自我追蹤裝置(self-tracking device)的普及使得轉換型醫療服務越來越受到新興國家與開發中國家的重視。但隨著穿戴式健身追蹤器停用率的提高以及用戶中斷使用的現象出現，如何讓使用者能持續使用穿戴式健身追蹤器成為相當值得探討的議題。使用穿戴式裝置的價值不僅只是了解用戶的健康狀態，其價值更在於促進用戶能進行自我健康管理。因此，用戶須長期使用穿戴式裝置才能獲得最佳益處。除了技術因素之外，尚有其他因素影響著使用者是否會長期使用穿戴式健身追蹤器。本研究提出了一系列的研究，強調穿戴式健身追蹤器的永續性是基於它能促使用戶主動參與並且同時與服務生態系中的各個參與者產生連結。本研究採用服務系統觀點來解釋服務主導邏輯(S-DL)，並結合社會科技系統設計方法與使用者行為觀點以探討穿戴式健身追蹤器之服務價值。
本研究包含了三個系列的研究活動，以此探討在採用穿戴式健身追蹤器的醫療服務系統中A2A 的交互作用。首先，本研究採用文化洞察法探討使用穿戴式健身追蹤器的顧客歷程，以此探索穿戴式健身追蹤器的價值為何，意即何種價值將影響用戶決定持續使用該設備與進行健康改善。其次，透過情境模擬調查，本研究測試穿戴式健身追蹤器之說服設計的影響效果，因其具有自我與社會認知的特徵。第三，本研究認為A2A在穿戴式裝置上的整體交互方式涉及到宏觀的醫療體系。具體來說，本研究採用情境模擬調查並以五個國家的醫療系統作為研究對象進行跨國研究，探討使用者選擇在裝置功能與營養師參與之間如何共創價值。
本研究發現用戶參與對於用戶持續使用穿戴式裝置有正向影響，同時，自我效能對健康改善也有正向影響。從情境模擬調查的結果，本研究發現高互動性與高程度的團體動力會影響持續使用意圖。然而，只有自我健康風險認知能調節互動性與持續使用意圖的關係。最後，讓其他角色涉入可視為穿戴式健身追蹤器的高價值服務，例如：營養師。不過用戶能動性在選擇權與自我效能的部分會為其他角色的參與程度帶來挑戰。這說明了以使用者為中心以及連接良好的穿戴式健身追蹤器的重要性，這兩者將提供使用者適當的資源，同時將與健康相關的行為被視為個別領域。從跨國研究中，本研究也發現部分國家會受到醫療系統滿意度的影響。這表示穿戴式健身追蹤器提供的服務需要被客製才能產生價值來協助使用者面對健康問題。
本研究不僅有學術貢獻，且對科技化醫療服務產業提供管理意涵。簡單來說，本研究的發現主要來自於用戶在服務生態系統中與他人互動所獲得的價值。另外，關於用戶進行共創價值行為的動機以及影響持續使用穿戴式健身追蹤器的價值是需要被探討的。

Transformative health service through the use of self-tracking device gains remarkable attention from emerging to developed countries. Despite the rapid adoption and advanced technology, continuous use of wearable fitness tracker (WFT) become more challenging due to increasing abandonment rate and acceptance discontinuance phenomena. The value of using the wearable should not be concluded merely from the health outcome, rather than promoting self-health management. Thus, the optimum benefit could be achieved from the long-term use of the device. There is also a huge demand of what determines people to value the WFT for a longer period besides the technical factors. We propose series of research activities highlighting sustainability of WFT service by its ability to activate users and simultaneously connect actors in the service ecosystem. We translate the Service-Dominant Logic (S-DL) using service system view to integrate sociotechnical system design with the user behavior perspective for the WFT service.
This dissertation includes three series of studies activities incorporating the study of A2A interaction in healthcare service system through the utilization of WFT organized as follows. First, we explored in-depth phenomena of the customer journey with WFT using a cultural probe, to explore the value of WFT that shapes their continued use decision and wellbeing improvement. Second, we aimed to test the effect of persuasive design on the WFT device with self and social perceptions through a scenario-based experiment. Third, we consider that the holistic approach for A2A interactions on wearables will always involve a macro level of the healthcare system. We utilized scenario-based experimentation using cross-country studies to investigate how value cocreation works under users’ choices between device features and dietitian involvement in five different national healthcare systems.
This research discovered that user engagement with the wearable device has a positive effect on the continuous use, while self-efficacy also has a positive effect on wellbeing improvement. From the scenario-based experimentation, we also found that higher interactivity and high extent of group dynamics affected the continued use intention. However, only self-health risk perception moderates the relationship between interactivity and continued use intention. At last, involving other actor(s), i.e., dietitian, can be perceived as higher value for the WFT service. However, users’ agency on choice and self-efficacy might challenge the involvement of other actors. This indicates the importance of user-centered and well-connected WFT service to provide pertinent resources to its users but at the same time respect health-related actions as an individual domain. We also found that healthcare system satisfaction influenced some countries in cross-country study. This implies the needs of creating customized WFT service which can provide values to either supplement or overcome users’ health concern.
In summary, this research contributes not only to the academic literature but also to the managerial implications of technology-enabled healthcare service. The findings of this study are mainly derived from the value obtained from actors’ interactions within service ecosystem. Therefore, there is a further need to explore user motives underlying value cocreation behavior and implicit value on the sustained use of WFT.

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