12/07/2011, Catherine Serio, PHD, Behavioral Health Director
Digital Divide Part 3: Digital Empathy—Will Computers Replace Health Coaches?
My family has been in the midst of an interesting discussion: Will computers replace teachers? This debate was sparked, in large part, by the current national funding crisis and its impact on public education. Schools are thirsty for money. The school that my 10-year-old twin daughters attend is receiving $600 less per student per year than it did just 2 years ago.
One proposal gaining momentum is to add more computers to classrooms. Computers, some argue, provide more tailored instruction. So in a classroom of 27 students, Johnny can be at his computer working on dividing multiple digits while Sally, working on her computer, can master basic multiplication.
In 2010, CNN reported on the Hole-in-the-Wall experiments. First implemented in 1999, these projects placed computers with Internet connections into walls in the slums of India. Without supervision, children taught themselves to operate the computers. Using these “learning stations,” the children also learned some fundamental English and math.
Translate this compelling debate to health education: Will computers replace health coaches? Computers have the upper hand in many ways: First, they can reach more people for much less money. Second, eHealth programs have the capacity to deliver tailored content, just as in the Johnny and Sally example—a factor associated with positive outcomes. And, third, computerized health content has a powerful ripple effect: Content can be instantaneously connected to other content through faceted search. Information on diabetes can be linked with low-glycemic-index recipes that can be linked with nearby grocery stores.
But computers lack a core ingredient in health promotion: accountability. Computers can provide people with medical knowledge. But getting people to change their behavior and become healthier requires more than knowledge. Just because people can find sugar-free ice cream at a nearby store doesn’t mean they’re going to eat it.
Having another person you are accountable to, and who is accountable to you, increases the likelihood of action. It is much scarier for children to tell a beloved teacher that they forgot their spelling homework than it is to tell a computer. A poor child in India may know more English after using a learning station, but he won’t have the chance to use it without the chance to practice with another human being.
So in my house, we have concluded that this is not an either/or paradigm. Computers are tools of the time. We expect our children to use them and to benefit from their use. But teachers are still vital to guide the children and to hold them accountable for their education.
Such is the case with health. Computers can reach countless people and serve them with meaningful health content. While that will be enough for many people, there will be others who need the extra nudge of being accountable to someone else. A coach or care coordinator, like the teacher, can be a resource to those people. He or she can help explain the information, decide what actions the person needs to take, and ask for accountability. So the student, patient, or family member may expect to answer a fundamental question: Did you bring your homework today?