Main Article Content
paediatric, digital, health, apps, children
Research shows children and young people (CYP) engage with apps from as young as 1 years old. CYP often see the value of wearables and enjoy the educational experience of being proactively involved in their health education and management. Parents, carers and teachers are heavy influencers of digital health use, but adults themselves lack policies around digital health education, often focus on risks, and are less familiar with child-led digital health education.
Health applications (apps) can create a space for children to learn about health, healthy lifestyles and preventative health measures: Providing personalised knowledge as their bodies and needs develop. CYP are growing up in a world where many health services are likely to have a so-called ‘digital front door’, with some health management strategies or results likely to be delivered on-line or virtually. Due to stretched resources, CYP may need to be able to self-manage mild health conditions and could be better prepared to transition to adult services where they are likely to need to manage their digital health records and safe sharing of their personal health information.
CYP have the ability to be the ‘Trojan horse’, introducing apps, wearables or digital health solutions to parents, carers or wider family members without digital literacy or experience. Paediatric apps and related health tech or wearables need to keep a child safe, connected, educated, empowered and healthy. Children should ideally access health apps that are appropriate for their age and support management of their health preventatively and proactively. Children are best not considered as ‘little adults’, despite many apps, available on worldwide app stores, widening the age range of adult health apps to include children. Children have specific health, cognitive, developmental and physiological needs which need to be reflected in the health apps and digital health solutions recommended by health care professionals.
This paper examines the considerations needed for designing, recommending, and using paediatric health apps.
2 : Cara Goodwin A Research-Backed Guide to Educational Apps for Children: The research behind whether children learn from apps and which apps to choose. psychology Today 28 March 2022.
3 : V.A. Goodyear, K M. Armour & H Wood (2019) Young people learning about health: the role of apps and wearable devices, Learning, Media and Technology, 44:2, 193-210, DOI: 10.1080/17439884.2019.1539011]
4 : Holland Brown TM, Bewick M. 4. Holland Brown & Bewick. Digital health education: the need for a digitally ready workforce. Archives of Disease in Childhood, Education and Practice, 2022) doi:10.1136/ archdischild-2021-322022
5 : RCPCH P2040 paper asked for “ Widespread implementation of appropriate guidelines and frameworks that are specific to paediatric care to make technology safe and accessible for all”.
6: The Australian Research Council’s Centre of Excellence for the Digital Child. Australia, 2021.
7: Institute of Medicine (US) Committee on Clinical Research Involving Children; Field MJ, Behrman RE, editors. Ethical Conduct of Clinical Research Involving Children. Washington (DC): National Academies Press (US); 2004. 2, The Necessity and Challenges of Clinical Research Involving Children.)
8. De Buhr, E., Tannen, A. Parental health literacy and health knowledge, behaviours and outcomes in children: a cross-sectional survey. BMC Public Health 20, 1096 (2020). https://doi.org/10.1186/s12889-020-08881-5]
10 :Broekman FL, Piotrowski JT, Beentjes HWJ, Valkenburg PM. App features that fulfill parents' needs in apps for children. Mob Media Commun. 2018 Sep;6(3):367-389. doi: 10.1177/2050157918759571. Epub 2018 Apr 16. PMID: 30167307; PMCID: PMC6099983
11. Seoul-Kee Kim, So-Yeong Kim, Hang-Bong Kang. An Analysis of the Effects of Smartphone Push Notifications on Task Performance with regard to Smartphone Overuse Using ERP. Comput Intell Neurosci. 2016; 2016: 5718580.
Published 2016 Jun 5. doi: 10.1155/2016/5718580.
12. L Hale, GW Kirschen, MK LedBoureois, et al.Youth screen media habits and sleep: sleep-friendly screen-behavior recommendations for clinicians, educators, and parents Child Adolesc Psychiatr Clin N Am.Child Adolesc Psychiatr Clin N Am. 2018 Apr; 27(2): 229–245. doi: 10.1016/j.chc.2017.11.014.
13. S Whiting, M Buoncristiano, P Gelius et al. Physical Activity, Screen Time, and Sleep Duration of Children Aged 6–9 Years in 25 Countries: An Analysis within the WHO European Childhood Obesity Surveillance Initiative (COSI) 2015–2017
14. TN Robinson, J A Banda, L Hale et al.Screen Media Exposure and Obesity in Children and Adolescents. Pediatrics. 2017 Nov; 140(Suppl 2): S97–S101.
doi: 10.1542/peds.2016-1758K PMCID: PMC5769928
15. Canadian Paediatric Society, Digital Health Task Force, Ottawa, Ontario. Screen time and young children: Promoting health and development in a digital world. Paediatr Child Health. 2017 Nov;22(8):461-477. doi: 10.1093/pch/pxx123. Epub 2017 Oct 9. Erratum in: Paediatr Child Health. 2018 Feb;23 (1):83. PMID: 29601064; PMCID: PMC5823000.
16. K Denecke, P Bamidis, C Bond et al. Ethical Issues of Social Media Usage in Healthcare. Med Inform 2015; 24(01): 137-147 DOI: 10.15265/IY-2015-001
17. AF Monteiro, M Santos, M Pinto, AJ Osiris. Using mobile apps to promote children and youth online safety- a literature review. Project: Apps4eSafety: Using mobile apps to promote children and youth online safety. Nov 2017. DOI: 10.21125/I Eir.2017.1574
18. S Maloney, J Tunnecliff, P Morgan et al. Translating Evidence Into Practice via Social Media: A Mixed-Methods Study. J Med Internet Res. 2015 Oct; 17(10): e242.
Published online 2015 Oct 26. doi: 10.2196/jmir.4763
19. Committee on the Science of Children Birth to Age 8: Deepening and Broadening the Foundation for Success; Board on Children, Youth, and Families; Institute of Medicine; National Research Council; Allen LR, Kelly BB, editors. Transforming the Workforce for Children Birth Through Age 8: A Unifying Foundation. Washington (DC): National Academies Press (US); 2015 Jul 23. 4, Child Development and Early Learning.
20. Transforming lives: Combating digital health inequality
Bob Gann NHS Digital, UK. International Federation of
Library Associations and Institutions 2019, Vol. 45(3) 187–198
DOI: 10.1177/0340035219845013 journals.sagepub.com/home/ifl
21. A Colver, T Rapley, JR Parr et al. Facilitating transition of young people with long-term health conditions from children's to adults’ healthcare services – implications of a 5-year research programme. Clinical Medicine 2020Vol 20, No 1: 74–80 ORIGINAL RESEARCH Clinical Medicine 2017 Vol 17, No 6: 74–8
22. Healthy Children: A Forward View for Child Health Information, NHS England National
Information Board, Nov 2016
23. G Spencer, H Fairbrother, J Thompson. Privileges of Power: Authenticity, Representation and the “Problem” of Children’s Voices in Qualitative Health Research
International Journal of Qualitative Methods, Vol 19: 1–8 2020
24. O Abraham, R M Wytiaz, AM Feathers. Paediatric use of medications and adherence apps: a qualitative analysis of the perspectives of children and parents. Journal of Pharmacy Practice and Research, Volume 49, Issue 2 p. 123-129 23 September 2018. https://doi.org/10.1002/jppr.1460
25. Park E, Kwon M. Health-Related Internet Use by Children and Adolescents: Systematic Review. J Med Internet Res. 2018 Apr 3;20(4):e120. doi: 10.2196/jmir.7731. PMID: 29615385; PMCID: PMC5904452.
26. R. O’Loughlin, H Hiscock, T Pan, et al. The relationship between physical and mental health multimorbidity and children’s health-related quality of life. Qual Life Res (2022). https://doi.org/10.1007/s11136-022-03095-1 January 2022. DOI: https://doi.org/10.1007/s11136-022-03095-1
27. S Livingstone, J Davidson, J Bryce et al. Children’s online activities, risks and safety A literature review by the UKCCIS Evidence Group. October 2017.
28. Mobile data analytics. ‘25 Mobile App Statistics To Know In 2022’. MindSea Team.
29. Coproduction Collective. Supporting co-production in research, policy, and practice. Website: https://www.coproductioncollective.co.uk/
30. N Masnoon, S Shakib, L Kalisch-Ellett, G E Caughey. What is polypharmacy? BMC Geriatr. 2017; 17: 230. doi: 10.1186/s12877-017-0621-2. PMCID: PMC5635569 PMID: 29017448
31. NHS England National Information Board. ‘Healthy Children: Transforming Child Health Information. NHSEngland publication gateway reference 05454 Nov 2016.