The program, run as a community-based public health promotion effort, offered participants wearable activity trackers linked to a mobile app that supported step monitoring, personal goal setting, and a points system redeemable for health-related products. The researchers purposively recruited participants across different levels of engagement, deliberately seeking out both enthusiastic users and those who had drifted away, in order to capture the full range of experiences with the technology. Fifty participants took part in the focus groups, with a mean age of 40.1 years and 44 percent men.

The research team stratified the analysis into two age bands, 19 to 39 years and 40 to 64 years, and analyzed the transcripts inductively, allowing themes to emerge from the data rather than testing predetermined categories. Credibility was reinforced through double coding of the material, peer debriefing among the researchers, and triangulation across data sources. The age-stratified results point to fundamentally different motivational engines in the two groups. Younger adults framed their engagement around appearance, fitness, and the appeal of exploring new technology, treating the wearable partly as a gadget and partly as a fitness tool. Middle-aged adults, by contrast, emphasized health maintenance and practical rewards, treating the device as a means of sustaining long-term wellbeing and extracting tangible value from the points they accumulated through daily activity.

Across both age groups, the researchers identified a common set of facilitators that kept people engaged. Ease of use mattered, as did real-time feedback, the immediate visibility of steps and progress that the tracker and app provided. Trust in the public program itself also emerged as a facilitator, suggesting that the government sponsorship of the initiative lent credibility to the technology. The barriers were equally concrete. Participants reported technical issues that disrupted their tracking, limited personalization in the feedback and goals the app offered, and administrative inconvenience in dealing with the program. These friction points, rather than any loss of interest in health itself, appear in the accounts as the forces that eroded sustained engagement with the devices.

When asked what would improve the program, participants converged on three recommendations: more personalized feedback tailored to individual patterns, automatic data synchronization to eliminate manual steps and technical glitches, and broader usability of the reward points so that the incentives would feel more valuable and flexible. Each recommendation maps directly onto a barrier identified in the analysis, linking the technical shortcomings to concrete design changes. The study’s authors conclude that enhancing technical reliability, personalization, and age-sensitive design is essential for sustaining engagement and maximizing the public health impact of such initiatives. The age-sensitive element is the distinctive contribution of this work: because younger and middle-aged adults cited different motivations, a one-size-fits-all interface and reward structure may serve neither group optimally. A program that highlights fitness and novelty for younger users while emphasizing health maintenance and practical rewards for middle-aged participants would align the design with the motivations each group actually reports. As governments expand wearable-based health promotion programs to address chronic disease, which remain major public health concerns worldwide, the Seoul findings indicate that the factors influencing sustained engagement are not uniform across the population a program serves, and that understanding them by age group is a prerequisite for keeping citizens wearing the devices long after the initial novelty fades.

Subject of Research: Age-related differences in motivations, barriers, and facilitators of wearable and mobile app use in a government-led digital health initiative in Seoul, Republic of Korea

Article Title: Age differences in motivations, barriers, and facilitators of wearable and mobile app use in a government-led digital health initiative: a qualitative study

Article References: Yoon, J., Lee, M., Kim, S. J., Han, J., Joo, J., Cho, H., & Cho, J. (2026). Age differences in motivations, barriers, and facilitators of wearable and mobile app use in a government-led digital health initiative: a qualitative study. BMC Public Health. https://doi.org/10.1186/s12889-026-29596-z

Image Credits: AI Generated

DOI: 10.1186/s12889-026-29596-z

Keywords: wearable activity trackers, digital health, mobile health apps, qualitative study, focus groups, public health, age differences, health behavior, Seoul, patient engagement, differences, motivations