Taking Action

Digital Health & Young People: 3 Reasons why they hold the Key

Oct 18, 2021
Taking Action

Dear Diary,

I have been struggling with an eating disorder for the past few years. I am afraid to eat and afraid I will gain weight. The fear is unjustified as I was never overweight. I have weighed the same since I was 12 years old, and I am currently nearing my 25th birthday. Yet, when I see my reflection, I see somebody who is much larger than reality.

I told my therapist that I thought I was fat. She said it was 'body dysmorphia'.
She explained this as a mental health condition where a person is apprehensive about their appearance and suggested I visit a nutritionist. She also told me that this condition was associated with other anxiety disorders and eating disorders. I did not understand what she was saying as I was in denial; I had a problem, to begin with. I wanted a solution without having to address my issues.

Upon visiting my nutritionist, he conducted an in-body scan and told me my body weight was dangerously low.

I disagreed with him.

I felt he was speaking about a different person than the person I saw in the mirror. I felt like the elephant in the room- both literally and figuratively. He then made the simple but revolutionary suggestion to keep a food diary to track what I was eating.

This was a clever way for my nutritionist and me to be on the same page. By recording all my meals, drinks, and snacks, I was able to see what I was eating versus what I was supposed to be eating. Keeping a meal diary was a powerful and non-invasive way for my nutritionist to walk in my shoes for a specific time and understand my eating (and thinking) habits.

No other methodology would have allowed my nutritionist to capture so much contextual and behavioural information on my eating patterns other than a daily detailed food diary.
However, by using a paper and pen, I often forgot (or intentionally did not enter my food entries) as I felt guilty reading what I had eaten or that I had eaten at all.

I also did not have the visual flexibility to express myself through using photos, videos, voice recordings, and screen recordings. The usage of multiple media sources would have allowed my nutritionist to observe my behaviour in real-time and gain a holistic view of my physical and emotional needs.

I confessed to my therapist my deliberate dishonesty in completing the physical food diary and why I had been reluctant to participate in the exercise. My therapist then suggested to my nutritionist and me to transition to a mobile diary study.

Whilst I used a physical diary (paper and pen), a mobile diary study app would have helped my nutritionist and me reach a common ground (and to be on the same page) sooner rather than later.

As a millennial, I wanted to feel like journaling was as easy as Tweeting or posting a picture on Instagram. But at the same time, I wanted to know that the information I  provided in a digital diary would be as safe and private as it would have been as my handwritten diary locked in my bedroom cabinet.

Further, a digital food diary study platform with push notifications would have served as a constant reminder to log in my food entries as I constantly check my phone. It would have also made the task of writing a food diary less momentous by transforming my journaling into micro-journaling by allowing me to enter one bite at a time rather than the whole day's worth of meals at once.

Mainly, the digital food diary could help collect the evidence that I was not the elephant in the room, but rather that the elephant in the room was my denied eating disorder.

Sincerely,
The elephant in the room

The advancement in the digital health sector over the past two decades has been impressive. This advancement has transformed the way health services are delivered around the world. 

Digital transformation has enabled the delivery of quality health care services at doorsteps. It has facilitated the exchange of scientific knowledge and data essential to improving health outcomes globally. In addition, access to health information and services has further improved.

The digital transformation has introduced several possibilities into the healthcare space. On the consumer's side, it enhances access to health information and services and supports informed decision-making. Further, it promotes self-management of chronic diseases; and empowers individuals to take control of their health.

On the providers' side, it facilitates shared decision-making, capacity building of health care workers, and exchange of health data. Further, it supports the development of patient-centred health solutions and ensures a continuous learning environment during the COVID19 pandemic and beyond.  

However, we must recognize that transformations in the digital health sector contribute to existing health and social inequalities. So, it is critical that digital health solutions are not aligned with a 'one size fits all' approach to ensure they are fair and equal. Thus, digital health literacy should be prioritized to develop and implement inclusive digital health solutions locally, nationally, and global.


Why Digital Health Literacy?

The rapid transformation in digital health has heightened the risk of widening the digital divide. It may further exacerbate existing health inequalities. Therefore, to achieve equitable results from digital transformation, it is critical to acknowledge the importance of addressing digital health literacy. Digital health literacy can be addressed among individuals, communities, health organizations, and health systems worldwide. 

Digital health literacy is the ability of the individual to use electronic resources to make decisions about health.

It includes skills and resources that enable individuals to use digital tools to access, retrieve and utilize health information and health services. These skills and resources are crucial to support individuals to make informed decisions to improve their health.

Addressing digital health literacy will help understand the strengths and challenges people face to use technology to improve their health. It will further help to reach people who are already missing out from the existing services. It will help ensure that digital health services are inclusive to ensure no one is left behind.


3 reasons why young people are the change-makers

The younger generation has a high degree of access to digital technologies. They are often referred to as digital natives as they are born in the age of digital transformation. They have more skills, awareness, and confidence in using digital technology than the previous generations.

The young population should be considered essential stakeholders for digital transformation in the healthcare sector. Their enormous reach through professional and peer networks and ability to use digital platforms can help amplify and accelerate digital transformation

The knowledge and skills of young people can be utilized to enhance digital health literacy. It can further help to narrow down the existing digital divide. They can bring their unique perspective to global debates on how people of all ages can derive the maximum benefit from integrating health systems with digital technology.

Young people can act as change-makers in the following ways:

1. Acting as facilitators of health literacy within their families and communities

With a high degree of access and skills in using digital technology, the younger generation can play a fundamental role in empowering their community to utilize digital technology effectively. They can further support their families and communities to make informed health choices.

Young people can help the elderly and vulnerable people by enhancing their access to digital technology. Young people can further support them to use appropriate technology and connect them to essential health services. Moreover, they can raise awareness about recent advancements in the digital health sector. Therefore, they can play a vital role in building digital capacity within their families and communities. 

It is evident in the current COVID19 crisis, where the younger generation helped vulnerable people in their community to utilize digital technology to schedule vaccination appointments; connect them virtually to essential health services, and enable them to communicate with their family members.

2. Understanding the health literacy needs of people within their communities

To narrow down the existing digital divide and reduce health inequalities, it is essential to understand the local context, socio-economic and cultural barriers, and needs of people before utilizing technology to improve health. 

Young people can play a critical role in identifying the health needs of people in their community. Addressing the needs and barriers will help develop and select appropriate tools to deliver quality health services in an equitable manner. 

Engaging the younger generation in the planning, design and implementation of digital health solutions can help improve access and utilization of services that can meet the needs of a diverse population. 

It is not always necessary to use modern technological advances such as mobile applications, social media or artificial intelligence to reach people and improve their health outcomes. In certain areas with poor internet connectivity, traditional technology tools like simple text messaging, radio and television advertising can help reach people and motivate them to impact their health positively.

Therefore, harnessing the power and reach of young people can help to identify appropriate digital tools to engage individuals effectively. It may further help to determine which services are working and which are not working. Thus will help to tailor solutions according to the health needs of the individuals. This, in turn, may improve the reach and uptake of digital health solutions.

3. Creating new innovative digital solutions and updating the existing solutions

As digital natives, young people have enormous potential to transform digital health and support sustainable development. Their knowledge, skills, and motivation can help to develop new innovative solutions capable of meeting the changing health needs of the desired population. 

Equipping youth with the necessary resources, ethical guidance from senior leaders, and a platform to showcase their skills can help identify various youth-led and youth-oriented solutions from different parts of the world.

However, it is vitally essential that innovation in youth-oriented solutions is not hampered. Rushing too fast and violating the fundamental rights of young people is a sure way to ensure that digital medicine will never reach its potential. Further, youth will refuse to use it if their fundamental rights are violated and their element of trust is lost.

Therefore, it is critical to use an integrated co-design approach to develop next-generation digital health tools. Young people should not only be considered as health consumers but should be involved as key actors. They should be meaningfully engaged in planning, designing, and implementing innovative digital health solutions to increase outreach and adoption of digital health services to ensure no one is left behind.


Conclusion

I believe that the rapid transformation of the digital healthcare sector is increasing new possibilities and challenges. It highlights the tremendous need to address the digital health literacy of individuals, communities, and health systems. 

Addressing the strengths and challenges people experience using digital technology is critical to ensuring that digital solutions are inclusive and responsive to the changing health needs of diverse populations.

I firmly believe that the younger generation can be change-makers to reduce the existing digital divide. However, to harness their full potential, they must be involved when planning, designing and implementing innovative digital solutions to ensure that no one is left behind.

If appropriately used in the 21st century, data could save us from lots of failed interventions and enable us to provide evidence-based solutions towards tackling malaria globally. This is also part of what makes the ALMA scorecard generated by the African Leaders Malaria Alliance an essential tool for tracking malaria intervention globally.

If we are able to know the financial resources deployed to fight malaria in an endemic country and equate it to the coverage and impact, it would be easier to strengthen accountability for malaria control and also track progress in malaria elimination across the continent of Africa and beyond.

Odinaka Kingsley Obeta

West African Lead, ALMA Youth Advisory Council/Zero Malaria Champion

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Dear Digital Diary,

I realized that there is an unquestionable comfort in being misunderstood. For to be understood, one must peel off all the emotional layers and be exposed.

This requires both vulnerability and strength. I guess by using a physical diary (a paper and a pen), I never felt like what I was saying was analyzed or judged. But I also never thought I was understood.

Paper does not talk back.Using a daily digital diary has required emotional strength. It has required the need to trust and the need to provide information to be helped and understood.

Using a daily diary has needed less time and effort than a physical diary as I am prompted to interact through mobile notifications. I also no longer relay information from memory, but rather the medical or personal insights I enter are real-time behaviours and experiences.

The interaction is more organic. I also must confess this technology has allowed me to see patterns in my behaviour that I would have otherwise never noticed. I trust that the data I enter is safe as it is password protected. I also trust that I am safe because my doctor and nutritionist can view my records in real-time.

Also, with the data entered being more objective and diverse through pictures and voice recordings, my treatment plan has been better suited to my needs.

Sincerely,
No more elephants in this room

Satish Melwani

Satish Melwani

Satish Melwani is a dentist and a public health researcher. He is currently pursuing his PhD in Public Health from University of Tasmania with focus on enhancing health literacy of pregnant women and mothers to reduce the intergenerational impact of non-communicable diseases. He has experience in research, advocacy, implementation, noncommunicable disease prevention and health system strengthening. He is enthusiastic about influencing health policies and programs through health literacy to ensure no one is left behind.

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