Table 3.

Factors influencing adherence to the self-monitoring system.

Theme	Facilitators	Barriers
Usability and technical aspects	Minimal effort required for wearables (passive data collection) Perceived ease of use of some components (dashboard and step tracking) System reliability when functioning properly Integrated within the care platform, ensuring security without the need for multiple apps	Technical frustrations (synchronization failures and inaccurate readings) Repetitive chatbot questions Issues with usability, reminder preferences, and navigation Battery life concerns with wearables Discomfort (eg, skin irritation) Already owning a better functioning device that could not be integrated Limited abilities of the watch
Motivation and perceived usefulness	Perceived benefit of self-monitoring for health insights Positive reinforcement from tracking progress Goal setting motivation (for some patients)	Low perceived personal relevance No immediate feedback or tailored insights Lack of motivation to engage with the system
Psychological factors	Habit formation over time (routine integration) Sense of accountability and self-awareness	Psychological burden from continuous tracking (stress and anxiety) Self-monitoring fatigue (overwhelming number of reminders) Frustration with tracking unexpected fluctuations (eg, heart rate spikes)
Lifestyle behavior change	Increased awareness of physical activity and nutrition Some behavior modifications based on self-monitoring	Minimal impact of self-monitoring on stress awareness and management Limited engagement with lifestyle goal-setting features
External and social influences	Support from the study team and research nurse Social support from partner and social environment	Competing priorities (work and personal life distractions) Interruptions due to holidays, travel, or daily schedules Preference for wearing a different-looking watch for special occasions
Customization and adaptability	Flexibility in wearable use (passive tracking) Structured chatbot reminders (eg, notifications) The ability to configure and adjust the timing of chatbot prompt notifications to align with individual routines	Limited chatbot personalization (eg, saving meals)