Over 70% of young people, some as young as eight, are using apps, YouTube videos and other digital online technologies to track and manage their health, according to the authors of a new report.
The researchers, based at the universities of Bath, Salford and University of New South Wales say their findings highlight risks and opportunities for young people and suggest that more needs to be done to expand digital literacy lessons at school to focus on health.
Their recently published report with the Wellcome Trust, Digital Health Generation, describes young people in the UK and around the world as ‘growing up in a time when healthcare is increasingly turning towards digital tools’.
From survey data of over 1000 young people, it uncovers that young people are accessing digital health technologies from a very young age - 75% of survey respondents said that they owned their first mobile or tablet between the ages of 8-11 years - with 70% of respondends saying they use these devices for health purposes in relation to fitness or dieting.
According to the report, the growth of these technologies poses problems both in terms of data collection, security and ownership, but also in how young people navigate the multiple and sometimes competing health advice and guidance. As a priority schools should be supported in educating young people about digital health as part of the health curriculum, suggest the researchers.
They point to the significant growth over recent years in a range of websites, blogs, social platforms, apps and wearable technologies accessed and used by young people for health purposes as well as a surge in their use throughout lockdown this year. These cover a diverse range of technologies measuring performance and activity, such as Fitbits and Strava, as well as numerous dieting apps and YouTube videos.
Many of these technologies are focused on promoting ‘healthy lifestyles’ and can provide young people with important information on their health, including by collecting, tracking and sharing data for instance about how far we run or how much we eat. Yet despite their proliferation, there are currently no guidelines, and young people say they need more support.
Among findings, responses found that while young people often draw on the health advice provided through digital health (e.g. training plans and dietary advice), many were concerned that they would not be able to recognise if they were over-exercising or dieting too much. Digital health tools can also lead some young people to engage with forms of self-monitoring, which have been linked with disordered eating or excessive exercising regimens. In extreme cases, parents or others have intervened to stop young people from using fitness and dieting apps because of their perceived harmful effects.
Lead researcher behind the report, Professor Emma Rich from the Department for Health at the University of Bath explains: “Over recent years there has been a surge of new online apps, blogs and videos specifically targeting young people with messages all about personal improvement in their health and lifestyle. These technologies offer certain opportunities for young people, but they also carry risks both in terms of the direct advice and guidance given - and the implications this can have in relation to body image for instance - but also wider concerns about data storage and ownership by third parties.
“Our findings suggest young people want to learn more about this topic, but need help in navigating a fast-paced, fast-changing online environment. Digital health education should promote learning that will benefit young people in ways that help them feel better prepared to manage their online health identities, particularly in relation to social media. Educational policymakers need to take notice of this specific issue in order to update and expand current provision within the curriculum. This trend in online digital health technologies will only continue to increase and we need to ensure young people have the skills and know-how to best cope.”
Co-author, Professor Andy Miah added: “The research is a world-first, addressing a major and pressing gap in health knowledge by providing unique insights into young English people’s experiences of digital health technologies promoting ‘healthy lifestyles’. The experiences of the young people we spoke to highlighted complexities in digital health: many of the young people who participated in our research and forums have experiences of digital health which are both positive and problematic.”
In addressing this issue, the researchers argue that it is essential to bring together different stakeholders, crucially with young people front and centre of policy interventions.
The report was also authored by Dr Sarah Lewis (Bath), Professor Deborah Lupton (New South Wales) and Dr Lukasz Piwek (Bath).
Further notes on the project;
Throughout the two-year study, which was completed for and with young people, a mixture of quantitative and qualitative methods were used. This helped to draw on the experiences of over 1,000 young people and their parents in South-West England between 2017 and 2019.
The study involved three separate components:
- A survey completed by 1,019 respondents.
- 30 in-depth interviews and one focus group discussion with a further eight young people.
- A study which involved seven young people wearing a tracking device and sharing their experiences in real time plus interviews with their parents.
The report highlighted that young people are cautious about sharing their personal health information. Respondents said they were willing to share their health data with parents (64%), but to a much lesser extent with health professionals (35%) or their friends (33%).
There is a lack of comprehension, however, around how personal health data are shared and stored and minimal knowledge about data security or privacy. Most young people were not familiar with third party data use or data security issues, or the limitations of current health data protections.
Many young people expressed the need for health and fitness apps to have warning alerts or ‘limits’ built into them, involving messages advising them on when they might be exercising or dieting excessively.
Read Andy Miah's recent Conversation article - Digital homeschooling: we need to rethink our worries about children’s screen time.