CC BY 4.0 Attribution 4.0 InternationalButler, SoniaSculley, DeanSantos, DerekGironès, XavierSingh-Grewal, DavinderCoda, Andrea2025-01-212025-01-212025-01-21Butler, S., Sculley, D., Santos, D., Gironès, X., Singh-Grewal, D. and Coda, A. (2025) ‘Paediatric Preparedness: Document Analysis of the Challenges Experienced Using Smartwatch Technologies to Support Children Living with a Chronic Health Condition’, International Journal of Environmental Research and Public Health, 22(2), p. 133. Available at: https://doi.org/10.3390/ijerph22020133.1660-4601https://eresearch.qmu.ac.uk/handle/20.500.12289/14115https://doi.org/10.3390/ijerph22020133Derek Santos - ORCID: 0000-0001-9936-715X https://orcid.org/0000-0001-9936-715XSmartwatch technology is increasingly being used to support the management of chronic health conditions. Yet, many new digital health innovations fail because the correct foundations are not well established. This exploratory study aims to uncover the challenges experienced during the setup phase of a smartwatch intervention, to support the prototype development of a digital health intervention for children. Five children with a chronic health condition were asked to wear a smartwatch for 14 days that collects health data (pain levels, medication adherence, and physical activity performance). To explore the experiences of these children, their parents and the research team, all written records were analysed using READ’s four steps of document analysis and reported using the Standards for Reporting Qualitative Research checklist. The following three themes emerged: 1.) Infrastructure limitations: inexpensive smartphones prevented connection, and outpatient clinics’ internet black spots constrained setup and training; 2.) Personal phone restrictions: limited setup, training, and engagement; 3.) Elimination of the parent’s phone: provided children with digital support (a smartphone, pre-installed apps, cellular data) to allow active participation. Overall, we identified barriers hindering the use of smartwatch technology in clinical practice. More resources are needed to ensure paediatric preparedness for digital health support.133en© 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).http://creativecommons.org/licenses/by/4.0/AppChronic Health ConditionDigital HealthIntegrated CarePaediatricSmartwatchWearable TechnologyArticle