My Garmin syncs its data to Apple Health. I don't see why Pebble wouldn't be able to do it. My understanding of the post is that it mostly refers to internal iOS APIs that are not available to third parties (e.g. actionable notifications).
I have the Q11 too (and I fully agree with your appreciation of it), but I'd like to say that I never had this issue with the keyboard. I _do_ have it connected to the laptop (tested both on a M2 macbook air and a M4 Pro macbook pro) through a `ThinkPad Thunderbolt 3 Dock Gen 2` -- not sure if that may be what's avoiding your problem.