Computers in Human Behavior 118 (2021) 106710

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Computers in Human Behavior

journal homepage: http://www.elsevier.com/locate/comphumbeh

Wearable technology and consumer interaction: A systematic review and

research agenda
João J. Ferreira a, Cristina I. Fernandes a, Hussain G. Rammal b, *, Pedro M. Veiga c
a
University of Beira Interior, Department of Management and Economics & NECE Research Unit in Business Sciences, Portugal
b
UTS Business School, University of Technology Sydney, Australia
c
School of Education, Polytechnic Institute of Viseu & NECE Research Unit in Business Sciences, University of Beira Interior, Portugal

A R T I C L E I N F O A B S T R A C T

Keywords: There has been exponential growth is the use of wearable technology, and these are now considered to be of
Wearable technology critical importance in certain consumer goods and services sectors, including healthcare. However, research on
Digital technologies this topic remains fragmented, and the approaches to aid its study and enhance the understanding of how these
Consumer behavior
technologies are used and its implications for the future have not yet been delimited. Thus, this study aims at
Systematic literature review
Bibliometric techniques
identifying the different trends and themes prevailing in the literature on wearable technology. Through a
systematic literature review, using bibliometric analysis, we identify five themes: i) Wearable technology
decision-making; ii) Wearable technology well-being; iii) Wearable technology consumer behavior; iv) Wearable
technology utility, and v) Wearable technology and big data analytics. Our analysis of the review data suggests
that despite being multi-disciplinary, there is a lack of integration between this research field’s micro and macro
perspectives. This lack of integration and dialogue has led to several disconnected constructed terminologies,
overlapping research questions, studies that are not based on appropriate results, fragmentation, and mixing or
confusion of different theories. The study articulates key questions that could drive future research on wearables
and consumer interaction.

1. Introduction demand for equipment to assist and support the elderly (Srizongkhram,
Shirahada, & Chiadamrong, 2018, pp. 1–9; Talukder, Sorwar, Bao,
There has been a remarkable growth in consumers’ interaction with Ahmed, & Palash, 2020). Specifically, the technology can be used to
technology and artificial intelligence over the last decade (Ameen, monitor the health of the elderly, to decrease the rate of hospitalization
Tarhini, Reppel, & Anand, 2021). The use of wearable technology by and mortality, alert caregivers/medicos about diseases, improve mental
consumers is part of this contemporary technological revolution. Wright life, provide a healthier lifestyle, and assist in emergency management
and Keith (2014) describe wearable technology, wearable devices, or (Kekade et al., 2018; Lee & Lee, 2018). Thus, wearables are intended to
simply wearables as intelligent computers incorporated into different help consumers achieve a state of self-connection by using sensors and
accessories, including clothing, fashion accessories, and other everyday software that facilitate data exchange, communication, and access to
items worn by consumers. These devices are designed to provide users information in real-time. For this reason, wearable devices are a large
with a seamless, integrated solution that has long been expected of part of the content of the Internet of Things (IoT) (Kalantari, 2017;
computers. There has been a rapid increase in the introduction of new Sharma & Biros, 2019; Sun, Ji, Wang, & Liu, 2016; Wang, 2015).
computer wearables, with contemporary products featuring a combi­ Therefore, reflecting its contemporary usage, wearables can be said to
nation of sensors and computing devices embedded in clothing and include smart electronic devices that are worn close to or on the skin’s
fashion accessories, such as activity tracking bracelets or smartwatches surface and can transmit data and related information to the users.
(Friedman, 2017; Nieroda, Mrad, & Solomon, 2018). The technological changes brought about by these products have
An extension of the wearables is the wearable healthcare technology, disrupted the marketing environment (Barczak, 2016). Rajagopal and
which has the potential to offer an effective way to meet the growing Burnkrant (2009) suggest that incorporating technology into everyday

* Corresponding author.
E-mail addresses: [email protected] (J.J. Ferreira), [email protected] (C.I. Fernandes), [email protected] (H.G. Rammal), motaveiga@gmail.
com (P.M. Veiga).

https://doi.org/10.1016/j.chb.2021.106710
Received 20 May 2020; Received in revised form 20 November 2020; Accepted 16 January 2021
Available online 20 January 2021
0747-5632/© 2021 Elsevier Ltd. All rights reserved.
J.J. Ferreira et al. Computers in Human Behavior 118 (2021) 106710

products has ultimately yielded numerous complex, multifunctional 1955 when Edward Thorp and Claude Shannon invented a device that
hybrid products, such as activity trackers and organizers in watches. The was small enough to be worn by a person around their body and was
most complex part of these devices is that since they perform multiple used to beat Las Vegas casinos at the roulette wheel by predicting where
activities, wearables require a different design, marketing, and posi­ the ball would land (Fernández-Carmés & Fraga-Lamas, 2018). Further
tioning approaches than those used for traditional products. These de­ advancements in the field were made in the 1960s (experimentation
velopments provide the opportunity for research on wearable with smart glasses and helmets), 1970s (wearable devices to assist
technology and its consumption trends to be used by marketers and the photographers with lighting), and 1980s and 1990s (augmented reality
scientific community to make the theoretical and practical advances and smart shirts aimed at monitoring an individual’s vital signs)
needed to enhance the global knowledge-based economy. (Fernández-Carmés & Fraga-Lamas, 2018). The market for wearables is
As wearables’ manufacturing and marketing have extended beyond expected to grow to US$160 billion by the year 2026 as the technology
fashion, so has the academic literature in this area. There have been shifts from detachable components to embedded systems such as
some efforts to attempt to systematize the literature on wearable tech­ textile-embedded sensors, actuators, and therapeutic solutions (Jaya­
nology. For example, Khakurel, Pöysä, and Porras (2017) intended to thilaka et al., 2019).
provide a heuristic overview of recent trends in wearable technology Consumer reactions are behavioral intentions that later turn into real
while assessing its potential in the workplace. Kalantari’s (2017) review behaviors or as the acceptance of technology (Davis, 1989; Fishbein &
of the literature focused on the differences in the speed between Ajzen, 1975; Venkatesh et al., 2010). Some studies suggest that in­
adopting wearables and adopting other types of technologies. Recently, tentions are associated with the use of a particular good or service (Kim,
Khakurel, Melkas, and Porras (2018) undertook a systematic review in Ferrin, & Rao, 2008; Kim & Forsythe, 2008). Thus, consumer reactions
which they aimed to expand current knowledge on the trend of wearable can be considered a response that expresses and predicts consumers’
technology to assess its potential in the workplace and the challenges intentions to adopt the technology, often described as a linear process
related to the use of wearables in the workplace. Wu and Luo (2019) (Rogers, 2003). However, this process is iterative as consumers may
focus on wearable technology applications in healthcare, and Mahloko later change their intentions towards the technology (Joseph, 2005;
and Adebesin (2020) addressed the factors that influence the accuracy of Kleijnen, Lee, & Wetzels, 2009; Laukkanen, Sinkkonen, & Laukkanen,
the data collected by the consumer wearable health device for 2008). Hence, the term wearable technology or “wearables” has more
measuring heart rate, physical activity, and monitoring sleep patterns. relevance in today’s digital world that we live in. Wearables are not just
Despite these studies’ existence, the topic area remains scattered any items that can be used or carried on the body; they are strongly
between the healthcare and marketing areas and lacks a holistic review linked to advanced technology (Kalantari, 2017). For this study, we
of the literature. Such a review is required to clearly and effectively map consider wearables as technology-based products that are not only worn
the evolution of knowledge in this field and highlight the contextual by consumers but are also intelligent enough to incorporate information
approaches and guidelines that support it. To stimulate academic technologies that communicate autonomously and process information
improvement and provide a better sense of direction, we offer in this in motion (Park, Chung, & Jayaraman, 2014).
research a systematic review of this literature based on the following Thus, wearables cover various devices such as smartwatches, smart
questions: i) what are the various concepts and issues covered in the glasses, activity trackers, head-mounted monitors, contact lenses, smart
wearable technology literature? and ii) what are the theoretical, clothing, jewelry (e.g., smart rings), tiaras, and bracelets. Kalantari
contextual, and methodological guidelines applied in wearable tech­ (2017) gives several examples of wearables such as Google Glass,
nology research? Microsoft HoloLens, Apple Watch, Pebble Smartwatch, Fitbit fitness
This study makes several important contributions. First, we present a tracker, Oculus Rift virtual reality goggles, 9Solutions’ Real-Time
systematic literature review on wearable technology using bibliometric Locating Systems, iKey wearable keyboard, among others.
techniques. Our review highlights not only what the previous literature Robson, Pitt, and Kietzmann (2016) highlight how firms can equip
has analyzed about wearable technology but also prepares the ground employees with wearables to identify and overcome performance bot­
for the second wave of research on this topic, synthesizing the main gaps tlenecks. The data generated from the wearables can play an important
in knowledge and the emerging trends in studies. Second, we review role in improving key business processes and can help companies ach­
several prevailing theoretical/conceptual assumptions in wearable ieve savings while increasing efficiency in manufacturing, service, in­
technology research and offer perspectives that may shape future dustry, and commerce (Abraham & Annunziata, 2017). From smart
research. Third, we articulate a roadmap for a future research agenda by clothing used to observe individuals working with hazardous materials,
proposing multiple directions that can open new avenues for future to accelerated access to information in real-time, wearable technology
research and construct relevant and appropriate theories for measuring can improve service industries’ decisions and actions. In general, this
wearable technology contributions. technology can be used as an evolutionary tool for workforce training
In a systematic review of 74 publications on wearable technology, we and provide remote customer services like technical support to solve
summarize and categorize existing studies in this field using biblio­ problems more efficiently (Kalantari, 2017).
metric analysis. More specifically, this study aims to i) identify the As highlighted earlier, the health sector is of particular importance
fundamental contributions of research in this area of knowledge; and ii) for using wearables as they can provide solutions to reduce medical costs
determine the lines of research that constitute the most prominent in­ (Behkami & Daim, 2012). According to Roman et al. (2015), if the vast
tellectual structure to contribute to the definition of a future research majority of individuals adopt wearable healthcare devices, the national
agenda. health services’ savings could reach billions of dollars. However, despite
The next section presents an overview of wearable technology and the expected benefits of wearable healthcare devices, the market for
consumer reactions, followed by an explanation of the methodology these devices is still at an early stage. Barnes, Kauffman, and Connolly
used in this systematic review. This study’s results in terms of the core (2014) concluded that while many people are interested in wearable
domains of wearable technology, their intellectual and collaborative healthcare devices, only a small number have adopted a wearable
structures, and the results of co-citation networks are then discussed. healthcare device. Therefore, to expedite the adoption of wearable
The final section concludes by suggesting paths for future research and health services through devices, it is critical to understand which factors
discusses the limitations of the study. influence consumers’ intent to adopt them (Lee & Lee, 2018).
A challenge faced by the sector is ensuring that the use of wearable
2. Wearable technology and consumer reactions technology by consumers can be sustained. Lee, Kim, Ryoo, and Shin
(2016) address this issue and highlight that a third of American con­
The history of wearable computers as an idea can be traced back to sumers stop using wearable products within six months of their

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J.J. Ferreira et al. Computers in Human Behavior 118 (2021) 106710

purchase. Hence, the interaction between wearables and the consumers Table 1
needs to move from being seen as a short-term status symbol or fad to be Summary of documents.
considered a necessary accessory that enhances their day-to-day activ­ Description Results
ities. Addressing this and other related limitations and challenges are
Documents 74
key to such technologies’ future growth and success. By systematically Sources (Journals, Books, etc.) 51
consolidating and categorizing the literature, this study attempts to Keywords Plus (ID) 257
highlight the current research trends on the use of wearables and the Author’s Keywords (DE) 284
challenges associated with it and provides directions for future research. Period 2007–2019
Average citations per documents 11.23
Authors 215
3. Methodology Author Appearances 238
Authors of single-authored documents 8
This study uses the systematic literature review method to identify Authors of multi-authored documents 207
Single-authored documents 9
and review the extant research on wearable technology. The method
Documents per Author 0.33
was chosen as it allows the synthesis of the literature accurately and Authors per Document 3.03
according to rigorous standards (Malinen, 2015; van Laar, van Deursen, Document types
van Dijk, & de Haan, 2017). As highlighted by Tranfield, Denyer, & Article 54
Editorial Material 1
Smart (2003), systematic literature reviews differ from traditional
Meeting Abstract 1
narrative reviews in that they adopt a process that is replicable, scien­ Proceedings Paper 14
tific, and transparent. Literature reviews can either attempt to chrono­ Review 1
logically trace back the origins of an issue (author-centric review) or
guide readers through how prior studies have contributed to the
development of concepts and phenomena of interest (theme-centric re­ methodologies adopted by Waltman, van Eck, and Noyons (2010). All
view) (Linnenluecke, Marrone, & Singh, 2020). As this study’s focus is to calculations were performed using Microsoft Excel, NetDraw version
highlight the current development of the field and areas of future 2.148 (Borgatti, 2002), and VOSviewer version 1.6.5 (van Eck & Walt­
research interest, we followed the theme-centric review process. man, 2009, 2010).
We followed the review steps identified by Linnenluecke et al. (2020)
to undertake a systematic literature review. The first step involves 4. Results
identifying literature for inclusion by setting criteria such as search
keywords and searching for them within established databases. The next 4.1. Characterization of bibliographical references
step involves cleaning the data and removing duplicates, followed by the
analysis and synthesis of the evidence. This includes thematic coding to Fig. 1 shows the annual evolution of the number of studies published
synthesize and categorize studies. The final step involves the presenta­ during the duration of the period covered in this study. The average year
tion of the results from the systematic literature review. Some ways of of publication is 2017.1 ± 2.3, which shows that this is an emerging
presenting it include qualitative or quantitative meta-analyses or research field. The results show that research on the subject began to be
bibliographic mapping (Linnenluecke et al., 2020). published more frequently from 2016 onwards. The year 2018 (20
Intending to present a comprehensive review of the literature on publications) was the one in which the greatest number of publications
wearable technology, we searched for relevant publications in the Sci­ were observed. This increase in publications coincides with the devel­
ence Citation Index Expanded, Social Sciences Citation Index, Arts & opment and launch of smartwatches by Apple, Samsung, Sony, and other
Humanities Citation Index, Conference Proceedings Citation Index - technology firms. The widespread acceptance and use by consumers of
Science, Conference Proceedings Citation Index - Social Science & Hu­ these wearables could be seen as a driver for the increased number of
manities and Emerging Sources Citation Index (ESCI) compiled by studies.
Clarivate Analytics’ online Web of Science databases. The 74 references have an average of 11.0 ± 15.9 citations, 21 ref­
The search was conducted using the following expression "TS = erences (28.4%) had no citations, and approximately half of the refer­
("wearable*" or "fashion technolog*" or "tech tog*" or "fashion electro­ ences (38) had a maximum of 4 citations. Table 2 presents the five most
nic*") and ("consumer*" or "buyer*" or "purchaser*" or "customer*" or cited references and the five references with the highest citations per
"shopper*") and SU = ("BEHAVIORAL SCIENCES" OR "BUSINESS ECO­ year.
NOMICS" OR "PSYCHOLOGY" OR "SOCIAL SCIENCES OTHER TOPICS" There were 215 researchers who authored these 74 publications.
OR "COMMUNICATION" OR "OPERATIONS RESEARCH MANAGEMENT Table 3 shows the authors with at least two publications and the number
SCIENCE" OR "PUBLIC ADMINISTRATION"). The search was conducted of fractionalized publications (ratio of published articles to the number
in January 2020 and covered all documents published until the year of authors). Rauschnabel, P. A. stands out as the authors with the highest
2019.
The search resulted in 74 publications, 54 of these were journal ar­
ticles and 14 published in conference proceedings. Table 1 provides a
summary of these publications, with the earliest research published in
2007.
A descriptive analysis of the 74 publications was undertaken, mainly
graphic methods, frequency tables, and descriptive measurements
(mean and standard deviation). The analysis of co-citations has been
adopted as the standard since the 1970s and has enjoyed a predominant
position in the bibliometric analysis. This form of analysis is useful
because if a set of articles is cited simultaneously by some references,
potentially there are common ideas among these articles that generally
represent the central themes and intellectual structures of an area of
knowledge (Leydesdorff & Vaughan, 2006).
For the graphic mapping of the co-citation analysis, network theory
was used, and the determination of clusters was performed using the Fig. 1. Number of articles by year of publication.

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Table 2 Table 5
Most cited references. Countries with the most publications.
Articles # citations Country # Articles

Chuah et al. (2016) 75 USA 32

Rauschnabel, Brem, and Ivens (2015) 54 UK 12
Morris and Aguilera (2012) 51 Germany 11
Aladren, Lopez-Nicolas, Puig, and Guerrero (2016) 49 China 11
Venkatesh, Joy, Sherry Jr., and Deschenes (2010) 47 South Korea 7
# citations/year Finland 5
Chuah et al. (2016) 15 Australia 5
Shin (2017) 10.5 Sweden 4
Aladren et al. (2016) 9.8 Canada 4
Choi and Kim (2016) 9.2 Brazil 3
Rauschnabel et al. (2015) 9

applied cluster analysis, which allowed us to obtain homogeneous

groups of articles (Fig. 2 and Table 6).
Table 3
These clusters represent the key themes identified in the literature
Authors with the most publications.
and are discussed next.
Authors # Articles Authors # Articles Fractionalized

Rauschnabel, P. A. 8 Rauschnabel, P. A. 3.9 5. Themes in the wearable technology and consumer interaction
Li, H. 4 Banerjee, S. 1 literature
Wu, J. 4 Gidaris, C. 1
Lin, Z. 3 Haggett, A. 1
Brem, A. 2 Li, H. 1 5.1. Wearable technology and decision-making (cluster 1, N = 7)
Chuah, S. H. W. 2 Lyall, B. 1
Kim, S. 2 Mastrocola, V. M. 1 Although corporate press releases highlight the potential of a new
Krey, N. 2 Shin, D. H. 1
form of a wearable device that appears on the technology scene, such as
Ramayah, T. 2 Wissinger, E. 1
Rauschnabel, P. 2 Wu, J. 1 augmented reality smart glasses (digital glasses that integrate virtual
Ro, Y. K. 2 information into the user’s field of vision), research suggests that very
Zheng, H. 2 little is known about the consumer interaction with this nascent tech­
nology (Rauschnabel et al., 2015). Wu et al. (2015) investigated how the
adoption of wearable technology by company employees (using Google
number of published references (8 articles), followed by Li, H. (4 arti­
Glass to check into a hotel) influences consumer assessments. The au­
cles), Wu, J. (4 articles), and Lin, Z. (3 articles).
thors found that wearable technology adoption led to favorable
Regarding these studies’ sources, the 74 publications included in the
customer assessments in situations where the service presents failures.
review were published in 51 sources. Table 4 shows the sources with the
They also found that the adoption of wearable technology by male
highest number of publications, highlighting Computers in Human
employees led to less favorable customer evaluations.
Behavior (7 references), Augmented Reality and Virtual Reality: Empow­
Basoglu et al. (2017) explored the factors that influence the con­
ering Human Place and Business (4 references), Technological Forecasting
sumers’ use of smart glasses and found that the process of adopting this
and Social Change (4 references), and Journal of Services Marketing (3
type of technology was dependent on the preferences and needs of in­
references).
dividuals. They concluded that two factors influenced the adoption:
The countries with the greatest research expertise in the area are
product characteristics (factors that depend on the features of intelligent
highlighted in Table 5. Authors from the USA (32 publications), UK (12
glass design; independent device, the field of view, interaction, price,
publications), Germany (113 publications), China (11 publications), and
and display resolution according to the user’s preference), and user
South Korea (7 publications) had the greatest number of publications.
intention characteristics (factors that depend on the self-efficacy of
anxiety, involvement, risk task characteristics, fun, utility, ease of use,
4.2. Co-citations analysis
attitude, and intention). However, despite the benefits of these devices,
they are seen to threaten the privacy not only of those who use them but
The initial sample of 74 publications was cited 816 times. The sample
of other people, thus influencing decision-making processes (Rausch­
was further refined to only include publications with at least 10 citations
nabel et al., 2015).
to allow for co-citation analysis, which reduced the final number to 28
The exponential development of the Internet of Things (IoT) brings
publications. To visually present the results, we used the network the­
with it the essential challenge of meeting the quality expectations of
ory, elaborating a network for its representation (Fig. 2), and later
end-users (Shin, 2017). The quality of the experience can become the
guiding paradigm for quality provision management and application
Table 4 design in IoT. Thus, it is fundamental to have a relationship between
Sources with the most publications. consumer experiences and IoT quality (Shin, 2017). Consumer concerns
Sources # about health risks, the privacy of IoT users, and wearable health devices
Articles have been intensified recently (Marakhimov & Joo, 2017). However,
Computers in Human Behavior 7 there is limited research on the impact of these concerns on consumer
Augmented Reality and Virtual Reality: Empowering Human Place and 4 behavior patterns related to wearable health devices’ post-operative use.
Business
The authors found that health and privacy concerns face increasing
Technological Forecasting and Social Change 4
Journal of Services Marketing 3 consumer concern.
Applied Ergonomics 2 Rupp et al. (2018) found that while portable fitness devices can be
Information & Management 2 effective in motivating people to be active, consumers were abandoning
Journal of Business Research 2 the technology soon after purchase. Examining the profile of various
Journal of Retailing and Consumer Services 2
users (i.e., personality, age, computer self-efficacy, level of physical
Technology in Society 2
World Conference on Technology Innovation and Entrepreneurship 2 activity) and device characteristics (confidence, usability, and

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J.J. Ferreira et al. Computers in Human Behavior 118 (2021) 106710

Fig. 2. Network of co-citations of the 28 publications and their clusters.

intention to adopt a wearable fitness meter, which is a type of wearable

Table 6
health devices, Lee and Lee (2018) found that consumer attitudes, per­
Grouping resulting from the cluster analysis of the co-citation analysis.
sonal innovation, and health interests had statistically significant and
Article Cluster positive associations with the intention to adopt such a meter.
Rauschnabel et al. (2015) 1
Shin (2017)
Marakhimov and Joo (2017) 5.2. Wearable technology and well-being (cluster 2, N = 8)
Rupp, Michaelis, McConnell, and Smither (2018)
Wu, Fan, & Mattila (2015) Smartwatches have become an important starting point for the
Lee and Lee (2018)
Basoglu, Ok, and Daim (2017)
widespread of portable devices. Although still in the early stages of
Chuah et al. (2016) 2 diffusion, smartwatches represent the most popular portable device
Choi and Kim (2016) (Chuah et al., 2016). However, little is known about why some people
Jung, Kim, and Choi (2016) are more likely to adopt smartwatches than others. To deepen the un­
Wu et al., 2016
derstanding of the underlying factors that stimulate adoption behavior,
Canhoto and Arp (2017)
Nasir and Yurder (2015) Chuah et al. (2016) developed a theoretical model based on the accep­
Montgomery, Chester, and Kopp (2018) tance of technology and social psychology theories. They found that
Terry and Gunter (2018) perceived utility and visibility are important factors that drive adoption
Venkatesh, Joy, Sherry, and Deschenes (2010) 3 intent, suggesting that smartwatches represent "fashnology" (i.e.,
Rauschnabel, He, and Ro (2018)
Rauschnabel (2018)
fashion and technology).
Kalantari and Rauschnabel (2018) Recognizing smartwatch as the converging point of IT innovation
Ro, Brem, and Rauschnabel (2018) and fashion, Choi and Kim (2016) examined whether factors pertinent to
Verhoef et al. (2017) 4 fashion products’ characteristics affect the intent to use smartwatches.
Schall Jr., Sesek, & Cavuoto (2018)
They found that the characteristics of smartwatches, such as fashion
Holtermann et al. (2017)
Nieroda et al. (2018) products, significantly explain the intention to wear an intelligent
Wu, Li, Cheng, & Lin (2016) 5 watch, particularly the individual’s desire for exclusivity. A limited ef­
Wu, Li, Lin, & Goh (2017) fect of vanity on self-expressiveness means that the smartwatch is not yet
Wu, Li, Lin, & Zheng (2017a) considered luxury merchandise.
Wu, Li, Liu, & Zheng (2017b)
Wearable devices include objects that cover both mobile computing
and fashion characteristics. While the combination of the two features is
motivational resources) on behavioral intentions to use a wearable relatively new, consumers’ recognition of smartwatches as a fashion
fitness device, the authors found that computer self-efficacy, level of accessory is increasing. However, despite the growing interest in
physical activity, and personality traits indirectly increased the desire to smartwatches, sales are growing more slowly than expected. To under­
use a fitness device and influence perceptions of motivational resources stand this, we must understand potential consumers’ perceptions of
(Rupp et al., 2018). Also, confidence, usability, and perceived motiva­ smartwatches. Jung et al. (2016), in their study, concluded that screen
tional resources were associated with greater intentions to use physical format and autonomous communication are the most critical factors
conditioning devices. influencing smartwatches’ choices. However, brand and price have no
Similarly, little is known about what influences the individual’s particular influence.
adoption of a wearable health device has on their health and lifestyle Wu et al. (2016) argue that identifying factors that influence con­
(Lee & Lee, 2018). Studying the factors that influence an individual’s sumers to accept a smartwatch can improve the user-centered design.
The authors studied the intentions of using a smartwatch from a

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consumer perspective, combining the theory of diffusion of innovation, media acceptance theories to understand how people react to
the model of acceptance of technology, the unified theory of acceptance augmented reality devices, using the Microsoft HoloLens as an example.
and use of technology, and perceived pleasure. They concluded that the They concluded that the consumer’s adoption decision is motivated by
attitude, often identified as a weak mediator, is significant; however, the several expected benefits, including utility, ease of use, and image.
ease of use was not significant, which implies that it should be the basic However, no hedonic benefits were found to influence the intent of
specification of smartwatches (Wu et al., 2016). They also concluded adoption. They also found that the influence of descriptive standards on
that gender has no significant effect on the acceptance of smartwatches, the intent of adoption outweighs the influence of injunctive standards,
and individuals aged 35 to 54 exhibit a significant demand for fun in which are established determinants in technology acceptance research
using a smartwatch. (Kalantari & Rauschnabel, 2018).
The elderly population segment is constantly growing, and this
growth has been accompanied by an increase in chronic diseases, which 5.4. Wearable technology utility (cluster 4, N = 4)
inevitably leads to continuous changes in the health sector (Nasir &
Yurder, 2015). Thus, wearable technology is becoming an important Today’s consumers are immersed in a wide and complex variety of
topic in the field of health technology. Mobile health applications that networks, and each network presents an interconnected group of people
work with wearables allow users to collect and store all health and and companies that is growing with the emergence of the Internet of
fitness-related data in one place. Things (IoT) (Verhoef et al., 2017). Technology, particularly the use of
For Canhoto and Arp (2017), the Internet of Things (IoT) and mobile devices, enables these connections and facilitates many types of
particularly wearable products have shifted the health sector’s focus to interactions on these networks - from transactions, social information
prevention programs that enable people to become active and take re­ sharing to people interfacing with connected devices (e.g., wearable
sponsibility for their health. These benefits will only materialize if users technology).
adopt and continue to use these products, rather than abandon them Wearable sensors are increasingly being promoted to improve the
soon after purchase. The authors found that the factors that signal the health and well-being of employees, and there is growing evidence to
device’s ability to collect activity data are essential for adoption, while support their use as personal health and exposure assessment tools.
the portability and resilience of the device are essential for sustained Despite this, many workplaces are hesitant to adopt these technologies.
use. Schall, Sesek, and Cavuoto (2018) collected information on wearable
Montgomery et al. (2018) argue that portable exercise devices can sensors, particularly personal activity monitors, currently used by
solve some of the public health problems. However, they also raise occupational safety and health professionals. The authors found that
serious privacy concerns because the data they collect can be combined more than half of the respondents described being favorable to wearable
with personal information from other sources, increasing the spectrum sensors to track risk factors related to occupational safety and health.
of discriminatory profiles, manipulative marketing, and data breaches. Barriers, including concerns related to privacy/confidentiality of
According to Terry and Gunter (2018), mobile medical applications are collected data, employee compliance, sensor durability, cost/benefit
a fast-growing category of software typically installed on personal ratio of wearing devices, and good manufacturing practice re­
smartphones and wearable devices. Thus, a subset of these applications quirements, were described as challenges that prevent adoption. The
aims to help consumers identify mental states and/or mental illness. study’s findings suggest that the widespread adoption of wearable
Although this is still an incipient domain, many mental health devices technology appears to depend largely on the scientific community’s
are made available in the marketplace. ability to address the barriers identified (Schall et al., 2018).
Human beings in industrialized societies spend an increasing amount
5.3. Wearable technology and consumer behavior (cluster 3, N = 5) of time in sedentary behavior every day. Holtermann et al. (2017) define
sedentary behavior as sitting or lying down with low energy expenditure
In recent decades the development of new communication technol­ and is associated with harmful health outcomes. Despite the growing
ogies has revolutionized the behavior of individuals tremendously. interest in the health effects of sedentary behavior, organizations remain
Mobile devices, in particular, have developed a mentality of "always and unclear on how to address it due to the poor and diverse methods used
everywhere online". Despite numerous investigations highlighting the for assessment. Therefore, good practice guidelines are needed for re­
potential of new forms of wearable devices (intelligent augmented re­ searchers and practitioners to evaluate sedentary occupational behavior.
ality glasses that integrate virtual information into the user’s field of Although there are already many wearables that help combat sedentary
vision), the research on this technology remains limited (Rauschnabel, behavior, no system is autonomous and capable of evaluating sedentary
2018; Rauschnabel et al., 2018). The expected hedonic and symbolic behavior according to its definition (Holtermann et al., 2017).
benefits drive consumer reactions to these devices, and the users’ Hybrid products, such as Apple or Fitbit devices, claim resources
decision-making is strongly influenced by the extent to which these from different product categories (i.e., one technology and one fashion
devices threaten others’ privacy, but not the privacy of the user item) (Nieroda et al., 2018). As these products develop, marketers find it
(Rauschnabel, 2018; Rauschnabel et al., 2018). difficult to position and market them because they transcend traditional
Venkatesh et al. (2010) theorize and empirically investigate how categories. Using wearables as examples and using product design
consumer attitudes and preferences regarding body appearance are literature, the authors propose a typology of these hybrid products that
linked to their perceptions of fashion aesthetics. The authors based their include the dimensions of (1) mono versus multi-functionality and (2)
research on three research streams - production aesthetics, reception mass versus luxury fashion (Nieroda et al., 2018). In addition to being a
aesthetics, and aesthetic work. They identified four themes: fashion as fashion product, mono-functional wearables support one main function
wearable art, body and self-identity, body appearance and high fashion enabled by technology (e.g., an activity tracker), while multifunctional
brands, and aesthetic work through fashion. The findings highlight the wearables support multiple functions (e.g., being a clock, activity
growing importance of aesthetics in understanding consumer behavior tracker, and an organizer).
towards wearables (Venkatesh et al., 2010).
Ro et al. (2018) found that several investigations emphasize the 5.5. Wearable technology and big data analytics (cluster 5, N = 4)
emergence of a new technology called "wearable augmented reality
devices", in which smart augmented reality glasses (such as Microsoft Policymakers and business professionals worldwide are making
HoloLens or Google Glass) represent important examples. These tech­ extraordinary efforts in the field of eHealth (Wu, Li, Cheng & Lin, 2016).
nologies offer enormous innovation potential for companies and soci­ Indeed, wearable technology’s thriving development in health services
eties. Kalantari and Rauschnabel (2018) use various technology and is creating great opportunities and a remarkable future for health

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J.J. Ferreira et al. Computers in Human Behavior 118 (2021) 106710

services. Wearable devices can be seen as a key link between healthcare store all health and fitness-related data in one place (Jung et al., 2016).
and big data analytics (BDA) (Wu et al., 2017). The benefits of the BDA A subset of mobile medical applications aims to help consumers identify
in health care have been widely recognized, but due to the uncertainty mental states and/or mental illness. However, there remains the chal­
around rules and regulations regarding patient data, some companies lenge of ensuring sustained use of technology, with many users not
have been slow to adopt this technology. Applying a model of compe­ continuing with wearables after a short period. Features that signal the
tition among mobile device companies with and without BDA strategies device’s ability to collect activity data are essential for adoption, while
and considering consumer preference for BDA and network effects, Wu device portability and resiliency are essential for sustained use.
et al. (2017) demonstrate that investment in BDA directly affects the Perceived utility and visibility are important factors driving adoption
equilibrium price, market share, and profit of the company, and affects intent, suggesting that smartwatches represent a kind of "fashnology" (i.
the performance of competitors. When a company with a BDA strategy e., fashion and technology). Smartwatches’ characteristics as fashion
adopts a different competitive strategy: conservative or expansive, products significantly explain the intention to wear an intelligent watch,
market results are different. particularly the individual’s desire for exclusivity. The expected hedonic
For Wu et al. (2017a), the rapid growth in consumer adoption of and symbolic benefits of use drive consumer reactions to these devices.
portable devices has caught the attention of several researchers. The consumer’s decision to adopt these devices is motivated by some
Competition in the handheld market is substantial and complicated. The expected benefits, including utility, ease of use, and image. Hence,
authors investigated the impact of network externality on the competi­ studies on consumer intentions should combine the theory of diffusion
tion of handheld devices in a two-dimensional product differentiation of innovation, the model of acceptance of technology, the unified theory
model based on considering a market with a wide range of products of acceptance and use of technology, and perceived pleasure.
(horizontal differentiation) and various quality levels (vertical differ­ Today’s consumers are immersed in a wide and complex variety of
entiation). Studying two types of network externalities according to networks, and wearables can play a critical role in consumers’ day-to-
product compatibility in two types of market structures, Wu et al. day activities. However, marketers face challenges in positioning
(2017a) found that horizontal network externalities diminish robust wearable hybrids and marketing them because they transcend tradi­
profits. Network externalities also increase (decrease) the profit of the tional product and consumer categories. Hence, marketers need to
high quality (lower quality) company in the vertical domain. highlight the perceived utility of the wearables in a way that captures all
Wu et al. (2017b) investigated the impact of the BDA on competition segments of the market. For example, consumers favor using wearable
in the health care IT market and on optimal adoption decisions of the sensors to track risk factors related to occupational safety and health
BDA by the IT provider. To capture the specific characteristics of the (Schall et al., 2018). Technology has improved our life and enhanced
BDA in healthcare, they simultaneously modeled the BDA’s efficiency comfort, leading to increased sedentary behavior in the developed
and privacy risk from a consumer perspective and the BDA’s benefit and world. While there is potential for wearables to address some of these
cost from a supplier’s perspective in a stylized two-dimensional product concerns, a truly autonomous system lacks the evaluation of behavior
differentiation framework. The authors concluded that enterprises such as sedentariness. For consumers, some of the barriers to adoption
should apply optimal pricing strategies appropriate to the BDA’s effi­ include concerns related to privacy/confidentiality of collected data,
ciency and privacy risk dynamics (Wu et al., 2017b). employee compliance, sensor durability, cost/benefit ratio of wearing
devices, and good manufacturing practice requirements.
6. Discussion Our final observation relates to wearables being a key link between
healthcare and big data analysis (BDA). The successful development of
Given the summary analysis of these five themes, we can conclude wearable technology in health services creates great opportunities and a
that there are advantages, disadvantages, and challenges associated remarkable future for health services. Investment in data access, storage,
with wearable technology. In terms of drawbacks and challenges, we analysis, and subsequent use in strategic decision-making is critical for
find pressing issues related to privacy and devices’ autonomy. A critical firms’ success. Investment in BDA directly affects the equilibrium price,
weakness in the knowledge about wearable technology is that despite market share, and profitability of the company, and at the same time,
being multi-disciplinary, there is a lack of integration between this this strategy also affects the rival’s performance. When a company with
research field’s micro and macro perspectives. This lack of integration a BDA strategy adopts a different competitive strategy: conservative or
and dialogue leads to several disconnected constructed terminologies, expansive, market results are different (Wu et al., 2017 a,b). Hence,
overlapping research questions, studies that are not based on appro­ enterprises must apply optimal pricing strategies appropriate to the
priate results, fragmentation, and mixing or confusion of different BDA’s efficiency and privacy risk dynamics.
theories.
Our review of the literature shows that the decision-making process 7. Conclusion and research agenda
related to wearables’ use is influenced by the duality between the ben­
efits of the devices and the threat to privacy not only of those who use Through a systematic review, this study aimed to identify the main
them but also of others around them. Data security concerns have been issues prevalent in the literature on the topic of wearable technology.
highlighted in contemporary research in the technology area (Ameen This study covered a total of 74 references published between 2007 and
et al., 2021). The process of adopting wearable technology depends on 2019. Even though the issue of wearables is still in the emerging stage,
the preferences and needs of individual users. The preferences are the scientific research on it has been increasing, recording in recent
dependent on the characteristics of the product and characteristics of the years the highest number of publications.
user’s intention. Consumer attitudes, personal innovation, and health The systematization of literature made it possible to identify five
interests are factors in the adoption of a wearable technological device. themes (clusters) that concentrate the main issues discussed on this
Computer self-efficacy, level of physical activity, and personality traits topic, among which there is a clear interconnection of issues. This
indirectly increase the desire to use a physical conditioning device. The allowed us to answer the question: what are the various concepts and issues
existence of a relationship between consumer experiences and the covered in the wearable technology literature?
perception of the Internet of Things (IoT) quality is fundamental. For The first cluster, "Wearable technology and decision-making", en­
example, the adoption of wearable technology by employees leads to compasses articles that discuss how wearable technologies can influence
favorable evaluations of services by customers. the individual’s decision-making processes. The investigations present
When discussing the use of wearables on user well-being and con­ in this approach also take us into the field of invasion of the privacy of
sumer behavior, the literature focuses on wearables such as smart­ users of these types of devices. The second cluster, "wearable technology
watches and mobile health applications that allow users to collect and and healthcare", incorporates studies that analyze these devices’

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importance and use in the health sector. The third cluster, "Wearable Table 7
technology consumer behavior", addresses consumer preferences and Contextual, methodological, and future research agenda for wearable
why they do or do not purchase wearable devices. The fourth cluster, technology.
"Wearable technology utility", looks at wearable technologies’ acquisi­ Theory What is the relevance of extant theories in the study of wearable technology?
tion from a consumer utility perspective. Finally, the last cluster,
"Wearable technology and big data analytics", links wearable technol­ • Should new theories be developed?
• Besides those related to technology and information sciences, what
ogies to big data analytics (BDA), helping the health sector to collect key
subjects should also be important in the study of wearable technology
data on its users. consumers (psychology, behavior sciences, sociology)?
Our second question focused on what are the theoretical, contextual, • How can existing theory be developed and improved to help explain the
and methodological guidelines applied in wearable technology research? practices of wearable technology consumers?
Context What are the similarities and differences in the various wearable technology
We found theories related to motivation, behavioral intentions, so­
approaches?
cial psychology, diffusion of innovation, acceptance of technology, and
media acceptance widely used in this research field. Table 7 shows the • What factors explain these differences?
contextual and methodological guidelines of wearable technology • How can the context lead to changes in the adoption of wearable
research, and the indicative knowledge gaps and insights for future technology consumers?
• What are the institutional pressures at play in the adoption of wearable
research.
technology consumers? Within the same sector, what are the
We detail some of these future research areas identified in Table 7. configurations that change from company to company? Between
Wearable technology is multi-disciplinary and has relevance for medi­ different sectors, what are the similarities in the organization of the
cine, engineering, information technology and systems, strategy, mar­ companies?
Content What role do resources and capabilities play in choosing wearable technology?
keting, data analysis, and many others. Hence, future studies could take
a multi-theoretical approach and develop a wearable technology • How do institutional logics relate to the option for wearable technology
framework that incorporates the various stakeholders’ interests and consumers?
concerns (Loncar-Turukalo, Zdravevski, Machado da Silva, Chouvarda, • Why do some entrepreneurs show more/less importance to wearable
& Trajkovik, 2019). technology consumers?
• What are the socially responsible practices in the workplace from the
In terms of context and content, we suggest that future studies should
workers’ perspective?
consider the differences in the level of institutional, economic, and Method How can we significantly measure wearable technology adoption?
technological development between countries. A standardized approach
to producing wearable technologies may not be suitable due to the lack • How can we measure the impact between the use or not of wearable
technology? Are they different or similar metrics?
of supporting infrastructure and the consumers’ technological literacy,
• Do different levels of wearable technology usage require different
especially in emerging economies. Rammal (2019) suggests that their methods?
environment influences consumers’ behavior, and digital innovation • How can we combine various methods to explore wearable technology
and technology may not be accepted equally worldwide. Additionally, from different levels of analysis?
the limited infrastructure development and weaker institutional envi­ • Can we develop large-scale databases to measure wearable technology
performance?
ronment in emerging economies can also raise concerns about intellec­
tual property protection and personal data access, privacy, and security.
Thus, future studies could address these issues by: Credit author statement

- considering the segmentation of the market and adapting of products João J. Ferreira: Conceptualization, Methodology Cristina I. Fer­
to meet the needs of these market segments; nandes: Data curation, Writing – original draft preparation. Hussain G.
- Formulating strategies to protect intellectual property in countries Rammal: Writing-Reviewing and Editing. Pedro M. Veiga: Writing –
with weak institutional systems; and original draft preparation.
- analyzing the use of technological safeguards to limit access to per­
sonal data and guard against misuse. References

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