DARE to wear: digital health promotion and disease prevention using wearable devices

Global healthcare systems are under increasing strain to ensure long-term sustainability, necessitating a fundamental transition towards proactive, preventive healthcare strategies. Wearable sensor technologies are uniquely positioned to facilitate this paradigm shift by enabling continuous physiological and behavioral monitoring, facilitating early risk stratification, and enabling timely interventions. DigitAl lifelong pREvention (DARE) is a nationwide initiative conceived in Italy to develop and evaluate novel digital tools and services aimed at fostering innovative health promotion and disease prevention pathways, with wearable devices identified as a critical enabling technology. Herein, we present a comprehensive overview of 16 pilot investigations designed in DARE to rigorously assess the utility of wearable devices in the continuous monitoring of physical activity, joint mobility, sleep architecture, heart rate variability, nutrition, and glucose homeostasis across diverse health domains, including healthy aging, chronic disease prevention, and lifestyle modification programs targeting over 20000 participants. We meticulously detail the methodological characteristics of these study protocols, explicitly outlining the technical specifications, functional capabilities, and inherent limitations of the 18 distinct wearable devices (sourced from 12 different manufacturers) employed across these clinical trials. The breadth of applications and the heterogeneity of the target populations underscore the significant potential of wearable devices as an integral component of future digital health prevention strategies.