The digital footprint: A new enigma

The Millennial generation grew up using computers in classrooms and at home, thus they embrace a world full of technology that excites, providing instant feedback, gratifications, sometimes sadness, and rapid changes in their everyday world. Children of Millennials are more likely to be handed a computer chip than a rattle shortly after birth! Indeed, more parents are handing their infants and toddlers smartphones or iPads to keep them entertained rather than a traditional toy or book. What is the significance of these rapid changes for pediatric nurse practitioners (PNPs)? The article written by Pat F Bass III, MD, MS, MPH, “Living life online: Talking to parents about social media,” presents essential information for PNPs and all healthcare providers so they can speak knowledgeably with parents concerning possible adverse consequences for children who now interact with social media more than 2 hours each day.

Where’s the guidance?

Dr Bass reminds us that the online world has created new vocabulary such as: texting, tweeting, sexting, cyberbullying, virtual worlds, and digital footprints. While I fully agree that healthcare providers must provide anticipatory guidance to parents about social media, I also question how many healthcare providers are comfortable speaking with parents about social media, and in particular, speaking with preteenagers and teenagers about social media and possible consequences.

A quick review of trusted anticipatory guidance sources reveals that we are not prepared to address issues related to social media. One of the objectives of the Centers for Disease Control and Prevention’s national Youth Risk Behavior Surveillance System (YRBSS), administered to middle school and high school students every other year, is to determine trends in social problems among children and teenagers in the United States. However, the 2015 survey contained only 1 question on the use of electronics, asking the adolescent to respond Yes or No to the question, “Have you been electronically bullied though email, chat rooms, instant messaging, websites, or texting?”

Thus, relevant questions for adolescents on their experiences with social media are missing from the YRBSS survey. Such questions, if included, would better inform healthcare providers on problems related to social media use, and ways to address potentially harmful issues when providing anticipatory guidance at routine healthcare visits.

Another well-respected resource for anticipatory guidance is Bright Futures(Hagan, Shaw, Duncan, 2007). However, to date, issues related to the use of social media by children/adolescents and parental information have not been included in Bright Futures.

Recently, implementation of the SSHADESS Screen (AAP, 2014) over the traditional HEEADSSS screen for adolescents has been recommended for use during route healthcare visits. However, screening questions for adolescents on the use of social media are not included in the recommended screening questions.

Meeting the unmet need

Dr Bass has provided a snapshot of what dangers await unsuspecting adolescents: simply sharing personal information or photos that lack security may make them victims of their own permanent digital footprint. It is indeed time to research current adolescent behaviors on social media; identify evidence-based recommendations for anticipatory guidance for parents and adolescents; and help adolescents create digital footprints that “cause no harm.”