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Archive for the 'Difficult and priority issues in digital health' Category

The Smartphone Dilemma: Exploring Parental Decision-Making for 9-12 Year Olds

By CBC Digi-Hub Blog, on 10 May 2023

Written by Rachel Perowne, PhD Student (UCL Centre for Behaviour Change)

Children’s interaction with the online world is a hot topic – recently, The Economist magazine asked whether smartphones are to blame for recent increases in the rates of suicide among girls [1]. This week, the Children’s Commissioner for England published a report evidencing the effect of pornography on harmful sexual behaviour among children and suggesting a link between exposure to pornography and children being given their own phones at younger ages [2].

I was 21 when I got my first mobile phone and over 30 when I got my first smartphone, but today’s children and young people are growing up in the digital world where the concept of a ‘brick phone’ or landline is alien, and smartphones are the norm. As technology plays an ever-increasing role in our lives, it’s not surprising to learn that children are acquiring smartphones at a younger and younger age. To illustrate, in 2018, 35% of 8–11-year-olds owned a smartphone [3] and this had risen to 60% by 2022 [4].

So how do parents make the decision to give their child a smartphone?

This question fascinated me – both as a parent with a son approaching 11 years old and as a researcher interested in young people’s wellbeing in a digital world. I could hear many of my friends and peers with children of a similar age debating what to do and I took the opportunity, whilst waiting for my PhD to officially begin, to examine this, with the support of my supervisor Prof Leslie Gutman.

Our study, published this month, on parents’ perspectives of their children’s smartphone ownership [5], involved interviewing 11 mothers and fathers of 9- to 12-year-old children and using the COM-B model to identify which elements of Capability, Opportunity and Motivation were influencing their decision making.

Our analysis identified a number of influencing factors across all three COM-B domains:

  • The external environment was a key enabling factor in parents deciding to give their child a smartphone; parents see smartphones as an inevitable aspect of the modern world that can only be resisted for so long because ‘technology is everywhere’.
  • Added to this, the pressure of peers being given a smart phones – the social opportunity – creates a ‘domino effect’ which then affects parents’ motivation, making them want to prevent their children being left out and help them build their social relationships.
  • They also see advantages in being able to track their child’s movements and ensure they are contactable once they start travelling independently to and from school. ‘When they… go to school by themselves, then obviously I need to give the smartphone’. Hence the transition from primary school is a key time for many children being given a smartphone.
  • However, parents are conflicted. They also have worries about their children entering the world of smartphones and the unfettered access to the internet that this can bring. ‘Having his phone in his room at night is a big worry for me’.
  • They worry about the impact of social media, about bullying, about overuse and addiction but are sometimes unsure of what the real benefits and risks are. ‘I think there are certain risks and I think there are certain benefits but it’s all kind of in my own head’.

This uncertainty is understandable. Evidence is mixed on the impact of smartphones on younger children, with many recognising that smartphones can support learning and increase digital skills which are important for life in a technological world. At the same time, whilst causal linkages are hard to demonstrate, correlations are apparent between smartphones and sleep disturbance, anxiety and academic performance. It seems clear that young people are also particularly prone to Problematic Smartphone Usage (where usage interferes with daily life and activities).

So where to go from here?

The parents we spoke to were grappling with their decision-making. They felt that there was a lack of guidance and support for them in planning how and when to give their child a smartphone. This challenge is heightened because their own digital technology skills and knowledge are often inferior to their child’s, meaning that their efforts to control usage and access can be undermined by a tech-savvy child. Our paper discussed potential intervention strategies (using the Behaviour Change Technique Taxonomy (v1) [6] including:

  • Restrictions such as having a recommended minimum age for smartphone ownership
  • Guidance and support for parents preparing and planning to give a child their first smartphone
  • Education from credible sources on the benefits and risks of smartphones for children
  • Training in setting up appropriate controls on a child’s smartphone

Whether there is a role for regulation and restriction (such as age limits) of smartphones is a debate that rages. In either case, it seems clear that expecting parents to navigate this significant decision on their own is too much. Given the potentially lasting impacts of owning a smartphone for children, better guidance and support from authoritative, trusted sources are required.

[1] https://www.economist.com/graphic-detail/2023/05/03/suicide-rates-for-girls-are-rising-are-smartphones-to-blame [2] https://assets.childrenscommissioner.gov.uk/wpuploads/2023/05/Evidence-on-pornographys-influence-on-harmful-sexual-behaviour-among-children.pdf

[3] https://www.ofcom.org.uk/__data/assets/pdf_file/0024/134907/children-and-parents-media-use-and-attitudes-2018.pdf

[4] https://www.ofcom.org.uk/__data/assets/pdf_file/0024/234609/childrens-media-use-and-attitudes-report-2022.pdf

[5] Perowne, R., & Gutman, L. M. (2023). Parents’ perspectives on smartphone acquisition amongst 9-to 12-year-old children in the UK–a behaviour change approach. Journal of Family Studies, 1-19. https://www.tandfonline.com/doi/full/10.1080/13229400.2023.2207563https://www.tandfonline.com/doi/full/10.1080/13229400.2023.2207563

[6] Michie, S., Richardson, M., Johnston, M., Abraham, C., Francis, J., Hardeman, W., Eccles, M., Cane, J, & Wood, C. (2013). The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: Building an international consensus for the reporting of behaviour change interventions. Annals of Behavioral Medicine, 46(1), 81–95.

Is “brain hacking” right for behavioral medicine?

By ucjubil, on 9 May 2017

By Jason Fanning a health psychologist and programmer

It’s an attractive possibility: A health app so engaging the user does not want to put it down. All the better if they feel compelled to move a bit more or eat a bit less to get that next reward! This is certainly the model for many of the most popular social media applications, and the term “brain hacking” – or the attempt to purposefully trigger the brain’s reward circuit to prompt the user to come back time and time again – has recently entered the popular lexicon and received coverage from several major news outlets. (more…)

Getting help from Doctor Google

By ucjubil, on 2 May 2017

By: Julia Mueller, PhD candidate at the University of Manchester
Supervisors: Professor Chris Todd, Dr Caroline Jay, Dr Simon Harper


George has been coughing for months. When people point it out, he dismisses their concerns. “It’s just me getting older. And all those years I smoked!” But over time, he becomes more concerned. Finally, he turns to the Internet. Online, he finds a confusing, overwhelming mass of information. He can’t figure out which information is relevant. “If I go to the doctor with a tickly cough, he’ll think I’m trying to waste his time,” he reasons. So he leaves it at that. (more…)

In search of ‘well being and behaviour change’ in the workplace

By ucjubil, on 28 March 2017

By: Dr Mark Cobain, co-founder and director, Younger Lives Group


“I get asked to deliver wellbeing all the time. I still don’t know what the hell it means!” Occupational Health Professional, March 2017

Last week we exhibited our new ‘Younger Lives’ products at the Health and Wellbeing at Work event at the National Exhibition Centre in Birmingham. It’s the first time we attended. Most of those attending were largely from occupational health and human resource communities from small and large organisations in the public and private sector looking for ways to “engage” their staff with health and wellbeing. Many were just starting their foray into the space, trying to get inspiration for new ways to introduce the concept to their people.


Should a health intervention fit routines or disrupt them?

By Carmen E Lefevre, on 24 November 2016

By: Andrea Maltman, Virgin Pulse


At last count, Gallup reported that unhealthy and absent workers cost the UK economy £2.1billion in lost productivity.

Employers have proof that the health of their employees cannot be separated from the health of their organisations.

But as the modern workplace becomes the logical place to improve health and behaviours, important questions loom. Questions like: should a health intervention fit existing routines, or disrupt them?

There is a temptation to opt for the latter; to shower employees with gym memberships, boot camps and high-tech fitness devices.

These may be beneficial additions to any health strategy. But in reality, they rarely become true habits because they are too ambitious and removed from an employee’s routine to be sustainable.

What employees actually need is something small and in-sync with their current lifestyle, according to Dr BJ Fogg. He is a member of the Virgin Pulse Science Advisory Board and a leading expert on behavioural change.

In his Ted Talk, he says that for a behaviour to occur, three elements must be present: motivationability, and a trigger.

However he warns that, in order to do something difficult – like improve health and lifestyle habits – high levels of motivation are needed. And often, these alone aren’t enough.
“Relying primarily on motivation to change behaviour in the long-term is a losing strategy,” Dr Fogg says.

“But you can take motivation off the table if you make the behaviour change small enough. Then, it’s very easy to repeat, and it can become a habit.
“As we create these habits, little by little, we approach desired outcomes in a very reliable way; one that doesn’t regress, make us give up, or go back to the way things were.”

Examples illustrate the point: if a sedentary employee – dealing with stress, career pressure, deadlines and family demands – gets out of bed faced with a gruelling workout or boot camp session, then there’s little motivation and the odds are stacked against them.

But if that same employee wakes up and decides their new behaviour will be getting off the train one stop early, or listening to a meditation podcast during the commute instead of music, it’s not that huge or different.

Soon, they’ve managed to create a new behaviour, maintain it, and establish the foundations of a long-term habit – probably without even noticing.

The Virgin Pulse Global Challenge is designed to work this way. It’s based on the behavioral science outlined above, yet it also provides members with a simple and engaging journey that improves their physical and psychological health in the long term.

Statistics from the 2016 Global Challenge prove that small changes can get big results[1]:

70% of members now meet the recommendation of 10,000 steps per day

68% who tracked their weight have lost weight

69% now meet the recommended amount of sleep

69% report a decrease in their stress levels at home or at work

58% report an increase in either productivity or concentration


The results are clear: positive changes don’t need to disrupt an employee’s life. But what they do need to be is small, rewarding and introduced slowly until the desired outcome is achieved.

[1] Global Challenge. Final Global Report. 2016. Pre-event (257,984 respondents); post-event (120,402 respondents).


BIO: Over the past 13 years, the Virgin Pulse Global Challenge has helped transform the cultures of the world’s leading organisations and improve the health and performance of over two million employees. In 2016, Global Corporate Challenge (GCC) proudly joined Virgin Pulse to become the leading provider of technology solutions that promote employee engagement and wellbeing. The GCC program is now known as Virgin Pulse Global Challenge. Part of Sir Richard Branson’s Virgin Group, Virgin Pulse offers a breadth of best-in-class solutions to maximize employee engagement and performance initiatives and drive measurable and positive outcomes for your employees and business.