How To Teach Kids (Digital) Health Literacy?

The Medical Futurist
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In a world of social companion robots, chatbots, or artificial intelligence buddies, adults have the responsibility to teach kids well how to live a healthy life with the available technologies, how to balance between the online and the offline world, how to keep their mental stability in the face of innovations. As it’s an awfully difficult job, we collected examples where digital health technology could help and in which areas should analog methods prevail.

The land where kindergarteners play with the texture of raspberry

When was the last time you paid attention to the crunching sounds while eating a raw carrot? Have you ever listened to it? What about feeling the texture of dough or the scent of squashed blueberries? That’s exactly what kindergarteners in Finland are encouraged to do in the framework of a lifestyle program called SAPERE supported by the government of the Scandinavian country. Instead of telling children ‘not to play with your food’, they are encouraged to experiment with lemons, get their hands dirty in a bowl full of flour, or pick apples from the kindergarten’s vegetable garden.

Apparently, it helps kids to get to know and eat more berries, vegetables, and fruits – all the food items that small children tend to disregard for gums, candies, or dinosaur-shaped chocolate bars. As a consequence, they learn at a very early age that eating healthy stuff can be fun instead of obeying a parental command. This sensory-based food education given to 3–5-year-old children in the kindergarten increases their willingness to choose vegetables, berries, and fruit, according to a study from the University of Eastern Finland. The research also states that positive and personal food-related experiences gained in the kindergarten can help modify dietary preferences in a direction that is beneficial for health. Dietary preferences learned in early childhood often stick with a person all the way to adolescence and adulthood.

Diabetes Monster and healthy attitudes toward food at an early age

The SAPERE method was so successful in Finland that it was included in the program of every single Finnish kindergarten since then, and some European cities and countries also started to experiment with the program. Why do the Scandinavians allow their little ones to play with food? They believe they can reduce their share of the alarming global obesity epidemic among young children, and prepare them for a healthier adulthood. Namely, the WHO estimated in 2016 that the number of overweight children under the age of five was over 41 million. Almost half of all overweight children under 5 lived in Asia and one quarter lived in Africa. According to the CDC, data from 2015-2016 show that nearly 1 in 5 school age children and young people (6 to 19 years) in the United States has obesity; and the percentage has almost tripled since the 1970s.

Although child obesity has its roots in many problems: genetic factors, metabolism, specific eating and physical behavior, short sleep duration, negative childhood events, the impact of the environment, there are several ways how to improve those bleak numbers and prevent diseases like diabetes or cardiovascular conditions in an earlier age. The Finnish SAPERE method is one of them for how to teach a healthy attitude towards a wide range of food items and encourage children to have a diverse diet where sweets, pizza, and spaghetti is balanced out through vegetables. The U.S.-based Shannon School is doing something similar to primary school children, but nutritious education is part of the curricula at many schools around the world – and we believe many more should follow their examples.

Nevertheless, digital technologies could also aid children on the path towards healthy eating. Michelle Obama’s Let’s Move initiative included an Apps for Healthy Kids contest, where the winner was Smash Your Food from Food N’ Me, a game that builds kids’ awareness of the fat, sugar and oil content of different foods by letting them guess those numbers and then check their guess through a simulation of smashing the food in a compressor. A similar app from Medtronic uses an animal avatar called Lenny the Lion to teach kids with diabetes about carb counting, while Ayogo deployed Monster Manor for similar purposes. The Austrian-based mySugr developed the mySugr Junior for children aged 6-10 to help them manage their condition with the help of the diabetes monster.

Donation to charities through step count and fighting inactivity with gamification

However, not only food and eating should be on the radar of health-conscious parents. Physical activity is key to the fight against obesity and a variety of childhood diseases. While the WHO recommends 60 minutes of regular, moderate to vigorous-intensity activity every week, a youth risk survey across the United States from 2011 showed that 13.8 percent of students had not participated in any kind of physical activity that increased their heart rate on at least 1 day during the 7 days before the survey. Another survey from the UK even showed that the number of children meeting the recommended amount of physical activity for healthy development and to maintain a healthy weight drops by 40 percent as they move through primary school.

From sensors during pregnancy through baby monitors until fitness trackers for kids, the scale of digital health devices for the family is widening. Several digital health techniques exist to help reduce these statistics and encourage kids to move more. For example, raising a health-focused and fit child is easier through gamification. If you tell a kid to go out of the house and leave the video games because that’s healthy, you can be sure as a parent that it won’t happen. On the other hand, if you say that they can collect points or coins and then have some rewards, the story will be completely different.

Some companies already realized the benefits of gamification for children’s healthcare. Leapband, Zamzee, or Vivofit jr., for example, encourages kids to stay on the move. The latter tracks steps, sleep and 60 minutes of daily recommended activity. Kids are able to earn coins to redeem for agreed-upon rewards, while parents can monitor the kiddos’ steps and active minutes, assign chores and even hand out those virtual rewards. In the case of Zamzee, kids can cash in their “Pointz” even for donations to a charity, which is apparently a popular choice. HopeLab released an efficacy study which showed Zamzee got kids to move 59 percent more than non-users over a six-month period.

Emotional, cognitive health and meditation

As in the case of adults, it is also not enough for children just to get the appropriate amount of food, enough sleep and physical activity for being healthy. Physical health greatly corresponds to mental as well as cognitive health, and unfortunately, statistics show that the youngest generation is plagued by mental health troubles. The CDC says that only in the U.S. 9.4 percent of children have received an ADHD diagnosis, 7.4 percent have a behavior problem, while 7.1 percent fight anxiety and 3.2 percent have diagnosed depression.

Researchers also found that trends show an increase in mental health troubles among kids – and that might also have something to do with screen time as well as the use of the latest technologies in general. A study published in the journal Preventive Medicine Reports found that young people who spend seven hours or more a day on screens are more than twice as likely to be diagnosed with depression or anxiety than those who use screens for an hour a day. Thus, parents should definitely pay more attention to how much time their kids are spending in front of smartphones, tablets, or TV screens, and what kind of programs they are watching.

Moving beyond mindless video games or silly cartoons, some mental health apps or cognitive games could even improve the situation. For example, the MindShift app aims to help young adults cope with anxiety, by acting as a portable coach that guides users through challenging situations. Breathe, Think, and Do with Sesame is another app that helps kids learn to deal with frustrating situations using the “breathe, think, do” method. Regarding cognitive games, we can recommend Lumosity, Elevate, Peak, or CogniFit, which all improve brain activity through engaging games and show kids that there’s more out there than killing zombies.

On a more institutional level, some schools are experimenting with meditation. Teachers at Brighton State School on Brisbane’s bayside are among a growing number of educators embedding meditation into their daily lesson plans to help children deal with their emotions and improve focus and behavior. That sounds like a practice to be followed in the future!

Preparing kids for medical emergencies

Medical education is also an important aspect of children’s health. It is very useful to teach kids early about bacteria, diseases, allergies, or even medical emergencies. The Medical Futurist team loved the French animation, Il était un fois… la vie (1986). It was fascinating how the creators talked about the human body as a construction where tiny cars floated through human veins, grab-cranes worked on teeth and bacteria as tiny monsters tried to attack innocent screaming lady-cells, while white blood cells defended the body as well-trained soldiers.

That’s a way kids also understand and find entertaining – and that’s what digital health technologies also employ. The American Red Cross developed an app called Monster Guard focused on helping prepare children for emergencies. It teaches kids through “Monster Guard Academy” how to prepare and stay safe during home fires, hurricanes, floods or other disasters, and they get points and medals for completing tasks. The Italian Resuscitation Council (IRC) produced a very innovative and challenging project called “VR CPR”. The aim of this project is to create a full self-directed learning platform for cardiopulmonary resuscitation training in VR. Imagine how children might exercise CPR in VR on their little teddy bears in the future… and if we are already imagining things further down the road…

The future of children’s health

How could a kid’s childhood look in 30-40 years if we will manage the save the planet from ourselves? We believe that every child might get the results of their genome sequencing as early as the day after they are born – but parents will have the responsibility to hand it over to them when they believe that it is time for it. As genetics will get more and more significant in the coming years, parents might consider having a conversation about genetics and genomics with their kids. We know that the appearance of cheap direct to consumer genetic testing brought with it an era when anyone can have their ancestry test in weeks and that might create awkward situations within families, but as that option will not vanish anytime soon, isn’t it wiser to tell your kids the truth early enough? And regarding health risks, it is even more important to be honest, as they could have the chance to shape their diet and lifestyle according to their genetic background.

On another note, the use of VR, AR, artificial intelligence and robotics seems to be inevitable in raising children 30-40 years from now. No matter whether it is about babysitting, education or play-time, digital technologies have the capacity to completely reshape the experience of being a child and a parent. New York-based Elemental Path, for example, develops Cognitoys, dinosaur-shaped toys kids can have a discussion with. It teaches them how to count, how to create stories together (!), remember colors and more. They can sing or play games and they also have amazingly bad word-wits. Toys that use artificial intelligence might become real friends with kids.

As a consequence, parents will need to teach their kids how to survive in the digital as well as the real world in the future; how to find the balance between the analog and the digital, the real and the virtual. Not an easy job, but we should never forget that technology is out there as a tool to help humans, we are the ones making the decision on how to use it. So, we should use it well, and teach our kids to do the same.

How To Teach Kids (Digital) Health Literacy?