Sustainability of technologies.

Access to technology. How are decisions made locally. Technology may be the same but access may be different. Access to health related technology may differ. Equitable access.

Contracting in UK can be challenging for companies. US more a partner of choice. Model of Mental Health Mission - single point contracting.

What is a medical device and what isn't - particularly challenging when linked to lifestyle. Medical device route complex and challenging. Where are you putting that device, scope, implementation and scalability.

Inequalities and digital exclusion. End user angle really important.

Right to education and technology. Access without increasing inequality.

Engaging with more people because of remote nature - more accessible e.g. for people in rural areas. Challenge can be around digital literacy / exclusion of certain groups.

Trade off between online and human / in-person component.

Dangers of chat bots - misinformation. Who is regulating guidance / advice is chat bot is 'in charge' of delivery that guidance to an end user.

Digital technology relying on algorithms to deliver guidance - high risk. What is feeding into this - research - problems of bias.

AI, machine learning is only as good as the information you give it in the first place.

Data that feeds into tools can be patchy, collected in different ways - this can lead to biases in outcomes.

Pipeline of implementation challenging. Ideation at translation stage can be difficult to put into practice.

Making lifestyles worse?

Companies often come with a product. Commercial interest in intervention can be challenging to navigate.

Challenging to get necessary data from tech companies to inform research projects. Lack of commercial value / interest. Research could have negative impact on company. Design of algorithms for continued engagement.

Social media data gathering increasingly difficult.

Infrastructure for 'safe space' data. Could this be set up for social media data.

How do we work with these companies and overcome these barriers?

Better access to data through secure environments. Is it better to have to one system for all data or separate owners for different spaces / locations.

What do we mean by lifestyle and technology?

Lack of separation, constant monitoring, e.g. cameras in homes, apps for nursery children.

Technology is part of our lives. Need to educate rather than ban.

Ethically need to have interventions in place to justify the need to screen.

What technology - communication, equipment, medical devices etc?

What does technology need to look like to support health and wellbeing?

How to embed technology in education.

Do we need to create an add-on for lifestyle? What information is being used to formulate lifestyle advice?

Have technologies that inform a choice rather than making the choice for an individual. However, need to be cautious about access to information. Could it disadvantage some communities?

Technologies evolving from defined purpose to wider application - e.g. improving performance in elite athletes, heart rate monitoring to improving public health - fitness trackers.

Good relationships with local authorities and businesses.

Need better mapping of commercial links in Birmingham.

Cross-discipline collaboration, answer questions in a novel way.

A lot of different infrastructure funding through NIHR.

Lifestyles as a term - should it be revised?

How can we think about infrastructures? How are body/mind/technologies connected?

The AI Boom

AI boom has fundamentally shifted how people are consuming and interrogating content.

• AI now becoming more seamless - e.g. integrated into Google. Can it be suitable for use in therapy for young people? Will AI accelerate feelings of distrust and what will the effect on young people's communication be? What are young people asking ChatGPT?

• Is there now an overreliance on AI from young people and could this lead to a rejection of authoritative figures? This is currently a very underexplored area.

• Lots of research is already being conducted on trust within linguistics and communication - ESRC bid being developed by Ruth.

Sleep and mental health

• Biological changes caused by adolescence which has an impact on sleep in young people - but society also imposes many demands on them (e.g. having to wake up for work/college/university).

• Biological effect of light which can cause sleep disturbances.

• Companies incorporating some solutions such as changing brightness levels on phones to be less bright before bedtime.

• Conflict between not using phone before sleep and people who use their phone for sleep e.g. listening to music or podcasts?

General challenges/problems

• A key question is - what education do we need to use these tools well?

• Can people emotionally regulate and think critically about technology?

• Challenge of parenting for generations that aren't familiar with having access to this amount of technology.

• A holistic approach is needed - can't just be tackled by regulation or in schools.

• Multicultural and multigenerational approach needed.

• Schools can teach about appropriate tech use but how will parents access the same information when it comes from so many different sources?

• Parents need to be involved in the whole discussion - support, guidance and rules.

• Role of corporations will be critical - but they may be reluctant to limit tech use as then this affects profits! Corporations that are already interested in digital health will likely remain interested e.g. TikTok, Pinterest have a good wellbeing approach. Meta is one of the companies who are more difficult to deal with.

• We need better verification for people online who are providing health advice. However, this requires a lot of resources from the company and costs a lot.

• Tap into communication with people at companies who are already interested in digital wellbeing.

Impact of technologies on different age groups

• Shift towards 'younger' older adults - people in 60s and 70s are quite tech-savvy.

• We can promote digital health aspect of tech to these groups e.g. for use in physio for monitoring purposes. Use of tech to track if someone is doing the right exercises at the right time - rather than just leaving a leaflet and checking back in a few months! However, there are also examples where tech use for physio could be made more engaging e.g. for young children - lack of video demonstrations and no 'achievements' to work towards if the physio exercises are completed.

• Opportunities to 'gamify' these activities.

• Wyke Stommel - involved in a project in the Netherlands to look at digital communication with medical professions

  
  

Main areas that technology could propose solutions to

• Positive impact of social media to keep in touch with people all over the world - combating loneliness and allowing connection with family and friends elsewhere in the world

• Digital intimacy and how it's shifting

• Is remote working reducing the impact on the environment (e.g. through reducing travel) or is the growing use of AI servers going to cancel out these benefits?

• Influencers and 'coaches', people with lived experience e.g. endometriosis - support but not necessary good advice?

• Technology has put a barrier in accessing GPs e.g. the need to book appointments online, but this comes with its own problems for elderly people such as being scammed

• Technology is encouraging generation of new anxieties connected to institutions as well as with individuals

• Financial advice is another area where technology can be inaccessible for people less familiar with it

Domains of social practice

• Practices are not the same as behaviours - they are structured by existing systems e.g. economic and social systems

• Amie's domain - the home, parenting

• Ruth's domain - learning and how learning is integrated, both formally and informally

  
  

  Our topic

  How does trust impact wellbeing and society in relation to digital technology?

  
  

How do we sell this to a funder?

• Find research that is already going and move these up to controlled trial stage/intervention. Need a greater Sum.

Ethics and levelling up.

MRC interest in levelling up access to data.

Intersecting and overlapping biases. Who generates the data, who has access to the data?

Geographical element to data - e.g. ER wait times.

What is a medical device? At what point does a device become lifestyle. What regulatory infrastructures need to be in place. Intervention and translation expertise.

Lack of awareness of what constitutes a medical device, even in NHS settings.

Data sharing, where are the boundaries?

What should the pipeline look like?

Pipeline from R&D to end user.

Outline pipeline of development - clarity from experts across whole pipeline.

Challenge balance commercial interest and research / implementation purpose.

UoB Enterprise Invention Form - support through definition of medical device. If not ready or no obvious commercial benefit, can be challenging to find the right support for further development / implementation.

Is medical device the only option? What other avenues can be pursued?

What are the unintended consequences of introducing / using the technology?

What would influence your trust in the technology - social enterprise versus limited company; academic evidence versus funded backing?

What are the NHS looking for in emerging technologies?

Our Future Health - trust from user to share data.

Tools with a social and cultural impact. Changes in behaviour.

Scaling up of activities - support through pipeline of development. Bridging gap from initial start up work to wider implementation.

Usage of Impact Acceleration Account (IAA) funding and proof of concept funds.

Mapping existing networks and pathways in the university. Expertise in the Department of Applied Health Sciences (CMH).

Looking to universities to take an expert view on emerging technologies.

Stop to think "What problem am I trying to sovle?" Think about the end goal. Come with developed products rather than asking what the issue is?

Alternative option rather than last resort.

Users understanding benefits, risks and harms.

Regulation is not cohesive.

Research on user awareness. How do educate users on the technology.

AI for health - critical thinking vital.

Digital tech in diagnosis of conditions

Look at tech affecting throughout life from childhood through to old age.

Children - (preschool/reception) eg. self-regulation apps

• Imparting knowledge to practitioners

• Children interacting with apps directly

• Risk/benefits - consideration needed of how app is introduced and used.

Example of emerging tech: Meta smart glasses release will incorporate eye tracking, 3d reconstructions of what you're looking at, building on currently available window of info in the glasses.

• Harms - combine data recorded by smartglasses with harmful apps eg. nudify.

smart glasses are being pushed, not mainstream yet, but feels like next step moving beyond smartphones.

• Goods - combining data to provide help in emergency situations

What are the consequences and how do agencies get ahead?

• Different age groups use differently tech in pop-domain/sensationalised at the moment quickly becomes mainstream

• develping healthy relationships with chatbots - development has slowed down.

 - how does society regulate tech and provide tools for opting in and out as appropriate and tackle problematic categorisation of those who choose to disengage from tech (eg. whatspp groups).

Benefits - research in developments in child psychology, why do kids develop face recognition before body movement - tracking what infants see helps explain developmental progress.

Question - how do tech capabilities affect development in order to inform policy

Question - how do you regulate usage, teaching how to self regulate and interact healthily. need to look at risks and benefits of how available tech is used.

Considering a project on smartglasses and impact on developmental psychology - how different are the impact of smartglasses in comparison to smartphones?

• Richness of information leading to laziness? In contrast to smartglasses being marketed as increasing cognitive ability.

• Research into areas of brain affected by use of different techs.

• Would having more information available on a person enable improved social interactions? What assumptions would this introduce into interactions?

• What are the risks - how do you know people using smartglasses?

• Benefits to research with correct safety/control of data sharing.

• Risk - what will companies do with data collected? Personalised advertising etc.

Current research in smartglasses: google glass not so much take up. meta sunglasses much more uptake with new iterations coming.

• Information gathered gives raw data to meta rather than user.

• what is the testing for users currently?

Wearable camera research:

• Interesting Q - what are the upper limits that you think are acceptable with sharing your data with organisations (apple/meta...)

• What people are happy with sharing is changing - variation across generations

• At what age does the awareness/discomfort with who has you data and what are they doing with it kick in?

Summary:

• Look at emerging tech (smartglasses)

• Exploring use, benefits and risks, across demographics, looking at data sharing and privacy

• Look at areas of brain affected by emerging technologies.

• Digital Education needed

• Different attitudes across demographics to data sharing and privacy (not specific to a particular technology) - has implications for developers, government, consumers.

What existing strengths/resources do we have to answer these Q's? eg. does current Smart School research in existence provide a protocol for research in smart technologies and pathways to impacting policy?

• currently observational studies

• currently parental and school education as outcomes rather than context of engagement

If want to make policy recommendations from research, how are they regulated? Who is the oversight committee saying yes/no?

• Responsibility is pushed to user - GDPR onus is on user rather than provider of smart tech.

• To influence policy, need to make information available to user and highlight risk in accessible way

• Work with platforms to highlight harms

• Identify relevant stakeholders and engage appropriately

What links do we have?

• Meta links/advisory capacity exists in UoB/LES

• IDAI? - can propose projects for IDAI students.

• If there are proper safeguards, tech does really cool things, eg. sensor data from wearable devices going to NHS/research is appropriate. (Side note: EDI aspect - devices working better on light vs dark skin)

• Health anxiety over the numbers the wearable is giving the user eg. glucose monitors being used when not needed.

• In severe mental health conditions are there any benefits at all - paranoia psychosis etc.

• Examples of sensor use in health care:

  • Sensors used in Parkinsons sufferers allowing communication of emotions to enable helping themselves and others - facial expressions are different

  • Sensors helping non-verbal autism - including allowing of communication of physical pain

  • Adolescents - pain as expression of anxiety etc.

• Does using tech remove the skills needed to articulate emotions - being able to articulate can often be key to unlock tackling root problem.

• Chat GPT therapist - some guardrails, others don't, but can get uncensored version, and other providers do not have guardrails.

Responsibility comes back to individuals - not enough guidance or education, a need for examining personal boundaries.

• some work in school curriculums teaching children about this.

• Improve digital literacy and identify issues which can feed into policy.

• Cross-curricular tacking of the issues/imparting of education.

Define what Digital wellbeing and flourishing - start with the groups or aims of what we would define as flourishing wellbeing and then looking back at the technologies and how they work to support this.

Starting with the user - this then helps defines what the digital technologies are rather than starting with a technology. The definition of digital flourishing and wellbeing is a societal one rather than individual view.

Understand how technology and demands of technology interact, some are imposed on you for work or school, impacts on no separation from work and home, what do we elect to use and what are imposed on us?

How do we get a framework to understand the benefits or detriments of digital technology in their own lives?

The sense of choice of using technology is possibly less, not just forced upon us for train tickets etc, but also sociably can you avoid it without being socially excluded, how to we retain agency in our own decisions to engage with technology?

The consequences can be passed on different personality types that can enhance the dangers of digital technology (addiction etc). This is very difficult as there are so many other factors can influence this and not just personality type.

Existing Data Sets - can move this forward quickly. Rather than focusing on going to collect more data. Need to asses this first against the key questions, what requires more data and what can be uncovered from existing data.

Could offer self evaluation and support options for individuals so that it is flagged by the user rather than defined by there personality directly - addiction to tech etc.

Different groups of people accessing the same technology will have vastly different experience of that technology.

Framework for someone with high agency would work, someone with less resource of agency may be less suitable.

Need to put into a framework what do we mean by Wellbeing - What are we trying to influence and then work backwards of how do we do this, different groups, different populations.

WHO - created physical health, based on existing data and consensus, and then expanded and evolved. Physical activity is no longer X mins vigorous exercise it is now lifestyle. Technology and wearables is supporting this.

Need to define Wellbeing - Flourishing method - this is well known and then look at the digital evidence around those domains. Avoiding defining what is Wellbeing.

Wellbeing has evolved - but digital technology 'media literacy' is new. How is Wellbeing also influenced by new technology?

Health inequality - need to access the people who don't traditionally engage with research.

Summary:

Framework to help people think through their own digital technology use.

Can this be a pathway through to toolkits used by health practitioners, educators etc.

Do the technologies themselves need to have an element of self reflectance of how they are being used by the user and to reflect on how this is impacting their own wellbeing

• What data are we giving people access to in terms of our health?

• Disparity between some NHS services - difficulty in treating certain conditions and tech is not being applied in the same way for each one.

• No regulatory protection

• How do we educate a hyper-individualised society in relation to health and technology?

• Listening to people when conducting research projects e.g. young people.

• Need to listen to people across different demographics

Possible research questions/themes

• What are the emerging technologies?

• Rapid emergence of AI

• How do we educate holistically to equip people to maximise the good from emerging technologies and minimise harm?

• Different stakeholders - policy-makers, NHS professionals

• Education of policy-makers essential

• Research that considers everyone from the ground up

• Consideration of mental health in underserved communities

• Support, learning, educational needs among underserved communities and how do we facilitate this?

• Digital inequalities and health inequalities (the 'digital divide') and how they relate to wider social issues - a thread across all different themes. Higher deprivation has increased over the past few years - more likely to want online health advice. More trust in these devices as it may be cheaper.

• What forms are digital inequalities taking and how is this emerging in the current social landscape?

• Future scanning - AI is in a lot of other things apart from large language models e.g. deepfake videos. No longer need huge amounts of computing power to do this.

• How can we educate today for what's coming tomorrow?

• More trust in visual-based forms of communication?

• Shift from authority to authenticity (or perceived authenticity - deepfake authenticity!)

• Critical thinking and emotional regulation in teaching people to use emerging technology

• Autotranslation for multilingual purposes is another area to consider - how accurate is the translation?

• What kinds of literacies are needed beyond verbal communication to better enable diverse communities to thrive?

• Attitudinal changes take a long time to develop - this is the biggest challenges

Possible methods

• Adopting bottom-up approach - participatory co-production e.g. speaking to young people from diverse communities, use of focus groups.

• PPI work with specific communities to help us frame thinking

• Scenario-testing - asking people how would you respond to the use of emerging technologies and how do you feel about it? e.g. people don't necessarily know how CCTV is used but they do know that it's used in shops etc. Ties in with theme of educating people and makes people more engaging. Hypothetical situations may be easier for people to discuss.

• Survey-based approaches - measuring across different contexts. This could be integrated into scenario-testing. As people learn more about the topic how is their view changing?

Funders

ESRC Digital Good/Sociodigital Centre