Wearables and the science of human behavior change - part 1 (january 2014)

Inside Wearables
How the Science of Human Behavior Change
Offers the Secret to Long-Term Engagement
January 2014
Dan Ledger, Principal, Endeavour Partners 
Daniel McCaffrey, Behavioral Scientist & Product Manager, SyncStrength
© 2014 Endeavour Partners LLC
www.endeavourpartners.net

About This White Paper Series
In the last 18 months, wearable devices, such as wristbands, smartwatches, eyewear,
wearable bio-monitors, and the complementary services that support them have become
the focus of much speculation and anticipation. Companies as varied as large original
equipment manufacturers (OEMs), mobile network operators (MNOs), health insurers and
service providers are circling a huge potential market alongside tiny startups, all vying for
a stake. Yet the path to consumer adoption and sustained long-term engagement is far
from clear. Endeavour Partners has found that many businesses are struggling to
understand these technologies and how they can be effectively leveraged to create
unique and sustainable value, as well as a competitive advantage.
This white paper is the first in a series from Endeavour Partners that addresses critical
strategic issues in wearable devices and services, the factors that are significant
contributors to long-term success, how to design workable business models to create
and capture value, and future opportunities in this space.
This series will answer several key questions for companies launching their own
wearable products and services and those building services on top of the existing
products in market.
• Where are the opportunities to create and capture value both in hardware and within
the complementary services? How will the business ecosystem evolve in the future?
Which types of players will win and which types will lose?
• How are wearable devices changing consumer behavior? Why do so many products
fail to achieve long-term utilization?
• What will the future technology and ecosystem landscape look like?
About Endeavour Partners
Endeavour Partners is a boutique strategy consulting firm / think tank with deep expertise
in mobile and digital businesses and technologies. We are a diverse team of passionate
practitioners including MBAs, engineers, data scientists, behavioral scientists,
economists, and programmers. We help clients anticipate the future, navigate the
resulting opportunities and develop creative and innovative strategies for growth. For
more information about Endeavour Partners or to learn more about the future of
wearables, contact Dan Ledger at dan@endeavourpartners.net or +1 (617) 949-1437. 
© 2014 Endeavour Partners LLCPage of1 17

Wearable Devices are Finally Achieving Mass Market
Penetration in the United States
Skeptics and proponents of the wearables market alike recognize the significant
technological innovations taking place and the opportunities for profits. Successful
ventures in this space will enable new revenue streams through services and/or
hardware or increase bottom line revenues by improving healthcare outcomes and
reducing costs. For companies across the value chain, the stakes are high.
Endeavour Partners recently conducted an Internet-based survey of thousands of
Americans and concluded that as of September 2013, one in ten U.S. consumers over
the age of 18 now owns a modern activity tracker from the likes of Jawbone, Fitbit, Nike,
Misfit Wearables, and others
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1 in 10 Americans
over 18 now owns
an activity tracker
Endeavour Partners’ survey did not include households without Internet access1
U.S. Activity Tracker Ownership  
(Endeavour Partners, September 2013)

Furthermore, there is a bimodal distribution among users by age. There is a younger
cohort of adopters, most of whom fall into the 25-34 age range. These users are
primarily focused on ﬁtness optimization. There is an older cohort of adopters between
age 55-64, who are focused on improving overall health and extending their lives. There
is a broad opportunity to launch wearable products and services targeting different
cohorts, and speciﬁc personas within those cohorts.
These consumers have adopted — with greater and lesser degrees of success — a
variety of wearable products and related wellness services designed to help them live
healthier lives by altering their habits.
While some companies have introduced wearable hardware and services, others have
built service offerings that leverage the multitude of devices in the market. Each of these
has a different value proposition or feature mix that claims to offer a unique method for
harnessing the power of the mobile Internet to meet consumer needs and preferences.
18%
0%
10%
20%
30%
19%
16%
% of activity tracker owners
% of U.S. population
25%
13%
17% 18%
20%
16% 15%
17%
7%
18-24 25-34 35-44 45-54 55-64 65+
Age group
Percent of Activity Tracker Owners vs. Percent of U.S. Population By Age

For example, mobile network operators such as AT&T, healthcare providers and insurers
such as Humana Inc., and data aggregators such as Tictrac and Foxing have each
introduced services that integrate with consumers’ wearable devices. AT&T’s mHealth
Platform is an open developer ecosystem that gives consumers the ability to aggregate
health data from applications and devices. Humana offers an activity tracker rewards
program and an app that integrates ﬁtness and eating behaviors. Tictrac and Foxing
collect and aggregate data from different activity trackers and body measuring devices.
The Dirty Secret of Wearables
In the midst of this frenzy of anticipation, the dirty secret of wearables remains: most of
these devices fail to drive long-term sustained engagement for a majority of users.
Endeavour Partners’ research reveals that more than half of U.S. consumers who have
owned a modern activity tracker no longer use it. A third of U.S. consumers who have
owned one stopped using the device within six months of receiving it.
Declining Rate of Sustained Activity Tracker Use Over Ownership  

The lack of long-term utilization raises the stakes for any company incorporating
wearables and related data into its products or services. It’s not enough to sync with, link
to, or work alongside one of the current devices on the market, or to partner with one of
the many startups to design an even better device. Designing a strategy to ensure
sustained engagement is the key to long-term success in this highly competitive space.
The Goal: Sustained Engagement
The criteria for success for many wearable devices and services goes well beyond
adoption. Success is deﬁned by the degree to which these devices and services make a
long-term impact on their users’ health and happiness.
Products and services that provide utility but fail to have a meaningful impact on users’
behaviors and habits -- such as an activity tracker that provides data but doesn’t inspire
action -- end up failing in the market. Users quickly abandon wearables that don’t help
them make positive changes. Devices that offer functionality to help the wearer change
their habits also promote sustained behavior change and lead to long-term health.
This reliance on behavior change means that traditional product design criteria are only
part of the key to developing successful wearable products and services.
There are several well-known criteria that are essential for adoption and short-term
utilization of wearable products and services. We refer to these as the “9 baseline
criteria” (summarized on the following page). Each of these criteria must be met; a failure
in one can lead to the overall failure of a product or service. However, these criteria
alone are not sufficient for long-term engagement, which is why we must turn to
behavioral science for answers.
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The 9 Baseline Criteria
Each of the criteria below must be met to drive initial adoption and utilization;
however, these criteria alone are not sufficient to drive long-term utilization
Selectability / Adoptability - The clarity, relevance and uniqueness of the value
proposition to consumers is essential for adoption; there are many similar choices in
the market and consumers are generally not familiar with this category of devices and
services, making selection a potentially stressful experience.
Design / Aesthetics - The majority of wearable products today are worn in a manner in
which they are visible. The aesthetics of a product are therefore critical. Companies
that embrace design elegance over breadth of features are more likely to find users
wearing their products for a longer period of time.
Out-of-Box / Setup Experience - The quality of the initial experience with a product or
service is critical. Companies starting from an idealized out-of-box experience will likely
achieve a far more pleasant and lasting initial experience than those that don’t.
Fit / Comfort / Form Factor - The fit and overall comfort of a device are critical for
adoption and sustained utilization. This extends well beyond the comfort of simply
wearing the device. Other common activities need to be considered. For example,
wrist-worn wearables with thicker bands can quickly become irritating in a number of
different activities like typing on a laptop.
Quality / Robustness - As Jawbone experienced in its initial launch of the Jawbone Up,
building a reliable wearable device is hard. A device that is designed to be worn on the
wrist throughout all of life’s activities experiences a high degree of wear and tear.
User Experience - The user experience must be immediately intuitive, familiar and
seamless which must transcend the device, the mobile app, web-services, and overall
support.
API / Integratability - Many devices and services support APIs such that data can be
accessed by other services to create new types of benefits for the users. As more
services become available that can leverage this data, the overall experience improves.
Lifestyle Compatibility - The less behavior change a device requires in order to simply
wear it, the more likely that it will drive longer term engagement. The more times per
week the user is required to take the device off (to charge or sync the device, or to take
a shower), the more likely they are to abandon it.
Overall Utility - Wearable devices and services built around them need to be designed
with a clear intent of how they will help people. Products and services that gather data,
and simply provide distillations of that data without a clear purpose will fail to achieve
any sustained utilization.

3 Behavioral Science Factors for Long-Term Engagement
In addition to the more well-known factors that influence adoption, there are many other
lesser-known behavioral factors that are as important – or perhaps more so – to long-
term sustained engagement. These factors are less understood and, in most cases, not
taken into consideration by companies moving into the wearables space, either with their
own devices or with products and services that leverage wearables.
As the market develops and the opportunities and challenges grow, these more nuanced
issues will be the ones that can make or break a product. But how can companies know
before launch whether a product or service will succeed? The answers to questions
about what will encourage or inhibit long-term sustained engagement can be found in
the field of behavioral science.
Human behavior is infinitely complex and in many ways, we are just beginning to
understand what makes us do what we do. The mechanisms that govern habit formation,
motivation, and how we perceive progress are particularly important for sustained
engagement.
In this section, we will present these factors in a manner that is accessible to those
designing products and services that leverage wearable devices.
Key Factor #1: Habit Formation
Sustained engagement with a wearable device or complementary service depends on its
ability to help the user form and stick with new habits.
Psychologists define habits as automatic behaviors or routines that are triggered by
situational cues, which are then followed by some form of reward. For example, when
we feel lonely (internal trigger) or receive a push notification (external trigger) while riding
the subway (situational cue) we check Facebook (behavior), and may experience
pleasure (reward). Decades of psychological and cognitive neuroscience research have
been spent studying the habit formation process.
Habit formation is a complex process that occurs over time. The behavioral sciences of
human decision-making and the applied practices of behavior change, goal setting,
cognitive neuroscience and health psychology offer critical insights about this complex
process.

Bad habits can be incredibly hard to break, despite a person’s desire to break them. Dr.
BJ Fogg at Stanford University reports that people so desperately want to change bad
habits that they set goals that are unattainable and unrealistic, leading to a vicious cycle
of personal failure and disappointment.
Wearable devices can help make the process of habit formation more effective and
efficient than ever before. The best engagement strategies for wearables will move
beyond presenting data (steps, calories, stairs) and directly address the elements of the
habit loop (cue, behavior, reward) and trigger the sequences that lead to the
establishment of new, positive habits.
BASIS Science, Inc is currently offering a wearable device, the Basis watch, which has an
effective habit change sequence solution. The Basis watch uses four types of sensors in
a lightweight customizable design to calculate various health metrics, including steps
taken, calories burned, sleep quality and resting heart rate. Basis emphasizes “life-long
wellness” and its watch guides users through a sequence of behaviors to create
desirable health habits.
Basis’ concentration on wellness as a whole, instead of speciﬁcally on exercise, helps
produce long-term sustained engagement. This is supported by a year-long research
study from the University of Michigan. The study showed that participants who adhered
to a long-term exercise regimen wanted to “enhance their daily life and wellness” and
were not exercising in order to “lose weight.” Researchers concluded that rebranding
exercise as a means to enhance wellness versus ﬁtness is a more effective way to
promote sustainable participation (Segar, 2011).
As Basis users navigate the initial goal setting process, the device sets up a sequence of
key habit formation elements -- cues, routines and rewards. Basis only lets users set one
goal for the following week because research shows that building life habits is easier
when people add changes in small increments over time.
The Basis goal setting sequence requires users to unlock the ability to add new habits by
acquiring points (reward) after completing a previous goal related to successfully
establishing a habit. From here, daily cues, routines and rewards are continuously
sequenced to develop habits for better health.

Key Factor #2: Social Motivation
Sustained engagement with a wearable device or complementary service depends on its
ability to effectively motivate users. Social connections are a particularly powerful source
of motivation that can be leveraged in many creative ways. In addition to using social
connections to inﬂuence behavior, social media and networking sites can be exploited to
alter habits for positive outcomes. This includes the communication of social norms
through ‘postings’ or ‘sharing’ of thoughts, pictures and comments with one another.
There are three key social mechanisms which support motivation and broader goal
attainment.
First, when users are able to share their goals or compete for goals with an audience or
group, they are more committed to achieving these goals (Cialdini, 2001; Ellison, 2007;
Locke, 2001). The human factors and mechanisms at work here include social support
from friends and family, as well as the fear and guilt from losing social capital by not
reaching a goal. Communicating goals on social networks such as Facebook and
competing or collaborating with others increases the likelihood of an intention to enact
behavior change.
Second, Bandura’s social cognitive theory (Bandura, 1986) posits that we learn not just
from our own experiences, but also vicariously from observing those around us. This
means that people do not learn solely by trying new behaviors and succeeding or failing.
For example, if person A observes that person B has lost 10 pounds by using an activity
tracker, person A learns that he or she may be be able to lose weight if he or she
acquires an activity tracker and replicates the same behavior. Bandura's social
motivation research has been used to predict behavior change in various health related
situations such as weight loss, smoking cessation and heart attack recovery.
Finally, social factors are huge determinants in our overall health (Lunstad et al., 2010).
Matt Lieberman’s Social Cognitive Neuroscience research lab at UCLA reports that
connecting socially with others is as basic as our need for food, water and shelter
(Lieberman, 2013). The extent to which these devices facilitate social connections has a
broader secondary effect on users’ overall health.

Leveraging social components into wearable products and services to increase
motivational factors must be done carefully. Companies must consider the impact and
added value that these devices and services will have on social relationships and
interactions as well as personal privacy, cultural inﬂuences and shared patterns of
behavior. However, when implemented properly, wearable devices can also drive a
sustained engagement through existing and new social network platforms and support
broader social media strategies.
Two examples of wearables that establish motivation by effectively leveraging social
connections are Polar Loop’s Flow Web service and the Nike Fuelband SE/Nike+ service.
Through Polar Flow, users are able to connect, share and encourage other people
around the world that also have a Polar Loop and are active. This gives the user a sense
of an online social network to share and compare with people around the world who also
want to do the same. In addition, users are able to view and share running or cycling
routes with people with whom they become friends on Polar’s platform.
Through the ‘Explore’ feature, they can see training routes of their ‘friends’ around the
world. Users traveling to new destinations are able to learn which routes and trails make
the most sense for them based on a comparison with a friend’s training regimen who
lives at that destination. This platform allows users to leverage three key social
mechanisms: group sharing, observational learning, and improved health through more
social connections.
The Nike+ platform encourages users to challenge friends from Facebook and their
personal address book who also use the Nike platform. The FuelBand's Nike+ software
includes the ability to separate friends into speciﬁc lists and groups. This way, users can
compare or compete against fellow Fuelband owners and group them into micro
communities. The ease of using Facebook puts Nike's wearable ahead of the social
competition, and the Fuelband device will connect to other social networks in the future
as well. This platform also allows users to leverage all three key social mechanisms.
Surprisingly, there are devices that limit the degree to which users can leverage social
channels to provide motivation and commitments to broader goals. For some devices
and services, users are unable to communicate within or across platforms to share data
socially with other users. This effectively limits the potential for users to reach their
goals. For example the Basis B1 logs a great deal of personal data, but does not provide
a social outlet to compare or compete with other Basis users.

Wearables may be the next frontier of online social networking as they have the potential
to integrate the mechanisms of sociability into our health, work and daily lives.
Key Factor #3: Goal Reinforcement
To achieve sustained engagement, a user needs to experience a feeling of progress
toward deﬁned goals.
Dr. BJ Fogg, director of Stanford Persuasive Technology lab, observes that the success
from achieving several smaller goals (which he refers to as “baby steps”) provides the
positive momentum necessary for achieving bigger goals. By setting small goals, people
are less likely to over-reach and fall short, and thereby gain the momentum necessary to
progress. This allows people to experience a sense of continuous progress.
Continuous progress requires objective feedback about progress and milestones. The
right feedback allows people to take the next step needed to gain momentum, move
forward and experience regular progress. This is in stark contrast to how people have
traditionally received feedback from people like teachers, doctors, coaches, managers or
personal trainers; this tends to be far more infrequent and less personalized.
One unique characteristics of wearable devices is their persistent presence. These
devices are always aware, always on and always connected to our skin. These wearable
devices now are able to track steps, calories, heart rate and body temperature, among
other metrics, and do so both passively and constantly. By being constantly connected
to our devices, we remain connected to our goals and can experience our progress via
on-demand feedback.
Products and services that help people experience continuous progress do so through
real-time updates that are powered by big data and insights. These products and
services point to a revolution in human persuasion strategy. When people are presented
with accurate, clear and concise real-time feedback regarding their actions, they are able
to alter behaviors they once thought unchangeable.

The Fuelband SE is an example of a wearable that applies these mechanisms to personal
progress. Throughout the day, users are notiﬁed directly on the visual interface about
‘hours won or lost’ based on the activity level for that hour. If users ‘won the hour’ then
they are given positive feedback with a congratulatory message. This way, users are
constantly connected to their hourly and daily progress, based on goals already set. In
addition to the Fuelband SE, other devices such as the Jawbone Up24 and the Fitbit
Force send users hourly cues through haptic buzzes and text message push notiﬁcations
to support progress. These devices constantly but gently remind users that they need to
do something in order to achieve their established goal.
Wearable devices and services have the opportunity to engineer personal progress for
users in a way that has never been experienced. These devices and services can now
be used as tools that facilitate efficient personal progress and provide feedback that
allow individuals to make healthier decisions about diet, lifestyle and exercise.
Facilitating personal progress will lead to improved health, user satisfaction and long-
term sustained engagement.

How Modern Wearables Stack Up
The success of a wearable depends on its adoption by the market and how well it
inspires long-term engagement. Adoption and sustained engagement depend, in turn,
on the twelve critical factors described above. While the nine well-known criteria are
crucial for adoption and short-term success, the three lesser known insights offered by
behavioral sciences are essential for driving long-term engagement.
Endeavour Partners assessed eight wearables currently on the market. We incorporated
them into our lives and experienced their strengths and weaknesses ﬁrst hand. We then
assessed each qualitatively, based on the twelve key criteria discussed in this report. We
found that while some companies are clearly thinking about their products holistically,
some are missing the mark.
Our assessment, presented on the next page, ranks the Basis B1 Watch, Jawbone Up24,
Nike Fuelband SE, FitBit Force, Polar Loop, Withings Pulse, Nike Fuelband, and Skechers
Go Walk.
Our research suggests that a low score in just one area can limit initial adoption, on-
going use, and ultimately, long-term engagement. Some companies understand this
better than others. Polar Loop, for example, scores well on three key behavioral criteria
of habit formation, social motivation, and goal reinforcement. It is too early to know
whether this attention to behavioral psychology will translate into success in the market.
Some companies are already beginning to embrace the complex science of behavior
change and habit formation; however, there remains a great deal of potential for
advancements in this area within this industry. Furthermore, technological advancements
including the availability of real-time biofeedback (heart rate, skin temperature, blood
pressure) and contextual data information (at the office, with a signiﬁcant other) will
change how technology impacts consumers’ health-related attitudes, beliefs and
behaviors even further. They will also allow companies involved with wearables to create
ever more effective and successful devices and services to promote health and wellness.
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How Modern Activity Trackers Stack Up
These graphs show how 8 wearable products in the market score against the 12 essential
factors that drive long-term engagement (9 baseline in blue and 3 behavioral in orange)
Basis B1 Watch Jawbone Up24 Nike Fuelband SE
Fitbit Force Polar Loop
Withings Pulse Nike Fuelband Skechers Go Walk
Selectability
Design
OOB Experience
Fit / Comfort
Durability
User experience
API
Lifestyle
compatibility
Overall utility
Habit formation
Social motivation
Goal reinforcement

How We Can Help
Endeavour Partners is a strategy consulting ﬁrm with deep expertise in mobile and digital
businesses and technologies. We help clients anticipate the future, navigate the
resulting opportunities and develop creative, innovative strategies for growth.
We work with top executives of companies impacted by the business and technology
forces at play in the mobile and digital sectors. We know how to understand what
consumers will want before they realize it themselves.
Why Choose Endeavour Partners?
We have a diverse team of practitioners from a variety of industries including MBAs,
engineers, data scientists, behavioral scientists, economists and programmers. We bring
years of experience to the table – in business, technical and even academic capacities.
This team allows us to bring a multi-disciplinary perspective to our engagements and to
offer more nuanced analysis and insight.
We have developed a broad network of relationships within our areas of expertise, built
over years of experience working in mobile and digital technology. We activate this
network in our engagements to understand how each player in an ecosystem is thinking
and likely to act. In addition, we are closely aligned with academic institutions – MIT,
Harvard and London Business School – that drive leading-edge thinking in business and
technology.
We love what we do. We are passionate about mobile and digital technology and
passionate about driving our clients’ success. This translates into highly driven and
active thought partners who are eager to have an impact.
For more information about Endeavour Partners or to learn more about the future of
wearables, visit us at www.endeavourpartners.net, or contact Dan Ledger at
dan@endeavourpartners or +1 (617) 949-1437.
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About the Authors
Dan Ledger, Principal, Endeavour Partners 
Dan is a principal at Endeavour Partners where he has led a great deal of research on
wearable devices, and consumer wellness in general. Dan has advised numerous
startups, as well as larger service providers on product deﬁnition, service design,
ecosystem strategy and go-to-market planning within this space. Prior to joining
Endeavour Partners, Dan worked for almost 15 years in the chipset business as an
embedded system engineer and manager. Through this experience, he brings a rich
understanding of the underlying technologies that go into wearables, and how they are
evolving. Dan holds a Master’s Degree from the Massachusetts Institute of Technology
and a dual Bachelor’s Degree from Washington University in Electrical Engineering and
Computer Engineering. He can be reached at dan@endeavourpartners.net.
Daniel McCaffrey, Behavioral Scientist & Product Manager, SyncStrength 
Daniel is a behavioral scientist and co-founder of SyncStrength Data Analytics who
consults with companies on combining behavioral science and mobile technology in the
broader consumer health space. He has experience across the healthcare ecosystem as
a behavioral scientist (Harvard Medical School), clinical researcher (National Institute of
Health) and health consultant (Co-founder of iBELIEVE). His past research in
neuroscience and cognitive psychology was conducted at the Brigham & Women's
Hospital, Massachusetts General Hospital and the National Institute of Mental Health. He
has published multiple peer reviewed articles and book chapters in neuroscience and
neuropsychology. Prior to this, Daniel gained valuable management experience in the
private sector at Goldman Sachs & Company and Citibank. Daniel holds a Bachelor’s of
Science and a Master’s of Business Administration from Quinnipiac University and a
Master’s Degree in neuropsychology from Suffolk University. He can be reached at
daniel@syncstrength.com and @demccaffrey.

Works Cited
Bandura, A. “Health promotion from the perspective of social cognitive theory.”
Psychology and Health, 1986, 13, 623-649.
Cialdini, R. B. Inﬂuence: Science and practice (4th ed.). Boston: Allyn & Bacon. 2001.
Fogg, B.J. “The new rules of persuasion.” RSA Digital Journal, Summer 2009. Online.
Holt-Lunstad J., Smith, T., Layton, J. “Social Relationships and mortality risk: A meta-
analytic review.” PLOS Medicine, 2010, 10.1371.
Lieberman, M. Social: Why Our Brains Are Wired to Connect. Random House Inc. 2013.
Locke, E.A., Latham G.P. “Building a Practically Useful Theory of Goal Setting and Task
Motivation: A 35-Year Odyssey (2001).” American Psychological Association.
Segar, M., Eccles, J., Richardson, C. “Rebranding exercise: closing the gap between
values and behavior.” International Journal of Behavioral Nutrition and Physical Activity,
2011, Vol. 8.
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