Chronic disease, physical activity and digital technology: support is necessary

Julien Cazal, Senior Lecturer in STAPS, sociologist, University of Rennes 2

Member of the VIPS research laboratory

Since it was adopted by the first National Health and Nutrition Programme at the beginning of this century, the promotion of a physically active lifestyle has become one of the major preoccupations of public health policy in France.

In the health domain, particularly where chronic disease is concerned, physical activity and sport can be one of the non-medicinal therapies prescribed by the medical profession in an attempt to give patients more autonomy in managing their illness. Being able to do a physical activity obviously depends on a number of personal, social, environmental and political factors, but it also requires, especially when patients are living with one or more long-lasting complaint (diabetes, cardio-vascular disease, cancer and so on), specific support to help in adopting behaviour which will lead to an improvement in health. There are several ways of achieving this, and they all try to create a favourable environment – in the widest sense – for exercising the body, always taking into account the capacity of each individual to do this.

The development of digital technology in this field is still very recent so there are not yet many studies on its impact on behaviour modification. Although so-called mobile health practices, using apps or smart devices for the purposes of good health, are being developed for the general public (smart watches showing the number of paces linked to daily recommendations for physical activity, apps on smartphones which can define targets depending on the initial level of fitness, and so on), they are used less in therapeutic patient education. This is because, apart from their innovative nature and problems in evaluating their real impact on health, several studies show that their use needs to be monitored in as far as they actually transform the relationship with knowledge, illness and health. If the goal is to give individuals more autonomy in managing their own health, some form of help in understanding how to use them seems necessary: fixing concrete, attainable objectives linked to the (para)medical sphere, real time feedback and follow-up, support community and so on. Paradoxically, giving the patient more autonomy, therefore, presupposes social conditions if it is to succeed.

This does not mean that digital tools cannot be very valuable, but it raises questions about how users – the general public or people with specific needs – can appropriate them, depending on their cognitive, social and cultural resources. It becomes even more important to consider this contextual aspect in that it may make it possible to avoid creating new forms of social inequality in the use of these new technologies and the benefits arising from them.