Wearable IoT health sensing beyond functional utility: Identity-expressive and hedonic determinants of user acceptance in intimate physiological monitoring devices — A sequential FA–ANP mixed-methods investigation with digital health policy implicati
Ai-Chieh Chang, Jiin-Chyuan Mark Lai, Shu-Hui Peng, Chun-Ming Shih, Ming Yuan HsiehBackground
IoT-enabled wearable physiological sensing devices are expanding rapidly into intimate sexual health monitoring contexts, encompassing IoT-enabled sexual wellness instrumentation, sexual health wearables, and related companion technologies, generating pressing digital health governance challenges alongside substantial market growth. Despite a sixfold sector expansion reaching USD 56.8 billion by 2022, the sensing design characteristics governing user acceptance of integrated multi-sensing unit (IMSU)-enabled devices remain empirically uncharacterized, leaving device developers, clinicians, and health informatics policymakers without an evidence base for design standards or biometric data governance frameworks.
Objectives
This research identifies and prioritizes the sensing material characteristics determining anticipated user acceptance of IMSU-enabled intimate physiological health monitoring devices across three psychosocial acceptance pathways: Behavioral functional utility, Desire-based hedonic engagement, and Identity-expressive self-concept alignment.
Methods
A sequential mixed-methods design integrated factor analysis (FA; n = 289 adult participants) with analytic network process (ANP) expert evaluation (n = 30 domain specialists), organized within a theoretical framework synthesizing the Technology Acceptance Model (TAM), Unified Theory of Acceptance and Use of Technology (UTAUT), and Human Determinism Theory of Behavior (HDTB).
Results
Positive anticipated acceptance achieved the highest Standardized Comprehensive Evaluated Weight (SCEW = 0.3449), exceeding negative acceptance by 8.2%. Three sensing characteristics dominated positive acceptance: visual-aesthetic sensing integration (BLMA-STIP, 0.2447), anatomical personalization (APMA-SSC, 0.2376), and auditory-responsive physiological feedback (RPMMC-STIP, 0.2204). Identity dimension characteristics outperformed Behavioral characteristics by 31.5%. Cross-method convergence was confirmed (r = 0.68, p < .01).
Conclusions
Acceptance of IMSU-enabled wearable health devices follows identity-expressive and hedonic pathways that substantially outweigh functional utility logic, extending TAM and UTAUT in domain-specific ways with direct implications for patient-centered device design, digital health communication strategy, and consent-based biometric data governance policy.