1、Digital Health Generation? Young peoples use of healthy lifestyle technologies Project Report Professor Emma Rich | Dr Sarah Lewis | Professor Andy Miah | Professor Deborah Lupton | Dr Lukasz Piwek Contents 01 DIGITAL HEALTH GENERATION | WWW.DIGITALHEALTHGENERATION.NET Contents 1 Suggested citation

2、3 Acknowledgements 4 Multidisciplinary advisory board 4 Executive Summary 5 Key recommendations and guidelines 10 1. Introduction 11 Methods 14 Phase 1: Survey of young peoples digital health engagement 15 Phase 2: In-depth interviews and focus groups 15 Phase 3: Researching young peoples digital he

3、alth experiences in real time 16 Ethics 16 2. Findings 17 What digital tools are young people using? 18 What digital technologies do young people use for health? 20 How are young people using digital health technologies? 22 One size does not fit all Digital health knowledge: What are young people le

4、arning about health? 22 How are young people discovering information and content about health? 24 What are young people doing online? Digital health practices 25 The influence of social media 26 Disaffection and obsessive practices 33 Monitoring, tracking and quantification: its almost a race to get

5、 to 34 eight thousand or ten thousand steps The labour and burden of digital health practices 38 The influence of others on young peoples digital health practices 41 Making sense of digital data and multiple messages 42 Digital literacy and the importance of support of others 44 The importance of fa

6、ce to face contact 47 Young people as creative producers of digital health practices 47 Data sharing and owning: Security and safety 48 Credibility and validity 50 02 DIGITAL HEALTH GENERATION | WWW.DIGITALHEALTHGENERATION.NET The promise and future of digital health 51 Young people as co-designers

7、of digital health 52 3. Impact, engagement and resources 55 On Digital 56 Events 57 Final Event 59 2019, March - Digital Health Generation National Conference, Bath 59 Presentations 64 4. Conclusions 65 Lost in a sea of health information 65 The need for guidance 65 References 67 03 DIGITAL HEALTH G

8、ENERATION | WWW.DIGITALHEALTHGENERATION.NET Rich, E., Lewis, S., Lupton, D., Miah, A., Piwek, L. (2020) Digital Health Generation?: Young Peoples Use of Healthy Lifestyle Technologies. University of Bath, Bath, UK. Suggested citation Our sincere thanks to all of the following for their contributions

9、 to and support of the research: The Wellcome Trust for funding the research study The Digital Health Generation: the impact of “healthy lifestyle” technologies on young peoples learning, identities and health practices (203254/Z/16/Z). The schools, teachers, young people and families who willingly

10、and enthusiastically participated in this research project. The various stakeholders who participated in the engagement activities and provided commentary, feedback and insight on our research and proposed recommendations. The project expert advisory board, who have been instrumental in advising on

11、the design and development of this project. The local authority team for supporting this project throughout its duration. Francis Sealey and Globalnet21 for hosting our webinars and our national policy event at the House of Commons. Artist Laura Sorvala, who created the artwork for the report and cr

12、eated an illustration of our national conference and key findings. The NHS Digital team: Hazel Jones, Director, Apps and Wearables programme, and Janet Morgan, engagement and uptake research, Apps and Wearables programme. The University of Bath, the University of Salford, the University of Canberra

13、and the University of New South Wales, Sydney Roots research company. Professor Emma Rich, University of Bath Dr Sarah Lewis Professor Deborah Lupton, UNSW Sydney Professor Andy Miah, University of Salford Dr Lukasz Piwek, University of Bath For enquiries please contact: Professor Emma Rich Departme

14、nt for Health University of Bath Bath BA2 7AY E.Richbath.ac.uk Acknowledgements Expert advisory board: We are grateful for the support from our multidisciplinary expert advisory board for their input into the design and development of this research study: Dr Huw Davies, Oxford Internet Institute, Un

15、iversity of Oxford Dr Victoria Goodyear, Birmingham University Associate Professor Mariann Hardey, Durham University Professor Christine Hine, University of Surrey Professor Shaun Lawson, Northumbria University Professor Sonia Livingstone, London School of Economics and Political Sciences Professor

16、Jessica Ringrose, Institute of Education, University College London Dr Ben Williamson, Centre for Research in Digital Education, University of Edinburgh NB all art work in this report has been created by Laura Sorvala: 04 DIGITAL HEALTH GENERATION | WWW.DIGITALHEALTHGENERATION.NET Executive summary

17、This report details the findings of the Wellcome Trust project entitled The Digital Health Generation: the impact of “healthy lifestyle” technologies on young peoples learning, identities and health practices (203254/Z/16/Z). The project generated new insights on young peoples use of digital health

18、technologies and involved research with over 1,000 young people and families. 05 DIGITAL HEALTH GENERATION | WWW.DIGITALHEALTHGENERATION.NET Digital health technologies are having a powerful impact on encouraging young people to approach health as a personal practice. Young people in the UK and else

19、where are growing up in a time when health care is increasingly turning towards digital tools to meet growing demand. In recent years, we have seen a significant growth in a range of digital technologies used for health purposes. These include websites, blogs, social media platforms, mobile phone ap

20、plications (apps) and wearable technologies (e.g. fitness bands with sensors). Many of these devices and software are focused on promoting healthy lifestyles. They can be used to find information about health, or as a tool to collect, track and share data about our health (e.g. how far we run, how m

21、uch we eat). Despite the rapid growth of these technologies, there are no guidelines for those with responsibility for young people (practitioners, coaches, teachers, researchers or families) to help support young peoples engagement with health-related digital devices and media. The research is a wo

22、rld-first, addressing major and pressing gaps in health knowledge by providing unique insights into young English peoples experiences of digital health technologies promoting healthy lifestyles. Throughout the two-year study, a mixture of quantitative and qualitative methods was used to undertake re

23、search with over 1,000 young people and their parents in South-West England between 2017 and 2019. The study involved three separate components: 1) a survey completed by 1,019 respondents; 2) 30 in-depth interviews and one 06 DIGITAL HEALTH GENERATION | WWW.DIGITALHEALTHGENERATION.NET focus group di

24、scussion with a further eight young people; and 3) a study which involved seven young people wearing a tracking device and sharing their experiences with us in real time plus interviews with their parents. The project team also undertook a series of engagement activities to bring together different

25、voices to exchange ideas and inform policy development and professional practice. Through a series of events and digital platforms, young people, families, academics, non-profit groups, industry and designers, health professionals, policy makers, teachers and others with responsibility for young peo

26、ples care participated in these discussions with us. The experiences of young people documented in this report point to the complexities of digital health and the need to avoid technological determinism: technology is neither inherently oppressive nor empowering. We found that many of the young peop

27、le who participated in our research and forums have experiences of digital health which are both positive and problematic. Taken together, our data collection and engagement activities provide detailed insights into the digital health experiences of our young participants. These activities have info

28、rmed the development of a series of recommendations and guidelines to support a range of stakeholders interested in digital health in the UK, including but not limited to: parents, coaches, teachers, health professionals, policy- makers, digital health industry and researchers. While our findings ar

29、e drawn on young people living in South West England, they have relevance for other countries in the Global North. The young participants in our study are active users of digital health technology. Internet-based activity and app use took place through personalised devices (tablets and smartphones)

30、and the internet use was a regular feature of their everyday lives. Many of the digital practices associated with these technologies reflect a shift towards young people becoming health consumers and expectations of self-management of their health. This group of English young people access a vast ra

31、nge of health-related content online, through multiple devices, from a young age. Moreover, they use these technologies to actively learn about health and track and monitor a range of health behaviours. The participants used a range of different technologies and move regularly between these: often t

32、hese systems are linked or integrated. Rather than remaining loyal to particular tools, the young participants frequently selected technologies which were relevant to them to meet particular needs as these arise. They were frequent users of search engines and health information websites. They also u

33、sed YouTube, online discussion groups, social media, apps or wearable devices. Young people are particularly reliant on technology for learning about a healthy body. Among the benefits of such experiences for our participants was the gaining of better knowledge of their bodies, illness and healthcar

34、e and feeling more in control of health and wellbeing states. While the participants valued the convenience, accessibility, detail and diversity of information offered by digital media and devices, their experiences also highlighted concerns about navigating the volume of information. Of particular

35、significance was the importance of face- to-face as well as online relationships and personal connections with other people for providing information and support, including family members and friends as well as medical professionals. Commercial health technologies and social media play a particularl

36、y powerful role in how young people learn about the healthy body. In addition to having to make sense of existing official knowledge, young people are also actively shaping health knowledge through the different media and material they produce themselves. While young people often draw on the health

37、advice (e.g. training plans, dietary advice) provided through digital health (e.g. training plans, dietary advice), many were concerned that they would not be able to recognise if they were over-exercising or dieting too much. As such, they expressed the need for health and fitness apps to have warn

38、ing alerts or limits built into them, involving messages advising them on when they might be exercising or dieting excessively. Digital health tools can lead some young people to engage with forms of self- monitoring which have been linked with disordered eating or excessive exercising regimens. In

39、extreme cases, parents or others have intervened to stop young people from using fitness and dieting apps because of their perceived harmful effects. 07 DIGITAL HEALTH GENERATION | WWW.DIGITALHEALTHGENERATION.NET Young people are using an expanding range of digital devices for health (social media,

40、apps, websites, videos, images, wearable devices) and the data on and about their bodies and health practices continue to accumulate, sometimes without their knowledge. As a result, their bodies and health states are becoming increasingly datafied and quantified. This has a significant impact on how

41、 they come to understand themselves and their health. The participants highly valued the capacity of digital technologies to generate detailed information about their bodies and health states and imagined new technologies that would be able to achieve even more detailed personalisation and customisa

42、tion. However, they expressed little knowledge or concern about how their personal health data may be exploited by others. Digital technologies provide opportunities and risks and they do not operate in isolation. Digital health practices provide a way of understanding the different ways in which yo

43、ung people use digital health in the context of their complex lives. Young people are not necessarily digital natives. Our participants demonstrated varied forms of literacy, understanding and opportunities and a better understanding of inequalities is needed by those involved in the design and deli

44、very of digital health care. The role of others is therefore crucial in data interpretation and responses. For our participants, not having access to someone who could help them interpret and make sense of health information and their personal data emerged as a key inequality and point of difference

45、 in their learning. Some participants said they did not have access to an adult who can help guide them and felt this inhibited their positive engagement with digital health technologies. Parents use different strategies to monitor what their children might do online. Some put in place rules and res

46、trictions and others prefer to talk to their children and guide them. Key findings: 1. 70% of the survey respondents overall reported using digital technologies for health purposes, while 55% of respondents identified their smartphones as the main technology they used to learn about health. Particip

47、ants reported that they mostly have to share larger devices (laptop or desktop PC) for finding health information. 2. A total of 42% of the respondents used digital health technology specifically to learn about how to improve their health. 3. The participants had accessed digital health technologies

48、 from a very young age: 75% of survey respondents said that they owned their first mobile/tablet between the ages of 8-11 years. 4. Young people reported a high degree of autonomy in how they used technology: 62% of survey respondents said adults did not check their internet use, 72% said that they

49、can use any technology to which they have access and 68% reported that they can do what they want when it comes to searching online for health information. 5. This freedom poses some risks, given that one in ten young people had identified something they considered to be inappropriate online in the week leading up to our survey. They were also concerned about advertising online and were unsure how to navigate or avoid this. 6. YouTube was the most popular source of health information, with 44% of survey respondents reporting use. Fitnes