The Interpretative Flexibility of Smart Wearables. A critical reflection on the promise of smart wearable technology
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This research is commissioned by the Netherlands Environmental Assessment Agency, which is exploring the role and meaning of smart urbanism. One of the smart city developments is the increased employed of smart wearable technologies. These technologies could play an important role in the transition towards a smarter health system that prioritizes preventive care strategies. This research critically investigates the promises and expectations surrounding smart wearable technology by examining how wearable technologies are integrated in daily lives of users. It attempts to discover the interpretative flexibility of the ‘practice of wearable technology’, identify the main issues surrounding wearable technology and explore the implications for the further diffusion of this technology. The following research question is answered: What is the interpretative flexibility of smart wearable technology and what are the implications for the social embedding of smart wearable technology? The Q methodology, a method for examining subjectivity, was employed to inductively identify the different interpretations of Fitbit users. The analysis yielded three social groups, labelled as ‘privacy protectors’, ‘competitive health fanatics’ and ‘gadgetheads’, who each have a different interpretation of wearable technology. The main differences between the interpretations of the social groups are based on three dimensions: data, healthcare possibilities and level of social use. For a successful social embedding of wearable technology, it is essential that the interpretations and issues of each social group are acknowledged and addressed. Each interpretation has different implications for how this technology can be embedded, and understanding these implications helps to devise socially desirable policies. Interviews with key practitioners revealed the main barriers for the social embedding of smart wearable technology. These barriers are issues concerning the Health Insurance Act, data security, data transparency, accuracy, reliability, interoperability, accessibility, awareness and governance. Various pathways have been suggested that can help tackle these issues; stimulating preventive care strategies, creating added value and simplifying wearable technology must be key objectives. This research has demonstrated that wearables have the potential to contribute towards the development of a smarter healthcare system in which preventive care strategies can flourish. However, in order to realize this development, it is important to adapt aspects of the healthcare system, as well as aspects of smart wearable technology. All parties involved must understand and experience the importance of preventive care and acknowledge the role that wearable technology could play in preventive care strategies before they start employing them. If the aim is to increase the use of wearables, it is crucial to assess each situation separately, and tailor-fit the practice of wearable technology to the specificities of the different social groups.