Tamira Snell: We Live Fluid Lives, With Fluid Behaviours 

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Tamira Snell is the Senior Advisor at Copenhagen Institute for Futures Studies. In CIFS Health Team, she focuses on health behaviour. This is the second part of her interview, on interactions between digital health and health behaviour, the first part here. Below, she dives into the relationship between the two realms, discusses how our health behaviour is likely to change in the near-, mid-, and long-term future, elaborates on challenges to this vision, and how to address them. 

Q4: Let’s talk about digital health and health behaviour. Where do you see interactions between the two, and what trends do you observe, if any? 

A4: The interactions between digital health and health behaviour, as already mentioned, have long been underway and will continue to unfold.  

Especially the interrelation between individualised and personalised health through digital measures and the social elements of belonging and incentives will be the two sides of the same coin. For many years, the focus has primarily been on the concept of personalised health through digitalisation, however, understanding the social components ingrained as well will be essential in the context of health behaviour change. 

Recently, Deloitte and the Perelman School of Medicine conducted a study on 602 overweight and obese employees using wearable fitness trackers. Social Incentives to Encourage Physical Activity and Understand Predictors (STEP UP) measured the effects of three different types of social incentives (social support, social collaboration, and social competition) on physical activity. All three groups with social incentives achieved greater physical activity than the control group, according to the study. A combination of data (progress tracking) and behavioral science (social incentives) can impact change. Other desirable behaviors, such as a healthy diet or improved medication adherence, can also be encouraged by these strategies. 

Another interesting area to follow, is the development of persuasive technologies. SoMe platforms are built on persuasive technology – technology created specifically to change its users’ opinions, attitudes, or behaviors to meet its goals. Ethics here will be a clear component, as well as data security, however digital health trends are increasingly intersecting our health behaviours. 

Q5: How do you wish health behaviour to change in the near, mid, and long term future? 

A5: I strongly advocate for the continuing development of our understanding of the complex dynamics and interconnections between behaviour and socioeconomic and cultural structures. In addition, I wish that the general perception of behaviours will become so mainstream that we automatically remember that behaviours exist in the flow of our everyday lives. We live fluid lives, with fluid behaviours. Behaviours, as well as health indicators, fluctuate throughout the day, across days and weeks and years. 

A combination of models of health behaviours and wearable, wireless technologies that embodies this understanding of fluidity will enable a new generation of interventions that can be tailored to changing behavior ‘on the go’. Changing behavior requires compelling, engaging interventions that are seamlessly incorporated into daily life. It is important to develop good habits that will last a lifetime. Further, short-term behavior changes are often followed by relapses, so future interventions should focus on achieving sustained behavior change, that is, maintaining healthy behavior throughout one’s lifetime. 

By using new technologies, it is possible to track calories, sleep, stress, blood glucose, exercise loads, that can be used by individuals for self-monitoring, by health care providers for tracking patients, and by health care providers for real-time and personalized interventions. During a year, behaviors and health indicators change. What is the relation between these fluctuations and health outcomes? By better understanding these relationships, interventions and maintenance of behavior can be improved.

Understanding the changes in health (behaviours) over the lifespan goes hand in hand with an insight into the momentary changes happening during every single day. An empirical theoretical perspective on health-related behaviors is essential to achieving this goal. Behavior is influenced by many factors, including metabolic, demographic, psychological, social, environmental, socioeconomic, and policy factors. While these theories account for variations in behavior, they fail to consider the real-time influences that affect behavioral change. Using new technologies such as wearables, global positioning systems, and smartphone technologies, we will be able to develop empirically grounded momentary models of health-related behaviors. 

Q6: What are the main challenges to this vision, and how will you suggest to address them?  

A6: The complexity of the behaviour puzzle imposes an ongoing difficulty in measuring linear cause and effect. We will need to move and shift towards the holistic health paradigm, and it has proven to be difficult to move from theory to practice. A shift is happening gradually. 

More data will quite possibly be owned by patients in the future of health, who  will then be able to share their information more easily with third parties, and thus play a more central role in making health care decisions. 

Through the collection, sharing, and analysis of health information, technology can provide riches of data, identify health risks earlier and enable a shift from treatment to prevention. However, data will not be the solution to all. For example, nonclinical decision-makers can also end up making bad decisions if they have access to more data and technology. It will be a balancing act to be approached carefully. 

And almost most importantly, applying the endless data to a better understanding of the interconnected webs of health behaviours will need to move further away from a single focus on what is happening to an in-depth search for why it is happening. Moving between deductive and inductive methods and reasoning will be crucial for future perspectives around health behaviours.