In this section, we present our findings on the self-leadership strategies applied by users and the wearable as well as the associated behavioral outcomes. First, we briefly present the specific leadership strategies identified in our data, and then turn to the abstracted use patterns and explain how they relate to behavioral outcomes.
Leadership strategies applied by users and wearables
Our interviews revealed that seven of the nine self-leadership strategies mentioned in the literature were present in the empirical data, namely goal setting, cueing, observation, reward, punishment, making activity more appealing, and positive talk. In addition, we identified the behavioral strategy of social comparison, which emerged from our empirical data. We found no evidence of two of the strategies mentioned in the literature, namely replacing dysfunctional beliefs and assumptions as well as mental imagery. As expected, our data revealed that leadership strategies were applied by the users themselves, but also by the wearables. The wearables used by our interviewees applied goal setting, cueing, observation, rewards, and positive talk and a sixth strategy that emerged from our data, namely social comparison. Table 3 provides an overview of the leadership strategies applied by users as well as the wearables.
The leadership strategies applied by the wearable can be related to specific technology features. Goal setting is supported by wearable features that automatically set exercise goals, but also allow users to manually adjust them. A typical example is the goal setting feature of the step counter, which sets a predefined goal of ten thousand steps per day. Cueing is assisted by features that prompt the user to perform a certain activity. For example, wearables send users reminders to take more steps, stand, breathe, or drink water. Observation is facilitated by features that enable users to monitor and evaluate their behavior. For example, graphics (e.g., progress bars) provide users with information about their goal attainment, while exercise histories allow users to observe patterns and trends in their behavior over time. Social comparison is similar to observation in that in both cases the wearable user makes a judgement about their own performance. However, unlike in observation, in social comparison there is an external observer effect, which may change the user’s behavior in unexpected ways. Moreover, social comparison differs from observation in that it is supported by different features such as those that allow users to connect and interact with other wearable users and compare their own performance to that of others. For example, users can take part in challenges and are ranked relative to other users based on their performance (e.g., number of steps over a certain period of time). The reward strategy is supported by features that reward the user for the successful performance of a behavior. A typical example is badges users obtain when reaching a certain goal (e.g., a certain number of steps). Positive talk is assisted by features that prompt users with motivational messages to overcome motivational issues.
Wearable use patterns and behavioral outcomes
We now turn our attention to the abstracted wearable use patterns. Our empirical data revealed four wearable use patterns showing how the application of self-leadership strategies or IT-based leadership strategies relate to behavioral outcomes: 1) Following (following leadership strategies provided by the wearable) and the outcome of compliance change, 2) Ignoring (ignoring leadership strategies provided by the wearable) and the outcome of no behavior change, 3) Combining (combining leadership strategies provided by the wearable with self-leadership strategies) and the outcome of behavior change, and 4) Self-leading (self-leadership supported by the wearable) and the outcome of no wearable-induced behavior change. In the first two use patterns, leadership strategies applied by the wearable (i.e., IT-based leadership strategies) were most prominent, while in the third pattern they were combined with users’ self-leadership strategies as individuals sought to change their patterns of physical activity. The fourth pattern was characterized by users primarily applying self-leadership strategies to control their physical activity. Apart from the leadership strategies, we found that the wearable use patterns differ in users’ motivation to change their physical activity pattern, ranging from low to high motivation. Table 4 provides an overview of the four wearable use patterns, including the individuals’ level of motivation to change their behavior, the applied leadership strategies and associated behavioral outcomes.
In the following sections, we will present the four wearable use patterns in detail. In our presentation we will focus on the specific leadership strategies (see Table 3) that were most prominent in each pattern (i.e., mentioned by at least one-third of the participants in each pattern). It is important to note that the patterns relate to use cases, not users. A use case represents, for example, increasing personal fitness or improving quality of sleep. Our analysis showed that most users can be assigned to a specific pattern. However, seven out of 50 users showed different patterns depending on the use case. For example, one user meticulously followed the IT-based leadership strategies provided by the wearable in order to increase her physical activity. Simultaneously, with regard to her sleep behavior, she acquired self-leadership strategies and combined them with the wearable’s leadership strategies, thereby exhibiting a completely different behavioral pattern.
FOLLOWING: Following leadership strategies provided by wearable and the outcome of compliance change
In this wearable use pattern, users were highly motivated to improve their health behavior, but were not sure how to do so. They willingly followed the leadership strategies deployed by the wearable, which provided clear performance standards and instructions for the behavior to be performed. Users let themselves be guided by the wearable instead of their own bodily feelings. Thus, although users indeed changed their behaviors, their actions remained closely coupled to the device (i.e., compliance) because users were either unable or unwilling to perform activities on their own initiative.
The interviewees usually pursued a general goal in using the wearable, such as improving their fitness or health by being more active in their everyday lives or losing weight. However, the users did not quite know how to achieve their goals and therefore relied on the wearable to guide them. To this end, they used the step counter, and also used the heart rate monitor during exercise.
Users who wanted to be more active followed the specific goals set by the wearable (i.e., IT-goal setting), such as meeting the criterion of a certain number of steps per day. Furthermore, they valued and tended to react to reminders sent by the wearable (i.e., IT-cueing), prompting them to perform a specific activity, either to achieve the goals set by the device (e.g., moving, standing), or to improve their overall well-being (e.g., drinking water regularly, doing a breathing exercise). Users appreciated that the wearable reminded them of certain activities and they did not have to think about them themselves. One interviewee described how he complied with the reminders:
“I work in the office and the wearable keeps telling me 'Hey now it's time to get up again'. I follow that quite often. This shows me that I’ve been sitting for two hours. Then I get up and get some water and move around a bit.” (male, 27, auditor)
Users also strongly relied on the wearable’s assessment of how well they have performed the desired behavior (i.e., IT-observation). Visual representations (e.g., progress bars), either shown directly on the wearable interfaces or on the accompanying smartphone application, were used as an “objective measure” to assess the extent to which they had achieved the goals set by the device. IT-observation was also facilitated by the device’s heart rate function, which guided users during their training. Users highly appreciated the wearable showing them their own activities and progress. Moreover, some users stated that they felt motivated by the badges awarded by the wearable and saw them as a reward (i.e., IT-reward). They gave the users a good feeling when they had achieved a goal. The following statement by a user is representative for the use pattern. It summarizes how the user tried to reach the goals set by the wearable (i.e., IT-goal setting), how she observed her goal achievement (i.e., IT-observation), and how she was motivated by the badges awarded by the wearable (i.e., IT-reward):
“I always try to reach the goal that the watch sets. It always calculates the new goal for the next week depending on how many calories I burnt the week before. I think that's quite nice. Sometimes it's also really stressful because the watch demands that I always close these three activity rings: the movement, active calorie, and standing ring. I always get such beautiful, colorful awards when I manage to do that. Humans are so predictable, but it simply works - terrible. I always have to laugh at myself when I'm happy, when such a firework appears on my watch.” (female, 24, student)
The same participant explained how the cues received from the wearable (i.e., IT-cuing) caused her to comply:
“Sometimes I stand in the bathroom brushing my teeth just before midnight. Then the watch says: ‘Come on, there are still six minutes of activity missing!’ and it suggests what to do to close this ring. Then I sometimes stand in the bathroom and walk on the spot or I make jumping jacks. It's such a nice feeling of success that you can go to bed with in the evening.” (female, 24, student)
In this wearable use pattern, users assigned leadership to the wearable and complied with the behavior it suggested. Users delegated leadership to the technology and used it as a way to control their actions, and deliberately pressured themselves to perform the activity and achieve the goal set by the device. Users indeed reported moving more in their everyday life, however, only as much as the wearable demanded of them. Their behavior remained closely coupled to the device, even though they may have been using the device for several years. Users relied on the wearable as a continuous external motivator as well as an “objective measure” because they were unwilling or unable to assess, for example, their own level of activity. Instead, they sought continuous confirmation from the device.
IGNORING: Ignoring leadership strategies provided by wearable and the outcome of no behavior change
Similar to the first wearable use pattern, the wearable offered various leadership strategies. However, these were ignored by the users and sometimes even perceived as disturbing. In this pattern, users were not motivated to change their physical behavior and the wearable can be compared to an ignored instructor.
The primary use purpose for some users was to explore the technical functionalities of the wearable, while others wanted to record and archive their own physical parameters. Although the users did not intend to change their behavior, they regularly interacted with activity-related functionalities such as the step counter and its daily or weekly overview and activity reminders. Some users also recorded their sleep or took part in challenges with other users.
The users in principle accepted the goals set by the wearable and considered them to be desirable (i.e., IT-goal setting). However, when the wearable sent them requests for action (i.e., IT-cueing) throughout the day, the users did not respond to them with compliance. They argued that they could not or did not want to comply with the wearable’s request due to external constraints (e.g., time limitations, local environment). Rather, they were annoyed and clicked the message away, as stated by one interviewee:
“The watch tells me once an hour that I should sit down and breathe consciously. I always deactivate this message when it appears the first time. It annoys me. And when I sit too long, it tells me to get up. That annoys me, too. I can't just get up in a meeting and say, ‘My watch just said I have to get up and move for a minute’.” (male, 31, account manager)
Furthermore, when the wearable informed the users about the discrepancy from the behavioral goal (i.e., IT-observation), users tended to take notice of this information or even actively look at it on a regular basis. However, they did this more out of interest or self-confirmation, as was the case for physically active users, rather than with the intention of adapting their behavior. Thus, the users remained unaffected when the goals set by the wearable were not achieved. One interviewee stated:
“I still have the initial settings with ten thousand steps, which I do not reach on a normal working day. When I'm in the app anyway, I check how many steps I've made recently. But don’t go outside to do the remaining steps when I see that I am not there yet. I don’t do that.” (female, 32, administrative employee)
Another participant explained how he frequently reviewed his activity and sleep data, but without changing his behavior:
“The greatest benefit is to record data so that I can look at it every evening. So far, I didn't have a specific goal that I wanted to achieve... I just liked sports and wanted to record it and analyze my data. [...] I also find it exciting to observe how I feel in the morning and compare it to the sleep patterns recorded by my watch. I want to know if that correlates. [...] It didn't change my behavior much, I would say. […] I'm always happy when I reach my goals, when the wearable vibrates and the fireworks are displayed. But I never check and think to myself: 'Oh, there are still five thousand steps missing' and walk around.” (male, 27, student)
Many participants mentioned that they took part in challenges through the wearable (i.e., IT-social comparison). Most of them stopped using these features as they lost interest in the rankings over time. Those that continuously used social comparison features did so mainly for self-presentation, rather than for achieving behavior change:
“I'm using Strava, too. It's cool when complete strangers say ‘well done!’ That’s motivating. It's a bit of ‘fishing for compliments’, it's self-confirmation.” (male, 40, product manager)
All in all, in this wearable use pattern, users showed no change in behavior resulting from using the wearable. Some of the users stated that they achieved the goals set by the wearable in their daily lives anyway, and thus perceived a further change in their behavior as unnecessary. At the same time, they showed no motivation to set higher, more ambitious goals that would require a behavioral change. Further reasons for the absence of behavioral change were (perceived) external constraints such as private or professional circumstances.
COMBINING: Combining leadership strategies provided by wearable with self-leadership strategies and the outcome of behavior change
This wearable use pattern is characterized by a high motivation for behavior change and a stronger reliance on the wearable in the initial use phase compared to later phases. Compared to the previously described patterns (i.e., following and ignoring), users developed a sensitivity to their own behaviors over time and acquired self-leadership strategies to complement those provided by the wearable. After that, the wearable did not become obsolete, but continued to accompany the user as an external motivator. Thus, the users combined IT-based and self-leadership strategies. This is the only wearable use pattern in which we observed substantial behavior change, i.e., shifts in behavioral patterns and routines that go beyond the wearable’s requests.
Most users who fit this pattern had a goal, which they wanted to achieve with the wearable, for example, to lose weight, overcome a disease (e.g., Type 2 diabetes), or resolve a sleep problem. Some users were made aware of a health deficit (e.g., low activity levels) by the wearable and were shocked at this insight, therefore criticizing themselves (i.e., self-punishment). One participant reported that the wearable originally made him aware of how little he moved:
“As I often drive to work and have a job where I don't move much, I watch my physical activity. In the beginning, it was shocking when I saw that I only walk two kilometers a day. That is really pathetic!” (male, 24, computer scientist)
To achieve their goals, users tracked their physical activity, in terms of daily steps and sports activities (e.g., speed, distance and pulse while running or cycling), or monitored their sleeping patterns. At the beginning of the use, the users employed the wearable to observe themselves and to gain “objective” information about their own behavior and body functioning.
Users reported that they initially pursued the goals set by the wearable (i.e., IT-goal setting). After a certain period of time, they internalized these goals and defined them as their own personal goals towards which they voluntarily worked (e.g., a daily goal of ten thousand steps) (i.e., self-goal setting). Some users reported that they initially pursued the goals set by the wearable and then increased them gradually on their own initiative and according to their own aspiration, as the following quote illustrates:
“I realized that actually it was not that many steps to the coffee machine and started to move more. I started taking the stairs instead of the elevator and walked to the station instead of taking the bus. At some point I regularly exceeded the standard goal of five thousand steps and then I raised my goal to ten thousand.” (male, 64, computer scientist)
Users also reported that at the beginning of their wearable use, they often looked at the graphics (e.g., progress bars) to check the status of goal achievement (i.e., IT-observation). They always wanted to know exactly where they stood with respect to their goals. Over time, however, users developed an inner feeling for how much or how little they moved (i.e., self-observation). While some users developed a general body sensation allowing them to assess their physical activity, others with a very stable daily routine knew after a while how many steps they were taking on an average day. In both cases, after a certain period of time, users were no longer dependent on the wearable providing them with this information. One interviewee stated:
“In the beginning I often looked at the status of my goals, but today I look at it less, because I can tell for myself whether I have done too little or too much. Today, I notice that myself and that’s the good thing about it.” (male, 60, bank employee)
Similarly, users described how they initially responded to their wearable’s reminders and prompts with compliance (i.e., IT-cueing). Over time, however, they developed a sense of when it was time to move again or drink water, for example. As a result, they moved on their own initiative after a certain amount of time (i.e., self-cueing), even before the wearable prompted them to do so. Thus, they internalized the cues of the technology, as indicated in the following statement:
“I no longer have to receive a warning every time saying ‘Hey you have to move,’ but I notice it myself. When I just sit at my desk and don't move, the Apple Watch automatically tells me after fifty minutes ‘Hey you should get up again.’ However, inside myself I already notice that it is time to move again. I find that impressive.” (male, 60, bank employee)
Positive reinforcement played an important role in this wearable use pattern. Many users reported that they had noticed an improvement in their overall health and fitness as a result of more exercise in their everyday life. This encouraged them to adopt the IT-based strategies and turn them into self-leadership strategies as illustrated by the following quote:
“Last year I had a heart attack. In rehab, I learned that the only thing you can do to not get a second one is to move even more. Based on the wearable’s measurements, I noticed that because I had already moved more, my heart was better than the average. Then, I set my daily goal to fifteen thousand steps, of which I always reached ten thousand. But at one point my way to work became too short and now I'm still taking a detour along the river. Then I am on the move for 1.5 hours. I do that three times a week.” (male, 64, computer scientist)
Interestingly, despite the internalization of the IT-based strategies, none of the users discontinued the use of particular features (e.g., switched off reminders or ignored progress bars). Instead, they continued to receive reminders and to observe their daily activities, goal achievement and overall progress on the wearable. However, their behavior became more and more decoupled from the information provided by the device.
In this wearable use pattern, we could observe a fundamental change in behavior. Users reported moving more in their everyday life, for example, by always taking the stairs instead of the elevator or walking instead of taking the bus. Over time, users learned about their behavioral patterns through the wearable and internalized its leadership strategies. This allowed them to decouple their behavior from the immediate feedback of the device, giving way to voluntary exercise out of intrinsic motivation. However, the wearable still played an important role as “objective proof” and “confirmation” that the users had done “enough” and acted as an additional incentive.
SELF-LEADING: Applying self-leadership strategies supported by the wearable and the outcome of no wearable-induced behavior change
In this wearable use pattern, the wearable serves as a tracker that merely supports self-led users. Users were able to direct their own behavior independently of the wearable and apply appropriate self-leadership strategies. Users indicated that they set their own goals independently of the device (i.e., self-goal setting) and were able to assess their own performance (i.e., self-observation). Interestingly, the application of these strategies led to no behavioral change, at least not any induced by the wearable. If users changed their behavior, it was not triggered by the device, but happened by their own choice.
The self-defined goals were often related to the optimization of the users’ athletic performance. Some users had concrete goals such as preparing for a marathon. The wearable served the purpose of documenting and providing an overview of the training as well as insights into how their body reacted during the exercise. For this purpose, the users recorded vital parameters during sports activities (e.g., heart rate, distance and pace) or their sleep (e.g., resting heart rate), and counted their steps.
The wearable served merely as a tool for monitoring the achievement of self-imposed goals (i.e., self-goal setting). While some users set their own goals only mentally, others used the device’s goal management features to enter them manually (e.g., step goal) as mentioned by one participant:
“Garmin used to adjust my step target automatically at the beginning. But I switched that off. Now I have it set at fixed ten thousand steps. As I said before, I move a lot and it would stress me if the number of steps was even higher. I can also choose how many workouts I want to do per week. That's between three and five for me, otherwise I'm training too much.” (male, 31, personal trainer)
Users recorded their activities according to their own needs and the wearable served as a digital logbook. Depending on their own preferences, some users recorded their activity continuously, while others selectively recorded specific activities. Moreover, users selectively looked at particular information provided by the wearable and were also able to interpret it and draw conclusions for their own behavior (i.e., self-observation). Recording and looking at one’s own performance and possible progress alone was motivating.
Despite observing their own physical activity regularly, some users underlined that they would attend to how their body felt rather than to the device during training. One interviewee stated:
“It is very exciting to see that I have a much lower pulse when swimming than when jogging, for example. In tennis, of course, it makes a difference whether I play singles or doubles. […] But these values are one thing; the subjective feeling is actually much more important. When you feel good, they don't matter.” (male, 62, retired lawyer)
In addition, one participant stated that despite using the heart rate monitor during training and competitions, he relied primarily on his body:
“I have been training for ten years and I base my training exclusively on how my body feels. I want my body to say when something is wrong. I have quit races from time to time when I had the feeling that something was wrong or I felt short of breath in places where it should actually be easy.” (male, 58, consultant)
In this wearable use pattern, leadership resided predominantly with the user. However, we did not observe any wearable-induced behavioral change in this pattern. Most users stated that they kept an already high level of physical activity constant or increased it based on their own initiative. The self-led and intrinsically motivated users regarded the wearable as a useful tool to optimize their everyday life and their sports activities in particular. The wearable provided them with valuable information allowing them to assess their performance more precisely and to make more informed decisions about their future behavior (e.g., to exercise more or less). Thus, the wearable played more of a supporting rather than a persuasive role, as the users performed their physical activities anyway out of intrinsic motivation and did not have to be driven by the wearable. In this pattern, the use of wearables seemed to be a self-leadership strategy in itself, in the sense of a natural reward strategy that was applied in addition to self-goal setting and self-observation. Some users incorporated the wearable into their activity as a kind of natural reward for their performance and thus made the activity even more pleasant and enjoyable (i.e., leadership strategy of making activity more appealing).