Correlates of Fitness Tracker Ownership and Use in Cancer Survivors: Cross-Sectional Survey

Background Consumer fitness tracker devices offer scalable opportunities to monitor real-world behavior and support health in cancer survivorship. However, adoption and sustained use outside structured research settings remain incompletely characterized, limiting their integration into survivorship care. Objective The primary objectives were to describe the prevalence of fitness tracker ownership and use patterns among cancer survivors and to identify sociodemographic, psychosocial, and usability-related correlates of device ownership and frequent use. Methods We conducted a cross-sectional survey of 893 cancer survivors enrolled in the Total Cancer Care protocol at a comprehensive cancer center. Participants completed an adapted online questionnaire assessing fitness tracker ownership, frequency of use, and perceived barriers and facilitators. Multivariable logistic regression models were used to identify sociodemographic, psychosocial, and usability-related correlates of device ownership and frequent use. Results More than half of the participants (506/893, 56.7%) reported owning a fitness tracker, and among owners, 82.2% (416/506) reported frequent use (most days or every day), including 71.3% (361/506) who wore the device every day. The most commonly used devices were the Apple iWatch (272/506, 53.8%) and Fitbit (147/506, 29.1%). In multivariable analyses, fitness tracker ownership was independently associated with sex, household income, and cancer site. Male participants had lower odds of ownership (adjusted odds ratio [aOR] 0.61, 95% CI 0.42-0.87; P=.006), while higher household income was associated with greater ownership (US $50,000-$99,999: aOR 1.70, 95% CI 1.13-2.57; P=.01; ≥US $100,000: aOR 3.64, 95% CI 2.41-5.50; P<.001). Ownership also differed by cancer site. Among owners, frequent use was concurrently and inversely associated with self-reported device discomfort (P<.001), low motivation (P<.001), information overload (P=.04), and limited app integration (P=.007). Conclusions In this single-center, predominantly White, higher-income sample of cancer survivors, fitness tracker ownership was common and patterned by demographic and socioeconomic characteristics, while sustained engagement among device owners was associated with psychosocial and usability factors. These findings suggest that scalable, fitness tracker–enabled survivorship care will need to address both structural disparities in ownership as well as behavioral readiness and user experience to ensure clinically meaningful implementation.