for the aged.

Noteworthily in the actualisation of HDA is its intersection with HMA and HSA. For example, smartwatches have been used to monitor irregular pulses and, as a result, screen for possible AFib and symptoms of other serious heart conditions and then detect the condition [84]. Although wearables do not provide diagnoses due to technical incapabilities and regulatory restrictions, the final diagnoses of health conditions can be established on detections deduced from analysing wearable health data. Wearable health data can be integrated with individual symptom data to improve disease detection [85]. Moreover, and as specifically mentioned in the analysed RTs, the detection of health conditions as an affordance of wearables can be life-saving.

However, to actualise HDA, wearers must have the action capabilities to interact with the particular wearable by engaging in continuous and accurate monitoring of specific health conditions and be able to analyse and interpret accurately the data obtained during the monitoring. For instance, the findings indicate that the actualisation of fall detection requires action capabilities to enable the fall detection notification and alerts and take immediate action in sharing the data received and alerts with a medical professional for further clinical investigations. Consequently, the effect of wearable HDA is early detection of diseases and health conditions, which can support proactive health management, a reduction in chronic diseases, better management of health conditions, and ultimately, a drastic reduction in mortality due to ailments. In particular, the possibility of responsive and proactive health care is especially important for chronic disease prevention and management [19].

6.4. Health Prediction Affordance (HPA)

Health prediction is a wearable affordance that implies medical inferences, or “medical guessing”, of future trends or occurrences based on obtained wearable health data [78]. The findings show that as wearers and physicians become aware of health irregularities through wearable health data, predictions on the cause can be made, leading to further clinical investigations. Similar to how doctors often peruse patients’ health records in traditional health databases, accumulated wearable health data can be perused over time to make medical predictions regarding a wearer’s health [86]. Health data from wearables can be used to predict readmissions, clinical risks, and mortality [87]. The assertions in [86,87] are implied and corroborated in the study’s findings.

Additionally, the findings indicate that the HPA can be crucial in managing respiratory diseases such as COVID-19 and asthma. Watch 7 and 8 wearers have actualised the wearable HPA in managing these respiratory diseases. Retrospective wearable health data, such as physiological alterations in heart rate, movement, and sleep time, have been used to predict COVID-19 disease in asymptomatic people [88]. Other instances include using accelerometer-sensed wearable health data to predict biological age and mortality [89] and respiratory rate data to predict chronic obstructive pulmonary disease (COPD) exacerbations [90]. The effect of the HPA is health consciousness and awareness as well as proactive instead of passive healthcare, which are crucial to leading a healthy life.

6.5. Collaborative Health Management Affordance (CHMA)

Collaborative health care involves the provision of health care through the active engagement of medical professionals, patients, family members, the community, and other stakeholders [91]. Collaborative healthcare is important for healthcare quality improvement. The findings indicate that physicians and wearers of Watch 7 and 8 perceive wearable CHMA as important and have achieved its actualisation by continuously integrating these devices into health management routines. Again, as with HMA, the findings indicate that the common health conditions for which wearers have actualised the CHMA are cardiological health conditions, and ECG-related data are the common data useful in this regard. This is not surprising, as extant literature shows that ECG-related data are the most common health data collected by modern wearables (see Appendix A), and these data are considered valuable, timely, and cost-effective in the clinical investigation, monitoring, and management of heart diseases [17,19,23,45].

Data sharing and alerts are prominent features of Watch 7 and 8, which aid in providing the CHMA. Wearers can share their health data with their caregivers, including their healthcare professionals, family, and friends. These caregivers can also be alerted about wearers’ health occurrences, which are informed by the health data collected using Watch 7 and 8. These findings support the report by [24,32] that wearables are able to facilitate data sharing or simply alert caregivers, family members, or medical professionals of imminent risks or crises leading to immediate, relevant interventions. For example, and as mentioned in some of the analysed RTs, a fall can be sensed by the accelerometer, and after a specified period of no movement from the wearer, the Smartwatch alerts the predetermined emergency contact person or a general emergency service such as 911 to facilitate immediate care and intervention.

The findings further revealed that the wearable CHMA can be life-saving when actualised. This further confirms the assertion in [23,46] that wearables have the potential to prevent disease mortality and save lives. However, actualising the CHMA requires wearers to have relevant action capabilities. For instance, Watch 7 and 8 wearers need to take steps as simple as allowing data sharing and emergency alerts and setting up their emergency contact lists to actualise CHMA. Nevertheless, the effects of CHMA, according to the findings and literature, are wide-ranging, from accurate diagnoses and cost-effective health management to a reduction in the progression of diseases and mortality rates [23,32,46,53].

6.6. Health Treatment and Medication Management Affordance (HTMMA)

The wearables HTMMA includes the determination of medical and non-medical interventions, drug administration, adherence, and adjustment towards improving the health of people with diagnosed health conditions [25,38,41]. Watch 7 and 8 wearers have actualised HTMMA in heart conditions such as arrhythmia (irregular or abnormal heartbeat rhythm) and AFib. These findings are supported by [92], which asserts that wearable health data obtained using ECG-embedded smartwatches, such as heart rate, is used to track life-threatening arrhythmia that can occur as a result of new medical interventions [92]. Consequently, when arrhythmia is detected, the medication and intervention are stopped, and the treatment is reconsidered [92]. Worthy of note in this regard is that wearables have been adjudged as having high accuracy in detecting arrhythmia [80].

In another instance, a smartwatch has been used to sense motor fluctuations in people with Parkinson’s disease (PD) to monitor medication adherence remotely and propose effective interventions [39,93]. The accelerometer-related data obtained are used to identify tremors and dyskinesia in PD patients and determine improvement or deterioration during treatment, as well as patients’ adherence to medications. Subsequently, the data obtained assists with medication adjustment based on the patient’s condition. Watch 7 and 8 would be relevant in providing HTMMA in this regard since they can effectively track heart arrhythmia, oxygen saturation, and movement, as indicated in the findings. In addition, the findings revealed that the HTMMA can manifest in non-medical treatment intervention. Nonetheless, to actualise HTMMA, it is not enough to perceive it; it is also necessary to have the action capability to obtain the ideal data and interpret it with a specific health goal in mind [46]. For example, the wearer needs to be willing and able to share their wearable data with their relevant health professionals, who can integrate these data into the available interventions or initiate new interventions. Notwithstanding, the HTMMA is promising and can be a critical turning point for health management and, even so, cost-effective health management.

6.7. Stress Management Affordance (SMA)

Stress is an intricate occurrence that arises from a psychological or physical danger to the stability of the biological system (homeostasis) [94]. It is characterised by a wide range of psychological, behavioural, and physiological reactions [94]. Stress management entails the use of interventions to capture and improve stress. In this regard, wearables can capture behavioural and physiological data non-invasively and provide useful information for stress management [95]. Wearables include features that facilitate stress management interventions, such as guided breathing exercises or mindfulness meditation. These stress management interventions can help wearers manage stress and improve their mental well-being [96]. The findings revealed that Watch 7 and 8 offer the SMA through these stress management features. However, to actualise the SMA, wearers must be cognitively capable of understanding the stress management interventions and follow through with integrating them into their daily lives when necessary [96]. The effects of the SMA on health and well-being management are mainly centred around mental wellness and reduced anxiety [95,96], which is important to maintain general health. Particularly, anxiety, which is reported as a rising mental health issue [49,50], can benefit from the wearable SMA through the continuous objective collection of wearers’ stress-related metrics and by providing relevant interventions [48,51].

7. Implications for SDG-3 Achievement

SDG-3 aims to ensure healthy lives and promote well-being for all at all ages. The discussion on the seven wearable affordances in health and well-being management identified through the findings has expounded the transformative potentials of wearables in contributing to the achievement of SDG-3. Figure 3 illustrates the potential contributions of wearables to SDG-3 as deduced from the findings.

The key contributions of wearables towards SDG-3 achievement are proactive health management, health consciousness, effective prevention and management of chronic and acute health and well-being conditions, health and well-being rehabilitation and recovery, health equity, and a reduction in health and well-being management costs and death from both chronic and acute diseases. Depending on the context, all of these have implications, directly and indirectly, for the achievement of SDG-3. For example, when individuals are able to take proactive steps towards their health, it will reduce the burden on healthcare systems. A lessened burden on the healthcare system will free up healthcare resources for any society, which is important to achieve the SDG-3 target of universal healthcare coverage and efficient healthcare services for all. Furthermore, proactive health and well-being management and health consciousness are important to reduce the mortality rate from non-communicable diseases, a target of SDG-3.

According to [9], while there is minimal progress in other targets of SDG-3, progress in two SDG-3 targets has regressed. The progress in achieving access to essential quality healthcare services, reduction in death from non-communicable diseases through prevention and treatment, and mental health and well-being have witnessed regression [9]. One of the indicators of SDG3 is the mortality rate attributed to cardiovascular disease, cancer, diabetes, or chronic respiratory disease [9]. The discussion in Section 6 shows how wearables can be integrated into health and well-being management to prevent and effectively manage cardiovascular and respiratory diseases, diabetes, and mental health conditions. Prevention and effective management of such chronic and fatal diseases will eventually result in a significant reduction in mortality rate.

The HMA directly contributes to SDG-3 through its support for preventive health and well-being management. HMA offers individuals constant monitoring of health and well-being metrics, providing valuable data for early detection of potential health conditions. The continuous tracking and monitoring of physical activities will encourage individuals to lead an active and healthy lifestyle and prevent sedentary diseases such as obesity and diabetes. As wearables enable continuous health monitoring, this contributes to the early detection of health conditions, leading to timely intervention, reducing disease prevalence and impact, and improving overall health outcomes. This contribution aligns with one of the targets of SDG-3, reducing the burden of diseases.

The closely linked wearable HSA and HDA, as well as the HPA, can enhance access to preventive health management as wearers can screen for and detect or predict health conditions before their onset or deterioration. Early screening for and the possible detection of health risk factors and diseases can contribute to the SDG-3 target of ensuring universal health coverage and promoting health equity. The implication of the wearable HDA to the achievement of SDG-3 manifests in the prompt identification of emerging health conditions through the wearable’s ability to detect changes in health status. Early disease detection supports the SDG-3 emphasis on reducing morbidity and mortality rates through proactive health measures. The HPA of wearables is a potential contributor to the promotion of SDG-3 in that it can benefit the forecasting of health trends and possible public health epidemics. This benefit is important in strengthening the healthcare systems, improving readiness, and promoting efficient responses to health issues. Altogether, wearables’ HSA, HDA, and HPA can contribute to achieving SDG-3 by reducing the burden of diseases and associated risks, such as an overburdened healthcare system and mortality from preventable and curable diseases.

The wearables’ CHMA contributes to SDG-3 by fostering active patient engagement and the empowerment of individuals to manage their health. The involvement of sick individuals and their friends and family in providing healthcare can foster a reduction in unplanned hospital admissions and adherence to treatment and medications [97]. As families and friends become actively involved in caring for the sick in society, it not only facilitates effective healthcare interventions but also increases disease knowledge and treatment awareness [97,98]. Disease knowledge and treatment awareness are important factors in disease prevention and overall health promotion [99]. This contributes to the objective of SDG-3 to promote health and well-being for all, emphasising the involvement of individuals and the community.

Wearable HTMMA can improve the effectiveness of healthcare interventions and the efficiency of healthcare services. Facilitating treatment adherence and medication management is important to support the SDG-3 target of ensuring access to essential healthcare services. Adherence to health treatment and management routines is essential to the successful treatment of health conditions, and the failure to adhere is detrimental to patients’ health and the resources and functioning of healthcare systems [100]. Thus, the HTMMA of wearables can also be relevant to SDG-3 in its targets to reduce the burden of disease on mankind and reduce the disease mortality rate.

Wearables’ SMA can potentially contribute to rising global mental health and well-being issues, an integral aspect of SDG-3. This contribution is fostered by continuously collecting and providing real-time mental health data to track stress, monitor sleep, and sometimes provide stress management interventions. Since mental health and well-being are major contributing factors to several health issues, disease progression, and disruption of health interventions [101], its promotion is crucial to meeting the goal of ensuring healthy lives and well-being for all at all ages. This way, there will be a paradigm shift from the focus on treating disease to preventing disease, making way for a healthier society.

8. Limitations and Future Research

The online reviews used as the primary data source for this paper are considered unique and valuable; however, they can also be seen as a limitation of this paper. The focus on a particular wearable type, the Smartwatch and a singular brand and only two models, the Watch 7 and 8, is another limitation of this paper. However, the focus on the two Apple Smartwatch models is not biased or malicious but due to the popularity and versatility of these smartwatches among other wearables and the research resource constraint. The implication of these limitations for the research, as with most qualitative research, is the restriction in the generalisability of its overall outcome. For example, the overall outcome reached in this research may not be entirely generalisable for all wearable types or Apple Smartwatch models because of the variability in the features, functionality, and application of wearables. Notwithstanding, as per the trustworthiness of a qualitative study, the outcome of this study remains credible, transferable, dependable, and confirmable in a similar context to the conducted research and provides valuable insights into the roles of wearables and their potential contribution to SDG 3.

Based on the paper’s limitations, future research should be carried out using different data sources and methods, such as surveys and interviews with wearable users. Researchers should also consider conducting similar research where other wearable types different from the Smartwatches are investigated for their role and potential contribution to SDG-3. For more nuanced knowledge generation and accumulation, studies can also be conducted to ascertain the role and potential contribution of other Smartwatch brands different from the Apple brands to SDG-3 attainment. Finally, future research can be carried out to investigate the role and potential contribution of wearables to SDG-3 in terms of managing the various types of chronic diseases such as diabetes or mental health issues like anxiety being the leading cause of death globally. Such research can be useful for knowledge building to provide a broader perspective on wearable potential in health and well-being management.

9. Conclusions

This paper confirms the essential role of technologies in achieving SDGs as expressed in the UN Report [9] on SDG’s progress. In particular, this paper determined the role of wearables in health management and their potential contributions to SDG-3 through the AT lens. Wearables can empower individuals to actively participate in their health and well-being management, promote the prevention and management of health and well-being conditions, and ultimately save lives. The integration of these technologies into managing health and well-being can contribute to the overarching goal of ensuring healthy lives and well-being for all at all stages. The identified wearable affordances for health and well-being management, which are health monitoring, health screening, health detection, health prediction, health treatment and medication management, collaborative health management, and stress management, indicate their potential contributions towards achieving the various targets and indicators of SDG-3. These contributions include promoting proactive health management, health consciousness, effective rehabilitation and recovery, disease prevention, effective disease management, cost-effective healthcare management, preventive healthcare, efficient healthcare services, health equity, and reduction in mortality rate.

Furthermore, the paper confirms the AT’s applicability in exploring technology’s impact on individuals, organisations, and society. The theoretical approach adopted in this paper conceptualised wearable affordances for health management, highlighting the inherent values of wearables for health and well-being management and in the broader scheme of promoting sustainability. Ultimately, this paper promotes the development, practical use, and sustenance of wearables for health and well-being management in an attempt to further align technology, health, and sustainability.