Fostering Digital Life Skills Through Social Media With Adolescents in 6 German States: Protocol for an Accessibility Study According to the RE-AIM Framework.

BACKGROUND: Social media is essential in the lives of adolescents, with 97% of US teenagers engaging daily. While it facilitates communication, learning, and identity development, it also poses risks like harmful content exposure and psychological distress, particularly for adolescents in their critical developmental stage. Teaching digital life skills innovatively counters these risks, adapting traditional competencies such as decision-making, problem-solving, creative and critical thinking, communication, interpersonal skills, self-awareness, empathy, and emotional and stress management to digital challenges. OBJECTIVE: This study evaluates the accessibility of the "leduin" program, a novel intervention designed to impart digital life skills through Instagram. The program aims to leverage social media's educational potential, focusing on effective strategies to engage adolescents. Emphasizing accessibility is crucial, as it determines the program's overall impact. METHODS: The leduin program, developed through intervention mapping, applies behavior change techniques via social media for 9th and 10th graders. It is a 14-week spaced learning curriculum with daily sessions <5 minutes. Emphasizing the "reach" aspect of the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) model, the recruitment targets diverse educational settings across 6 German states, aiming for inclusivity. Recruitment will involve schools, youth centers, and therapeutic facilities. The study seeks at least 128 participants, a calculated minimum to detect medium-sized effects in the quasi-experimental design and explore varying engagement levels and program responses. Data collection includes preintervention, postintervention, and 6-month follow-up surveys, using multilevel regression, latent growth models, and qualitative analysis to extensively assess reach and gain first insights on effectiveness, acceptance, implementation, and maintenance. The study aims to reveal key factors influencing program participation and interaction; a detailed analysis of engagement patterns will reveal the effectiveness of the recruitment strategies and barriers to participation. Additionally, initial indications of the program's impact on life skills, social media-related skills, health status, risk behaviors, and academic performance will be analyzed. RESULTS: Recruitment was planned from May 2023 until the beginning of the leduin program in October 2023. As of March 2024, we have recruited 283 participants. CONCLUSIONS: The leduin program stands as an innovative and essential initiative in adolescent health promotion, harnessing the power of social media to teach important digital life skills. This study highlights the critical role of accessibility in the success of social media interventions. Effective adolescent engagement strategies are imperative, as they dictate the overall impact of such interventions. The insights gained from this study will be instrumental in shaping future programs, laying groundwork for a subsequent, more comprehensive cluster-randomized controlled trial. The study's design acknowledges the limitations of the current quasi-experimental approach, including the anticipated sample size and the absence of a control group, and aims to provide a foundational understanding for future research in this field. TRIAL REGISTRATION: Deutsches Register Klinischer Studien DRKS00032308; https://drks.de/search/de/trial/DRKS00032308. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/51085.

The use of a digital life story to support person-centred care of older adults with dementia: A scoping review.

Introduction: A life story (LS) is a tool healthcare professionals (HCPs) use to help older adults with dementia preserve their identities by sharing their stories. Applied health technology can be considered a niche within welfare technology. Combining technology and nursing, such as using life stories in digital form, may support person-centred care and allow HCPs to see the person behind the disease. Objective: The study's objective was to summarise and describe the use of life stories in digital form in the daily care of older adults with dementia. Methods: A scoping review was conducted in five stages. Database searches were conducted in Cinahl, PubMed, Scopus, Web of Science, and Google Scholar; 31 articles were included. A conventional qualitative content analysis of the collected data was conducted. Results: The qualitative analysis resulted in three categories: (1) benefits for older adults, (2) influence on HCPs' work, and (3) obstacles to implementing a digital LS in daily care. Conclusion: Older adults with dementia can receive person-centred care through a digital LS based on their wishes. A digital LS can enable symmetric communication and serve as an intergenerational communication tool. It can be used to handle behavioural symptoms. Using a digital LS in the later stages of dementia may differ from using it earlier in dementia. However, it may compensate for weakening abilities in older adults by enhancing social interaction.

How does digital life influence the health service use among rural residents? Evidence from China.

BACKGROUND: The Healthy China strategy is an important development objective of the 14th Five-Year Plan and Vision 2035 in China, while health service use in rural China has been a weak link in this strategy. OBJECTIVE: Nowadays, people's health service use will be influenced by digital technology due to the arrival of the Digital Age, and that is the reason why our interest is to discuss the effect of digital life on health service use among rural residents. METHODS: We use the data from the China Family Panel Studies (CFPS) 2020 to examine the effect of digital life on health service use among rural residents, and we use Instrumental Variables method to control the endogenous problem and use KHB model to discuss the mechanism of this effect. RESULTS: It was found that digital life has increased the health service use among rural residents significantly, and this result has been verified by robust test and Instrumental Variables method. Besides, digital life can increase health service use through the information channel effect and the health literacy effect indirectly. Moreover, digital life has a more significant impact on the residents with low social capital, low physical capital and low social trust, which represents the inclusivity of digital life. CONCLUSION: The results of our paper will be helpful to examine the effect of the digital policy on promoting the health service use in rural China, and our findings will provide evidence of how to use digital life to enhance health service use among rural residents. Based on this, the government should take measures to eliminate the digital divide between urban and rural areas by promoting the level of digital life among rural residents, paying more attention to the digital literacy development among them, and forging ahead toward the great goal of the Healthy China under the Digital Age.

Development and Validation of the Digital Life Balance (DLB) Scale: A Brand-New Measure for Both Harmonic and Disharmonic Use of ICTs.

The use of new technologies and information communication technology services (ICTs) has greatly increased, especially after the COVID-19 pandemic, resulting in an irrevocable change in people's work-life balance (WLB). Despite the thriving literature on the dysfunctional use of new technologies, a functional use of ICTs also seems to be possible. Inspired by the theory of psychology of harmony and referring to behavioral addiction models and substance use models, we defined the construct of digital life balance to indicate a harmonic balance between digital life and real life. In this context, the imbalance between online and offline life may reflect a dysfunctional use of ICTs and can be seen as a process of disharmonization. With this perspective in mind, the aim of this study was to develop a dedicated measuring instrument that could capture both people's balanced and unbalanced use of ICTs. Through two cross-sectional studies (Study 1= 1473 participants; Study 2 = 953 participants), we validated the scale internally and externally. In line with the literature, Digital Life Balance scores appeared to be negatively associated with addiction measures and positively associated with well-being measures. In conclusion, the Digital Life Balance (DLB) Scale appears to be a reliable (ω = 0.89) and valid instrument to investigate people's harmonic and disharmonic use of ICTs.

Digital Life Coaching During Stem Cell Transplantation: Development and Usability Study.

BACKGROUND: For patients with multiple myeloma receiving high-dose chemotherapy followed by autologous stem cell transplantation (SCT), acute life disruptions and symptom burden may lead to worsened quality of life (QOL) and increased emotional distress. Digital life coaching (DLC), whereby trained coaches deliver personalized well-being-related support via phone calls and SMS text messaging, has been shown to improve QOL among SCT survivors. However, DLC has not been investigated during the acute peri-SCT period, which is generally characterized by symptomatic exacerbations and 2-week hospitalizations. OBJECTIVE: We launched a single-arm pilot study to investigate the feasibility of patient engagement with DLC during this intensive period. METHODS: We approached English-speaking adult patients with multiple myeloma undergoing autologous SCT at our center. Enrolled patients received 16 weeks of virtual access to a life coach beginning on day -5 before SCT. Coaches used structured frameworks to help patients identify and overcome personal barriers to well-being. Patients chose the coaching topics and preferred communication styles. Our primary endpoint was ongoing DLC engagement, defined as bidirectional conversations occurring at least once every 4 weeks during the study period. Secondary endpoints were electronic patient-reported outcome assessments of QOL, distress, and sleep disturbances. RESULTS: Of the 20 patients who were screened, 17 (85%) chose to enroll and 15 (75%) underwent SCT as planned. Of these 15 patients (median age 65 years, range 50-81 years), 11 (73%) demonstrated ongoing DLC engagement. The median frequency of bidirectional conversations during the 3-month study period was once every 6.2 days (range 3.9-28 days). During index hospitalizations with median lengths of stay of 16 days (range 14-31 days), the median frequency of conversations was once every 5.3 days (range 2.7-15 days). Electronic patient-reported outcome assessments (94% adherence) demonstrated an expected QOL nadir during the second week after SCT. The prevalence of elevated distress was highest immediately before and after SCT, with 69% of patients exhibiting elevated distress on day -5 and on day +2. CONCLUSIONS: DLC may be feasible for older patients during intensive hospital-based cancer treatments such as autologous SCT for multiple myeloma. The limitations of our study include small sample size, selection bias among enrolled patients, and heterogeneity in DLC use. Based on the positive results of this pilot study, a larger phase 2 randomized study of DLC during SCT is underway to investigate the efficacy of DLC with regard to patient well-being. TRIAL REGISTRATION: ClinicalTrials.gov NCT04432818; https://clinicaltrials.gov/ct2/show/NCT04432818.

Meaningful Learning Experiences in Everyday Life During Pandemics. A Qualitative Study.

The COVID-19 pandemic has drastically changed the lives of people all over the world. In particular, an unprecedented educational crisis has occurred due to the circumstances of physical distancing and remote learning. This article focuses specifically on the meaningful learning experiences in the everyday lives of adolescents during the pandemic. 72 meaningful learning experiences were identified from 11 participants who recorded their specific learning experiences for a week by a means of a journal recorded by themselves. A content analysis was undertaken in order to identify the ecology (what, how, where, and who with) of the different learning experiences. The results show a prevalence of personal and conceptual learning, a presence of both formal and specifically informal, everyday activities among the meaningful learning experiences detected, the importance of peers, teacher and "learning experiences while alone," and the use of digital technologies as learning resources; they also reveal the assistance of others in the learning process. The main contribution of this study illustrates how students in everyday life during pandemics are involved in a whole range of different activities both at school and at home.

Reimagining Senior Centers for Purposeful Aging: Perspectives of Diverse Older Adults.

Senior centers must re-envision their programs to appeal to today's increasingly older and more diverse older adults. Using a purposeful aging framework, this study aims to inform senior center programming by capturing diverse older adults' perspectives on future goals, perceptions of aging, attitudes about senior centers, and experience with technology. Participants age 70 and older (N = 64) joined one of eight focus groups organized by race/ethnicity and preferred spoken language. Transcripts were coded using a grounded theory approach to identify perspectives in each domain. Across groups, shared perspectives included aspirations to make a difference, maintain health and independence, continue learning, and embrace positive perceptions of aging. However, both positive and negative attitudes about participating in senior centers and the effects of technology were presented. We discuss how to redesign senior center programming to meet members' proactive approach to aging and future goals, and facilitate more confidence with new technology.

The Coevolution of Cellularity and Metabolism Following the Origin of Life.

The emergence of cellular organisms occurred sometime between the origin of life and the evolution of the last universal common ancestor and represents one of the major transitions in evolutionary history. Here we describe a series of artificial life simulations that reveal a close relationship between the evolution of cellularity, the evolution of metabolism, and the richness of the environment. When environments are rich in processing energy, a resource that the digital organisms require to both process their genomes and replicate, populations evolve toward a state of non-cellularity. But when processing energy is not readily available in the environment and organisms must produce their own processing energy from food puzzles, populations always evolve both a proficient metabolism and a high level of cellular impermeability. Even between these two environmental extremes, the population-averaged values of cellular impermeability and metabolic proficiency exhibit a very strong correlation with one another. Further investigations show that non-cellularity is selectively advantageous when environmental processing energy is abundant because it allows organisms to access the available energy, while cellularity is selectively advantageous when environmental processing energy is scarce because it affords organisms the genetic fidelity required to incrementally evolve efficient metabolisms. The selection pressures favoring either non-cellularity or cellularity can be reversed when the environment transitions from one of abundant processing energy to one of scarce processing energy. These results have important implications for when and why cellular organisms evolved following the origin of life.

People with dementia and caregiver preferences for digital life story work service interventions. A discrete choice experiment and digital survey.

Objectives: Little is understood about the optimal way to implement digital life story work (LSW). The aim of this research was to explore the preferences of people with dementia and caregivers in relation to digital LSW in an effort to improve future engagement.Methods: 67 caregivers responded to an online discrete choice experiment (DCE) survey containing 16 pairwise choices. The DCE was analysed using a random effects logit model. Willingness to pay and odds ratios were also calculated. 17 participants with dementia completed an online survey in which they made choices about different aspects of digital LSW services.Results: Caregivers valued four out of five attributes [setting (p = 0.000), price (p = 0.000), elementary usability and accessibility (p = 0.001), and follow-up assistance (p = 0.034)]. In data from participants with dementia, the most preferred setting was individual one-to-one (70.6%), and the most preferred use of digital life storybooks was to share memories with others (64.7%). Marginally more participants with dementia said they would pay for the service (53%) rather than only use it free of charge (47%). Those with advanced ICT skills preferred to learn how to use the digital life storybook (64.7%), while those with elementary/intermediate skills, preferred to have it created for them (35.3%).Conclusions: This exploratory study provides an insight into preferences of people with dementia and caregivers, of how digital LSW is implemented. Results can contribute to future planning and tailoring of these services.

Citizens' Juries: When Older Adults Deliberate on the Benefits and Risks of Smart Health and Smart Homes.

: Background: Technology-enabled healthcare or smart health has provided a wealth of products and services to enable older people to monitor and manage their own health conditions at home, thereby maintaining independence, whilst also reducing healthcare costs. However, despite the growing ubiquity of smart health, innovations are often technically driven, and the older user does not often have input into design. The purpose of the current study was to facilitate a debate about the positive and negative perceptions and attitudes towards digital health technologies. Methods: We conducted citizens' juries to enable a deliberative inquiry into the benefits and risks of smart health technologies and systems. Transcriptions of group discussions were interpreted from a perspective of life-worlds versus systems-worlds. Results: Twenty-three participants of diverse demographics contributed to the debate. Views of older people were felt to be frequently ignored by organisations implementing systems and technologies. Participants demonstrated diverse levels of digital literacy and a range of concerns about misuse of technology. Conclusion: Our interpretation contrasted the life-world of experiences, hopes, and fears with the systems-world of surveillance, efficiencies, and risks. This interpretation offers new perspectives on involving older people in co-design and governance of smart health and smart homes.

Origin of life in a digital microcosm.

While all organisms on Earth share a common descent, there is no consensus on whether the origin of the ancestral self-replicator was a one-off event or whether it only represented the final survivor of multiple origins. Here, we use the digital evolution system Avida to study the origin of self-replicating computer programs. By using a computational system, we avoid many of the uncertainties inherent in any biochemical system of self-replicators (while running the risk of ignoring a fundamental aspect of biochemistry). We generated the exhaustive set of minimal-genome self-replicators and analysed the network structure of this fitness landscape. We further examined the evolvability of these self-replicators and found that the evolvability of a self-replicator is dependent on its genomic architecture. We also studied the differential ability of replicators to take over the population when competed against each other, akin to a primordial-soup model of biogenesis, and found that the probability of a self-replicator outcompeting the others is not uniform. Instead, progenitor (most-recent common ancestor) genotypes are clustered in a small region of the replicator space. Our results demonstrate how computational systems can be used as test systems for hypotheses concerning the origin of life.This article is part of the themed issue 'Reconceptualizing the origins of life'.

Evolvability Tradeoffs in Emergent Digital Replicators.

The role of historical contingency in the origin of life is one of the great unknowns in modern science. Only one example of life exists-one that proceeded from a single self-replicating organism (or a set of replicating hypercycles) to the vast complexity we see today in Earth's biosphere. We know that emergent life has the potential to evolve great increases in complexity, but it is unknown if evolvability is automatic given any self-replicating organism. At the same time, it is difficult to test such questions in biochemical systems. Laboratory studies with RNA replicators have had some success with exploring the capacities of simple self-replicators, but these experiments are still limited in both capabilities and scope. Here, we use the digital evolution system Avida to explore the interplay between emergent replicators (rare randomly assembled self-replicators) and evolvability. We find that we can classify fixed-length emergent replicators in Avida into two classes based on functional analysis. One class is more evolvable in the sense of optimizing the replicators' replication abilities. However, the other class is more evolvable in the sense of acquiring evolutionary innovations. We tie this tradeoff in evolvability to the structure of the respective classes' replication machinery, and speculate on the relevance of these results to biochemical replicators.