Categories
ISTE Standard 1: Change Agent ISTE Standard 2: Connected Learner ISTE Standard 3: Collaborator ISTE Standard 4: Learning Designer ISTE Standard 5: Professional Learning Facilitator ISTE Standard 6: Data-Driven Decision-Maker ISTE Standard 7: Digital Citizen Advocate

Screen Time, Zoom Fatigue, and Sedentary Behavior: Tips for Protecting Your Health in the Digital Age

Due to the COVID-19 pandemic, many universities have implemented remote or hybrid learning to help mitigate the risk of contracting the virus (Smalley, 2020). Numerous dietetics students across the United States have been enrolled in remote learning courses since March, 2020. With the completing of autumn quarter approaching, students on the quarter system are close to finishing up their second or third quarter of what has likely been remote or hybrid instruction. Students are becoming increasingly familiar with and confident in engaging in online courses, but how much thought has been given to the effects of increased screen time on their health and well-being?

My overarching question for this blog post is as follows: As the dietetics profession is increasingly utilizing telehealth technology to provide medical nutrition therapy services, what actions are recommended to protect whole body health in this type of work?

This questions aligns with the personal value of self-awareness/self-care and reflects ISTE Standard 7B:  “Partner with educators, leaders, students and families to foster a culture of respectful online interactions and a healthy balance in their use of technology – self-regulating time online to ensure well-being and physical health”(International Society for Technology in Education).

My goal is to increase awareness among dietetics students regarding the potential effects of escalating screen time, and the concurrent increase in sedentary behavior on physical, mental, and emotional health. I will provide tips on how to support health when engaging in remote learning. However, it is essential that dietetics students understand that the effects of screen time and consequent sedentary behaviors can flow into their professional work lives if they are not mindful and self-aware about the importance of prioritizing and protecting their health.   

Clinical dietitians comprise the largest segment of the dietetics profession, making it reasonable to assume that many dietetics students will provide medical nutrition therapy services at some point in their careers. Telehealth, an innovative technology used to assess, counsel, and educate patients and clients remotely, is becoming increasingly utilized by the dietetics profession. And while convenient for patients, an increased reliance on it increases screen time, sedentary activity, and most likely increases practitioner stress levels.

In an article titled, “Zoom fatigue: What you can do about it,” the author points out that while the term “zoom fatigue” was coined fairly recently after the popular videoconferencing company, the term “videoconferencing fatigue” has been used for a longer period of time to describe the potential for ill effects on health caused by sitting in front of a screen for long periods of time. The author compared use of telehealth technology before and after the COVID-19 pandemic hit. In doing so, she described the pre-COVID telehealth era where a practitioner might have a few videoconferencing meetings sprinkled throughout their day, but plenty of time to get up and walk around the hospital for various reasons before settling back in for another telehealth appointment. In contrast, over the past half-year or so when many practitioners were thrust into working from home and seeing clients in back-to-back telehealth appointments, there is less time, flexibility, and limited opportunities in scheduling to take adequate breaks from screen time, which increases the risk for a plethora of potentially negative effects on health and well-being (Maheu, 2020).

Regarding the potential physical effects of videoconferencing, Maheu (2020) states that a stationary posture is often required to keep visible via a computer camera, which limits movement and can increase body tension. She also mentions the effects of screen time on eye health, including strain and discomfort. Further, an article published by Norton staff discussed additional physical effects of screen time, including “forward head posture,” which can cause inflammation in the neck and back and cause the spine to misalign. The article also mentioned that having one’s head in the down position increases strain on the neck (Norton, 2020). To mitigate the physical health effects of videoconferencing, the above-mentioned articles provide the following recommendations on structuring the workspace environment to protect physical health:  

  • Consider purchasing an orthopedic chair or a standing desk
  • Stretch and move around every 20-30 minutes
  • Avoid slouching and sit upright
  • To protect eyes from strain and irritability:
    • use as large of a screen as possible
    • minimize contrast between computer screen and room lighting
    • reduce the brightness of the computer screen
    • Adapt the 20-20-20 rule: look away from the screen at something 20 feet away every 20 minutes for 20 seconds

Mental and emotional effects of videoconferencing

Further, there have been concerns raised about the effects that videoconferencing has on mental and emotional well-being due to increased social isolation and social disconnection. In an article published in Psychiatric Times, the author describes several differences in communicating via videoconferencing compared to in person meetings, and the consequent effects on mental well-being. To begin, the lack of a direct mutual gaze is lost when utilizing teleconferencing. One must look into their computer camera in order for it to appear that they are making eye contact with the recipient. However, if a person is actually looking into a computer camera they cannot look directly at the person on the screen, resulting in a loss of social connection. Additionally, non-verbal behaviors are less noticeable and subtle facial expressions can be missed. Thus, the combination of social isolation and social disconnection that may result from increased time using videoconferencing coupled with less time engaging socially in person can have a negative effect on mental and emotional health (Lee, 2020).

Tips for protecting mental and emotional health while relying on videoconferencing include the following:

  • Minimize screen time and space apart videoconferencing sessions as much as possible
  • Stay active and get plenty of fresh air and sunshine (American Psychiatric Association)
  • Keep connected with family and friends
  • Practice meditation and relaxation techniques (Ancis, 2020)
  • Get enough sleep

In summary, awareness of the effects of increased screen time and decreased physical activity as potential realities to our ever-increasing reliance on digital technology is key to protecting health and well-being. Maybe a walk in the crisp, cool autumn air amidst the freshly fallen leaves bejeweled beneath your feet is what the doctor has ordered . . .  

References

Ancis, R. (2020). Three tips for mental health during COVID-19 and Zoom. Psychology Today. https://www.psychologytoday.com/us/blog/the-cyberpsychology-page/202004/three-tips-mental-health-during-covid-19-and-zoom

Author unknown. (2020). Technology usage and the physical effects on your body. Norton. https://us.norton.com/internetsecurity-how-to-technology-usage-and-the-physical-effects-on-your-body.html

Author unknown. (2020). Working remotely during COVID-19: Your mental health and well-being. American Psychiatric Association. http://workplacementalhealth.org/Employer-Resources/Working-Remotely-During-COVID-19

International Society for Technology in Education. ISTE Standards for Coaches. https://www.iste.org/standards/for-coaches

Maheu, M. (2020, August 29). Zoom fatigue: What you can do about it. https://telehealth.org/blog/zoom-fatigue-what-it-is-what-you-can-do/

Smalley, A. (2020). Higher education response to Coronavirus (COVID-19). National Conference of State Legislatures. https://www.ncsl.org/research/education/higher-education-responses-to-coronavirus-covid-19.aspx

Categories
ISTE Standard 1: Change Agent ISTE Standard 2: Connected Learner ISTE Standard 3: Collaborator ISTE Standard 4: Learning Designer ISTE Standard 5: Professional Learning Facilitator ISTE Standard 6: Data-Driven Decision-Maker ISTE Standard 7: Digital Citizen Advocate ISTE Standards for Coaching

Social responsibility and utilization of digital media among dietetics professionals to reduce health disparities

Due to rapid advancements in information and communication technology (ICT), dietetics professionals have seemingly endless opportunities to provide evidence-based recommendations, dialogue, support, resources, and partnerships via digital media that foster civic engagement, which may play a role in reducing health disparities afflicting communities.   

In the Code of Ethics (COE) for the Nutrition and Dietetics Profession, dietetics professionals are expected to adhere to several core values, including social responsibility. Principle #4 in the COE pertains to “Social responsibility for local, regional, national, global nutrition and well-being” (Academy of Nutrition and Dietetics). The following ethical standards reflect the core value of social responsibility:

“a. Collaborate with others to reduce health disparities and protect human rights.

b. Promote fairness and objectivity with fair and equitable treatment.

c. Contribute time and expertise to activities that promote respect, integrity, and competence of the profession.

d. Promote the unique role of nutrition and dietetics practitioners.

e. Engage in service that benefits the community and to enhance the public’s trust in the profession.

f. Seek leadership opportunities in professional, community, and service organizations to enhance health and nutritional status while protecting the public” (Academy of Nutrition and Dietetics).

In our duties aimed at addressing social justice issues pertaining to food and nutrition, dietetics professionals can utilize digital technology as a powerful tool for civic engagement to address the COE standards, as described above.  

Utilizing digital media as a tool for civic engagement with a focus on community health aligns with the International Society for Technology in Education’s (ISTE) Standard for Coaches 7a: Digital Citizen Advocate: “Inspire and encourage educators and students to use technology for civic engagement and to address challenges to improve their communities” (International society for Technology in Education).

In a peer-reviewed journal article titled, “Shaping Social Networks to Reduce Health Disparities: The Nexus between Information Dissemination and Valid Discussion,” the following considerations are discussed, which may apply to the efforts of dietetics professionals when partnering with communities, via digital media platforms, to join forces in the collective efforts directed at reducing health disparities:  

  • Establish local online health-focused communities: Community members, rather than thought of as having a passive role in healthcare, must be viewed and respected as “smart and capable collaborators” (p. 2);
  • Community members should have opportunities to engage with others who have similar health-related needs;
  • Health-focused online communities can be designed as virtual groups or networks, and are implemented to provide social support and interpersonal communications, resources, community engagement, and collaboration;
  • Social media sites can be used as two-way communication tools (vs. one way communication tools) to engage communities on issues that affect their collective health and livelihood;
  • Social media sites can be utilized to promote social norms, which may enhance health and reduce risk of disease (Starland-Davenport et al., 2016).

Further, community members with similar healthcare needs may benefit from online social networks by receiving encouragement, emotional support, and sharing of information, which may result in increased self-efficacy and empowerment towards goal attainment.  In a blog post on the use of social media in healthcare, Newberry (2020) states that “nearly 40% of young people (ages 14 to 22) have used online tools to connect with others with similar health challenges. That includes social media groups.”

Virtual social support, whether organized as community groups with similar healthcare needs, one-on-one communications with a healthcare provider, or a community group including a healthcare moderator, may augment traditional healthcare, which may enhance the overall health and well-being of communities.  Additionally, Newberry (2020) asserts that Facebook groups are being created to bring patients together with similar healthcare experiences to offer support, education, and opportunities for group discussions with healthcare moderators.

In conclusion, dietetics professionals are charged with a social responsibility to provide their expertise in ways that enhance the health and wellness of communities. Digital technology tools provide the ability to connect, engage, and support community members in new and promising ways in our efforts to reduce health disparities.

References

Academy of Nutrition and Dietetics. Code of Ethics for the Nutrition and Dietetics Profession. https://www.eatrightpro.org/practice/code-of-ethics/what-is-the-code-of-ethics

International Society for Technology in Education. ISTE Standards for Coaches. https://www.iste.org/standards/for-coaches

Newberry, C. (2020). How to use social media in healthcare: A guide for health professionals. https://blog.hootsuite.com/social-media-health-care/

Starland-Davenport, A, Booth, B, Kieber-Emmons, A, Topologlo, U, Hogan, W, Thomas Kieber-Emmons. (2016). Shaping Social Networks to Reduce Health Disparities: The Nexus between Information Dissemination and Valid Discussion. Health Systems and Policy Research, 3(2), 1-10. https://doi.org/10.21767/2254-9137.100030  

Categories
ISTE Standard 1: Change Agent ISTE Standard 2: Connected Learner ISTE Standard 3: Collaborator ISTE Standard 4: Learning Designer ISTE Standard 5: Professional Learning Facilitator ISTE Standard 6: Data-Driven Decision-Maker ISTE Standard 7: Digital Citizen Advocate

Digital literacy: An essential component of professional competence in the nutrition and dietetics profession

In an era of evolving digital technology, it is essential that university dietetics programs incorporate curriculum on digital literacy in preparation of student contributions to the collective digital media environment.  This instruction is an important aspect of professional competence, as it will provide students with tools needed to critically navigate sources of information available on the Internet, and subsequently increase their competence as providers of evidence-based food and nutrition information available to the public.  When thinking of outcomes succeeding instruction on digital literacy, a component of digital professionalism, Ellaway et al. (2015) state that “professionals should maintain the capacity for deliberate, ethical, and accountable practice when using digital media” (p. 844).  

Deye (2017) defines digital literacy as “. . . the use and security of interactive digital tools and searchable networks. This includes the ability to use digital tools safely and effectively for learning, collaborating and producing.”  Digital literacy is reflected in the International Society for Technology in Education’s Coaching Standard Digital Citizen Advocate (7c): “Support educators and students to critically examine the sources of online media and identify underlying assumptions” (International Society for Technology in Education). 

Prior to becoming credentialed practitioners, dietetics students should be able to demonstrate competence in digital literacy through proper access, utilization, and referencing of online sources. Skills acquired in digital literacy will enable dietetics students to critically evaluate online nutrition and health information prior to referencing their curated digital communications intended for consumer communications.  Paulus, Baker, and Langford (2019) assert that “. . . we should enable our students to use [information and communications technology] ICTs to create contributions to public knowledge while they are still in school.  ‘. . . Students work best when they know their work is for their future beyond school…when they realize their work contributes (p. 55).’” An earlier start to contributing to the collection of digitally accessed, evidence-based food and nutrition information may further enhance identity formation as professionals while students are still in college.   

However, for dietetics students to be competent in digital literacy, it is essential that they understand the ethical considerations when making contributions to the digital media landscape.  Regarding competencies related to access, utilization, and referencing of online sources, Helm (2016) describes this as “content credibility,” and states the best practices in this area are as follows (p. 1828):

  • “Always provide accurate and truthful information.
  • Distinguish between science-based facts and a personal point of view.
  • Share only information from credible sources.
  • Include the source of nutrition studies or claims cited.
  • Place results of new studies in context.
  • Correct misinformation and respond to inaccuracies.”

Helm’s words of wisdom reflect several principles housed within the Code of Ethics for the Nutrition and Dietetics Profession, which are listed here:

  • “1a. Practice using an evidence-based approach within areas of competence, continuously develop and enhance expertise, and recognize limitations
  • 1b.Demonstrate in depth scientific knowledge of food, human nutrition and behavior.
  • 1c. Assess the validity and applicability of scientific evidence without personal bias.
  • 2d. Respect intellectual property rights, including citation and recognition of the ideas and work of others, regardless of the medium (e.g. written, oral, electronic).
  • 2e. Provide accurate and truthful information in all communications.
  • 3d.Refrain from communicating false, fraudulent, deceptive, misleading, disparaging or unfair statements or claims” (Academy of Nutrition and Dietetics).

Additionally, Helm (2016) discusses the importance of giving proper credit and providing citations to the original source of information. In the case of citing other blogs, the author pointed out that there must be a link to the original source of information as well as proper credit to the author or organization for which the author works.

In summary, when instructing students on the use of digital media tools to communicate evidence-based information, we must recognize that they are still learning core content, including key concepts in food and nutritional sciences as well as methods used and ethics involved in accessing digital information. Thus, it is important that students are knowledgeable in digital literacy and ethics as well as applicable core content before they publish information online, but these experiences are encouraged to increase to the contributions of evidence-based food and nutrition available to consumers as well as aid in the development of students’ professional identity formation.  

References

Academy of Nutrition and Dietetics. Code of Ethics for the Nutrition and Dietetics Profession. https://www.eatrightpro.org/practice/code-of-ethics/what-is-the-code-of-ethics

Deye, S. (2017). Promoting digital literacy and citizenship in school. National Conference of State Legislators, 25(7). https://www.ncsl.org/research/education/promoting-digital-literacy-and-citizenship-in-school

Ellway, R, Coral J, Topps, D, Topps, M. (2015). Exploring digital professionalism. Medical Teacher, 37(9), 844-849. https://doi.org/10.3109/0142159X.2015.1044956    

Helm, J. (2016). Practice paper of the Academy of Nutrition and Dietetics. Social media and the dietetics practitioner. Opportunities, challenges, and best practices. J Acad Nutr Diet, 116: 1825-1835. 

International Society for Technology in Education. ISTE Standards for Coaches. https://www.iste.org/standards/for-coaches

Paulus, M, Jr., Baker, B, Langford, M. (2019). A Framework for digital wisdom in higher education. Christian Scholar’s Review, 49(1): 41-61.

Categories
ISTE Standard 1: Change Agent ISTE Standard 2: Connected Learner ISTE Standard 3: Collaborator ISTE Standard 4: Learning Designer ISTE Standard 5: Professional Learning Facilitator ISTE Standard 6: Data-Driven Decision-Maker ISTE Standard 7: Digital Citizen Advocate ISTE Standards for Coaching

An exploration of student integrity in the digital age

Professionalism is a value that is important to me, and one that I work diligently to impart onto my students in both my actions and in my instruction. As the Nutrition and Dietetics Internship Director at Seattle Pacific University, I oversee supervised learning experiences for a cohort of 10 post-baccalaureate interns placed in a variety of clinical nutrition, community nutrition, and food service management sites across Western Washington. An essential component of pre-requisite knowledge prior to beginning supervised practice is an understanding the Code of Ethics (COE) for the Nutrition and Dietetics Profession. There are several principles and standards in our profession’s COE that address my overarching question, which is as follows:

How is integrity demonstrated in students’ digital profiles and communications on social media?

This question aligns with ISTE Standards for Coaches #7d: “Empower educators, leaders and students to make informed decisions to protect their personal data and curate the digital profile they intend to reflect” (International Society for Technology in Education).  

The following principles and standards from the Code of Ethics for the Nutrition and Dietetics Profession are relevant to the discussion of integrity in students’ online presence (Academy of Nutrition and Dietetics):

  • Principle #2 in the COE addresses “integrity in personal and organizational behaviors and practices,” and includes:
    • Standard D: “Respect intellectual property rights, including citation and recognition of the ideas and work of others, regardless of the medium (e.g. written, oral, electronic)  
    •  Standard H: “Respect patients/clients autonomy. Safeguard patient/client confidentiality according to current regulations and laws.”
    • Standard E: “Provide accurate and truthful information in all communications.”
  •  Principle #3 in the COE addresses “professionalism,” and includes:
    •  Standard C: “Demonstrate respect, constructive dialogue, civility and professionalism in all communications, including social media.”

In my quest to understand how dietetics students demonstrate integrity online, it is important to view potential ethical issues within the framework of our profession’s COE.  As outlined above, there are a variety of ethical considerations concerning integrity and professionalism. Following are some examples of how these ethical principles and standards translate into demonstrating integrity online in a student’s online presence:

  • Referencing information correctly in blogs, electronic newsletters, infographics, Tweets, and public service announcements when students are providing nutrition education to the public;
  • Verifying that all information communicated online to the public is accurate and truthful, including in blogs, electronic newsletters, infographics, Tweets, and public service announcements;
  •   Ensuring that students do not discuss confidential information (Peregrin, 2018) or include photos of their patients or clients in their social media posts or blogs;
  • Maintaining confidentiality of supervised practice environments by refraining from posting pictures from clinics and hospitals that may be considered private or containing sensitive information;
  • Refraining from posting or discussing proprietary, internal organizational information in social media posts (Peregrin, 2018);  
  • Keeping online conversations respectful and civil even when there is disagreement or differing perspectives, including both posts and responses to posts.  

Peregrin (2018) asserts that there is no guarantee that private social media posts are actually private, and anything a student posts or says online has the potential to be discovered by an unintended audience, such as a prospective educational program or potential employer. He points out that the content of students’ posts have the potential to affect them adversely in the future, so it is critical that students understand potential consequences for what they choose to communicate on social media.

In the K-12 curriculum “Commonsense Education,” a lesson plan developed on the topic of digital citizenship explains that each of us has a digital footprint, which is our unique public presence in online activities. The curriculum reinforces that one’s digital footprint is an aspect to our identity that can either work for or against us in future opportunities depending on what we post and how we handle ourselves online. This concept of the digital footprint seconds what Peregrin reveals about the impact of an online presence affecting educational and employment decision-making (Commonsense Education).   

In summary, there are many ways in which dietetic students can demonstrate integrity in their digital profiles and communications on social media. A periodic review of the Code of Ethics for Nutrition and Dietetics Profession is essential to ensure that students avoid any potential ethical issues which may stem from what they may post and publish in their online forums.    

References

Academy of Nutrition and Dietetics. Code of Ethics for the Nutrition and Dietetics Profession. https://www.eatrightpro.org/practice/code-of-ethics/what-is-the-code-of-ethics

Commonsense Education. Who’s looking at your digital footprint? https://www.commonsense.org/education/digital-citizenship/lesson/whos-looking-at-your-digital-footprint

International Society for Technology in Education. ISTE Standards for Coaches. https://www.iste.org/standards/for-coaches

Peregrin, T. Promoting student integrity. Ethical issues in the digital age. (2018). Journal of the Academy of Nutrition and Dietetics, 118(8), 1498-1500.