Most digital health apps fail because they treat people as rational decision-makers who exist in a vacuum, ignoring the messy reality of how bodies, social groups, and environments actually work. The UK faces a crisis of preventable illness: 60% of men and 49% of women are overweight or obese, costing the NHS £48 billion per year, with sleep loss and stress each adding £40 billion. Current digital health tools—fitness trackers, sleep alarms, diet apps—have had low impact because they target isolated individuals and assume that giving people data will make them change behaviour. This ignores how the gut, nervous system, and social context all shape decisions. A smart alarm that still disrupts sleep is physiologically antagonistic, not helpful. This fellowship proposes a new design foundation called "inbodied interaction"—aligning health technology with how the body actually performs optimally. The research will develop and test three strands: technology that supports physiology (e.g., displays preserving peripheral vision), tools that connect health experiences to lasting practice, and group-level systems that help communities build health-resilient habits together. If successful, this could transform self-management from a lonely, data-driven chore into something that works with—not against—how people actually function. The team will engage hundreds of participants directly and thousands more through nationwide citizen science trials, with an expert advisory board spanning industry and policy.
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We urgently need proactive health support at the level of the general population: we have become, on average, an unhealthy nation. The new statistical norm is overweight to obese (60% of men and 49% of women). Co-related conditions from heart disease to type II diabetes, cost the NHS £48 Bn/year. Lack of sleep costs £40Bn. Stress costs £40Bn. 6% of our GDP goes to preventable "lifestyle conditions." Of the top 20 western nations, the UK ranks 18th or lower in QoL, Health, Wealth, Education and Democracy. Our productivity is 20% lower than the rest of the G7. While there is incredible optimism and investment in the potential benefits of ubiquitous, pervasive technology to help redress these conditions, digital health approaches to date have had low impact. This fellowship hypothesises that the lack of broad and sustained uptake of digital health technology is not a fault of the technology per se but with the range of models that inform how these technologies are designed. The current state of the art in digital health tech is (i) targeted at individuals although health practices are significantly influenced by social contexts; (ii) it assumes that given the right data we will make a rational decision to adopt a health practice without taking into account how the rest of our bodies - from our gut to our nervous system - is involved in decision processes (iii) the tools themselves can be antagonistic to rather than supporting of how the body works. E.g. a "smart alarm" that still disrupts sleep rather than finds ways to help us get sleep is antagonistic to our physiology which requires certain amounts of sleep to stay healthy. While current digital health technologies can and do work for some of the people some of the time, they have not been sufficient to deliver health in the complex contexts in which the UK lives and works. We need to develop better models to inform health tech design. This fellowship proposes to develop and test Inbodied Interaction (the alignment of health tech with how the body optimally performs) as a foundation to deliver and sustain personal and social Health Resilience: the capacity for individuals and their groups to build health knowledge, skills and practice to recover from and redress health challenges, from stress at home to shift changes at work. In line with EPSRC's challenge to "transform community health" by enabling better "self-management," digital interactive technologies must be aligned with how we work as organic-physical-cognitive-social complex systems. In respect of that model of "self" the fellowship will innovate on three strands of inbodied interaction technology: 1) Environment-Body Aligned: designing technology to support our physiology, from displays that help us maintain peripheral vision to stay more creative, to light use in VR lenses to improve cognitive performance. 2) Experience-to-Practice Aligned: to provide rapid access to the effects of better health experiences, and connect these with personally effective means to maintain these. 3) Group-to-Culture Aligned: to support groups identify and build more health resilient practices that work for their contexts. Thus "self-management" is transformed into our 3-level model of how this "self" is empowered by health tech in various contexts to create build and maintain "health." Through our co-design we will be engaging directly with hundreds of participants, and thousands more citizens virtually through our nation-wide Citizen Scientist web trials. We also have regular engagement with our expert advisory team representing industry, policy, and a range of disciplines. The Team is committed to help translate our work from project to practice, from policy to process, for transformational impact. By Fellowship end, we will have new digital health technologies and validated models for those tools to deliver Health Resilience for a Healthy Nation, and so help #makeNormalBetter@scale, for all.
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