Accessibility and inclusion in digital health
Accessibility and inclusion in digital health

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Accessibility and inclusion in digital health

4 Digital health, children and young people

Just as adults are affected by mental health problems, so too are children. The Cheltenham Holistic Health Centre have identified a number of psychological problems in children which can manifest in a number of ways including, but not limited to:

  • anxiety
  • depression
  • behavioural difficulties
  • eating disorders
  • anger
  • self-harm
  • under-performance at school
  • difficulties with friends.

While psychological therapies can provide children and young people with a space to think and talk about their problems, and also to find a variety of ways to cope, access to therapies can be limited (Cheltenham Holistic Health Centre, n.d.). Even if the services are free, they may be time-limited, meaning that only a few sessions are available. 

A number of initiatives have been developed with digital technology and children in mind, such as Chat Health. This is an intervention involving a two-way communication system, in which children and young people aged 11 to 16 can ask a nurse questions through SMS text messages. A web-based management application allows teams of school nurses to reply; this is conducted anonymously and confidentially.

Other initiatives have also been developed for use by children such as web-based initiatives to improve health and wellbeing. These initiatives and Chat Health’s digital interventions are the focus of the next activity.

Activity 4 Chat Health, the web and me

Watch the video and, as you do, make notes. This will help you to respond to the questions that follow.

Download this video clip.Video player: Video 3 Chat Health
Skip transcript: Video 3 Chat Health

Transcript: Video 3 Chat Health

It allows us to express ourselves in a way that we can express to our friends. And to know that it's confidential makes me open up to other people besides my other friends.
Sometimes you have things that are so embarrassing that you can't talk about. So if you send a message, then you have-- the nurse already knows what you've going to talk about. And then we can just think of ways to get over that and just help. So it's really useful.
You can feel judged by talking to someone face to face. So I think if you can text them it's like they don't actually know who you are.
Hi, my name's Jane Dawson, and I'm a school nurse for the Brixton team, and I'm a chat health ambassador.
Hi, my name's Katie. I'm a school nurse in the Hinckley & Bosworth school nursing team. I've been a chat health ambassador now for the last two years.
I do chat health as part of my daily job, but it doesn't stop my day. I can go in and out of all the schools, come back, respond to text messages, and then go out again.
Generally, we get about 15 messages a day from young people asking a variety of questions or asking for a variety of advice.
We're informed when we're going to be a chat health ambassadors. So I plan my day to make sure I'm in the office in some points of the day to respond to the text messages. I also go out to my schools and promote the chat health service so young people know how to access it.
Chat health allows us to have a pause in what we're doing so we can have supervision with other staff or think about our responses, which enables us to provide a high standard service and also a standardised service as well.
I love the fact that the young people can access this service, and the feedback is just brilliant. They will text you saying, thank you so much for your support. And it just puts a smile on your face knowing that you've helped someone.
Hello, my name's Serita, and I like this website because it makes me fit and healthy.
I like the website because it will make you fit, and I like the characters.
I like your website because it has funny games in it and fun games in it, and it keeps me fit and healthy.
I like the website because it makes me fit and healthy, and I like the logo as well.
We love Health For Kids!
Website looks really great, and it really looks like they've taken on our advice, and the videos are a really nice touch.
I think that the quizzes are a really entertaining way to get information across to teens.
Today's website launch has been amazing, and I'm very proud to be a part of this wonderful, exciting launch.
I really think the website is really good. And it can really help teenagers who have problems, and it can really help you out.
It looks like it was really well designed, and it can fit basically every purpose, especially with everything new coming out for it.
You know, being involved in what we have all created as something essential for everyone is to benefit not just us alone. It's to benefit everyone in the UK. So I think that to be good.
Visit health for teens.
End transcript: Video 3 Chat Health
Video 3 Chat Health
Interactive feature not available in single page view (see it in standard view).
  1. From the perspective of the school nurses, what are the advantages of Chat Health?
  2. From the perspective of young people, what are the advantages of Chat Health?
  3. From the perspective of children and young people what are the benefits of web-based innovations to improve health and wellbeing?
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Interactive feature not available in single page view (see it in standard view).


  1. Chat Health gives nurses flexibility; for example, they are able to respond to texts and help young people deal with issues they would otherwise not get help with. Nurses can go out to other schools to demonstrate its use and promote the app for young people. Participating in supervision also assures that the most appropriate and considered responses are provided to young people. Supervision means they can ensure that the service is delivered to a high quality standard.
  2. Children and young people are able to address issues they don’t have the confidence to raise in person via the app. They can talk about issues that they find embarrassing. Chat Health assists them in finding ways to cope. Children value the fact that the service is confidential, anonymous and that they don't feel judged as they feel they might in a face-to-face situation.
  3. For children and young people, interacting with web-based interventions to improve their health and wellbeing was appealing and fun, and it was clear that the children were engaged. For older children (those in their teenage years), becoming involved in the design of the interventions was key. They were enthusiastic, but also consulted as ‘experts of their own experience’, and this gave them the confidence to endorse an intervention. They would have also developed key skills and knowledge in the process of developing the app.

Chat Health and similar web-based interventions are able to capture a young audience and harness technology to support children and young people.

If you’re interested in exploring more about children’s mental health and wellbeing, you might be interested in the free OpenLearn course Supporting children’s mental health and wellbeing [Tip: hold Ctrl and click a link to open it in a new tab. (Hide tip)] .

What about other age groups and other forms of digital innovation to deliver support and care? This is the focus of the next section.


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