Abstract
BACKGROUND: Digital health interventions targeting behavior change are promising in adults and adolescents; however, less attention has been given to younger children. The proliferation of wearables, such as smartwatches and activity trackers, that support the collection of and reflection on personal health data highlights an opportunity to consider novel approaches to supporting health in young children (aged 5-11 y). OBJECTIVE: This review aims to investigate how smartwatches and activity trackers have been used across child health interventions (for children aged 5-11 y) for different health areas, specifically to identify the population characteristics of those being targeted, describe the characteristics of the devices being used, and report the feasibility and acceptability of these devices for health-related applications with children. METHODS: We searched 10 databases (CINAHL, Embase, ACM Digital Library, IEEE Xplore, Cochrane Library, PsycINFO, Web of Science, PubMed, Scopus, and MEDLINE) to identify relevant literature in March 2023. The inclusion criteria for studies were as follows: (1) peer-reviewed, empirical studies; (2) published in English; (3) involved a child aged 5 to 11 years using a smartwatch for health-related purposes. Two researchers independently screened articles to assess eligibility. One researcher extracted data relating to the 3 aims and synthesized the results using narrative and thematic synthesis. RESULTS: The database searches identified 3312 articles, of which 15 (0.45%) were included in this review. Three (20%) articles referred to the same intervention. In 77% (10/13) of the studies, the devices were used to target improvements in physical activity. Other applications included using smartwatches to deliver interventions for emotional regulation and asthma management. In total, 9 commercial devices were identified, many of which delivered minimal data feedback on the smartwatch or activity tracker, instead relying on a partner app running on a linked parental smartphone with greater functionality. Of the 13 studies, 8 (62%) used devices designed for adults rather than children. User feedback was positive overall, demonstrating the acceptability and feasibility of using these devices with children. However, the studies often lacked a child-focused approach, with 3 (23%) studies gathering user feedback only from parents. CONCLUSIONS: Interventions involving smartwatches and activity trackers for children aged 5 to 11 years remain limited, primarily focusing on enhancing physical activity, with few studies investigating other health applications. These devices often provide limited data feedback and functionality to support children's independent engagement with the data, relying on paired smartphone apps managed by caregivers, who control access and facilitate children's interaction with the data. Future research should adopt child-centered methods in the design and evaluation of these technologies, integrating children's perspectives alongside their caregivers, to ensure that they are not only feasible and acceptable but also meaningful and effective for young children. TRIAL REGISTRATION: PROSPERO CRD42022373813, https://tinyurl.com/4kxu8zss.