Leveraging Social Media to Engage Adolescents in Health-Promoting Behavior

by Jennifer Barrows

Coauthors: Tim Flannery, MD; Mark Daniels, MD; Clarisse Casilang, MD; Linda Mendoza, MSN, CPNP

Medical Devices & Digital Health

Healthcare struggles to engage meaningfully with adolescents. This engagement gap can have a negative impact on the immediate and lifelong health of young people. This gap can evolve into a chasm during the transition from pediatric to adult care when adolescents are more vulnerable to behavioral health issues, more susceptible to emerging or worsening health problems, and less likely to access care. However, the transitional period also presents an opportunity for adolescents to engage in health-promoting behaviors that contribute to their present and future well-being. Knowing that adolescents prefer digital communication and typically spend >8 hours per day online, healthcare should meet them where they’re at: on their smartphones and through their social media. This project will explore the use of a novel intervention that leverages the influential power of social media to deliver personalized and contextualized health content through a pioneering digital platform called Nudg. Nudg is unique from other interventions in that its content is created for young people, by young people. We envision Nudg as a radical new approach that integrates humanistic healthcare with modern innovations in technology to promote healthy behaviors and optimize well-being in adolescents from an underserved community.

Nudg is an innovative cloud-based digital platform at the intersection of healthcare and social media, well-positioned to have a significant impact on the health and well-being of young people. It engages adolescents through personalized and contextualized short-form content (nudges) delivered through existing social media channels. It integrates with wearable devices including activity trackers and heartrate monitors to customize content based on real-time data. In adolescents with T1DM, Nudg syncs with a continuous glucose monitor (CGM) and an insulin pump, creating a feedback loop that uses biometric data to deliver personalized content and to the evaluate biobehavioral response. For example, Nudg might alert an adolescent with T1DM of an elevated blood glucose level, prompting them to bolus their insulin. Data from the CGM and the insulin pump will indicate if the adolescent was effectively engaged, as evidenced by enactment of the behavior and improvement in blood glucose.

The goal of this project is to develop and test culturally relevant Nudg content across our pediatric health network including the outpatient endocrinology and Wellness on Wheels clinics. We will build on evidence in the T1DM setting by creating content for adolescents with other common conditions such as asthma and obesity. We will collaboratively design, implement, and evaluate Nudg content with adolescents, for adolescents to promote healthy lifestyle behaviors such as being physically active, establishing healthy nutrition habits, managing stress, and getting adequate sleep. We will engage adolescents in formative research and community engagement workshops to explore the cultural relevance of Nudg and to develop content that meets the needs of our Hispanic population. This project will amplify the voices of adolescents and engage them in all aspects, strengthening its potential impact. Given that our health network includes >100 outpatient clinics, this project could have a positive influence on the well-being of thousands of vulnerable adolescents from an underserved community.