1 00:00:02,970 --> 00:00:09,030 Hello, I'm Gemma Hughes and I'm associate professor at the University of Leicester School of Business in the UK. 2 00:00:09,510 --> 00:00:13,350 And this is a talk called What kind of a Problem is Loneliness? 3 00:00:13,710 --> 00:00:16,890 Studying technology to understand policy concerns. 4 00:00:17,400 --> 00:00:24,150 And it's a talk I gave to the M.S. and Translational Health Sciences students in October 2023. 5 00:00:25,320 --> 00:00:28,500 So why have I chosen to talk about this particular topic? 6 00:00:28,920 --> 00:00:32,760 Well, the first reason is that it draws on a really interesting research study. 7 00:00:32,760 --> 00:00:35,340 Hopefully you will agree that the study is interesting. 8 00:00:36,150 --> 00:00:43,020 Secondly, it's really relevant to translational health sciences students because it involves looking at innovations which, 9 00:00:43,080 --> 00:00:50,670 although they have been carefully designed, they face some challenges of translation in terms of uptake, adoption and spread. 10 00:00:52,140 --> 00:00:58,050 It also provides the study also provides some examples of different kinds of qualitative research methods, 11 00:00:58,440 --> 00:01:05,940 and it provides an example of how a particular methodological approach can shed new light on a subject, 12 00:01:06,270 --> 00:01:12,120 not just by providing new answers, but by offering different ways of framing new questions. 13 00:01:13,020 --> 00:01:22,590 So what the talk will cover. First of all, I'm going to introduce you to the research study that this talk is based upon the virtual presence study, 14 00:01:23,610 --> 00:01:31,110 and then going to talk a little bit about loneliness, social isolation, health and technology and the connections between those things. 15 00:01:32,130 --> 00:01:37,290 And then I'm going to spend some time talking about the methodology that was used in the virtual present study, 16 00:01:37,890 --> 00:01:41,910 the what's the problem represented by the PR approach. 17 00:01:42,780 --> 00:01:46,200 I'm then going to say a little bit about the empirical data that we found, 18 00:01:46,680 --> 00:01:52,770 and I'm going to give you a relatively brief overview of findings before we stop for questions and discussion. 19 00:01:54,420 --> 00:01:59,400 So first of all, let's introduce you to the research project called Virtual Presence. 20 00:02:00,510 --> 00:02:06,090 Virtual Presence was funded by the Research Council of Norway from 2020 up until 2023, 21 00:02:06,750 --> 00:02:12,810 and it's a cultural analysis of the emergence of telepresence technologies as a solution to loneliness. 22 00:02:13,590 --> 00:02:20,100 It's led by Mark Holder, who is professor of sociology at Oslo Metropolitan University in Norway, 23 00:02:20,610 --> 00:02:26,790 in collaboration with Trish Green Hoge here in Oxford and Ivor and Gilbertson, who is professor. 24 00:02:27,030 --> 00:02:33,990 So at either end, Engebretsen, who is professor of Interdisciplinary Health Sciences at the University of Oslo in Norway. 25 00:02:35,880 --> 00:02:42,420 So the study aims to understand more about what loneliness is as a social and cultural phenomena. 26 00:02:42,840 --> 00:02:45,780 To add to what we know about loneliness as a health problem. 27 00:02:46,350 --> 00:02:54,120 And it set out to do this by looking at one kind of the proposed solutions to loneliness of telepresence technologies. 28 00:02:54,810 --> 00:03:01,710 So this idea of learning more about a problem by examining the solutions indicates a certain methodological approach. 29 00:03:02,910 --> 00:03:07,020 But let's start by taking a minute or two to think about this problem of loneliness. 30 00:03:07,680 --> 00:03:13,950 What is loneliness and why is it a problem that might concern those of us interested in health? 31 00:03:15,770 --> 00:03:18,830 What is loneliness? Can you measure loneliness? 32 00:03:20,180 --> 00:03:25,640 What does loneliness feel like? How can you tell if somebody is lonely? 33 00:03:26,720 --> 00:03:34,130 They may look very lonely like this isolated figure pictured against a bleak mountain landscape. 34 00:03:35,270 --> 00:03:39,920 Or they may be sitting like this person in a cafe surrounded by people. 35 00:03:40,160 --> 00:03:44,809 But they may still feel lonely. It's possible to be lonely when you're with people. 36 00:03:44,810 --> 00:03:53,110 When you're in a crowd. If loneliness is painful or upsetting, can you actually be happy alone? 37 00:03:53,560 --> 00:04:01,660 There's an image here of a woman who's looks like she's camping or hiking in a landscape or on her own completely alone. 38 00:04:02,050 --> 00:04:11,080 But she looks very, very happy and contented. So just these very simple questions already indicate that loneliness is quite complex phenomena. 39 00:04:11,680 --> 00:04:15,490 And there are multiple ways of thinking about and understanding loneliness. 40 00:04:17,410 --> 00:04:23,890 Let me ask you some more questions. When did people first feel lonely? 41 00:04:26,070 --> 00:04:34,740 So we can think about the history of emotions. There's a historian, Faye Alberti, who dates loneliness to around the year 1800. 42 00:04:35,130 --> 00:04:43,710 In her book, The Biography of Loneliness, she tells us that the language of loneliness didn't really exist until around 1800. 43 00:04:43,890 --> 00:04:52,230 In Western culture and history, she links the birth of loneliness to the birth of modernity and a more individualistic society. 44 00:04:52,860 --> 00:04:57,900 She describes loneliness as an emotion cluster and a form of social practice. 45 00:04:59,310 --> 00:05:06,150 But can loneliness also be a positive experience? Solitude and loneliness are sometimes linked. 46 00:05:06,630 --> 00:05:11,070 We might think about the romantic poet Wordsworth, wandering, lonely as a cloud. 47 00:05:11,850 --> 00:05:18,060 Being alone. Being in solitude can allow a romantic connection with the natural world, for example. 48 00:05:20,310 --> 00:05:29,219 Contemporary understandings and research on loneliness frequently refer back to the work of Robert Weiss, who is an American sociologist. 49 00:05:29,220 --> 00:05:40,050 His study, completed in the 1970s, identified a distinction between emotional isolation, which involved lacking a particular relationship, 50 00:05:40,410 --> 00:05:45,960 such as might follow divorce or bereavement and social isolation, 51 00:05:46,500 --> 00:05:52,740 which might be the kind of isolation or loneliness experienced, for example, when moving to a new city for a new job. 52 00:05:54,150 --> 00:06:03,270 So these these two different definitions of isolation, emotional and social give us different facets of loneliness, 53 00:06:03,300 --> 00:06:06,150 although there are, of course, potentially connections between them. 54 00:06:08,060 --> 00:06:13,940 More recently, seminal work on biological and evolutionary constructs of humans as essentially social beings, 55 00:06:15,200 --> 00:06:22,550 is argued by Cacioppo and colleagues that loneliness has a function like thirst or hunger. 56 00:06:23,150 --> 00:06:27,050 When we are thirsty, we know we need to find a drink when we are hungry. 57 00:06:27,140 --> 00:06:35,030 We know we need to eat. When we are lonely, we seek out company because of the evolutionary advantages of being in groups. 58 00:06:36,140 --> 00:06:42,860 And these ideas help explain why loneliness is bad for us, not just in how it makes us feel, but in other health outcomes. 59 00:06:44,750 --> 00:06:49,220 So theories of loneliness range from socially constituted patterns of isolation really 60 00:06:49,400 --> 00:06:55,370 related to social identity and situation through to biological and evolutionary theories. 61 00:06:56,360 --> 00:07:04,370 The importance of the relationship between cognitive factors and social situations in producing loneliness has emerged from psychological studies. 62 00:07:05,990 --> 00:07:09,770 So we can see just from the very simple questions that I asked initially and from 63 00:07:09,770 --> 00:07:13,430 this very brief explanation of different ways of thinking about loneliness, 64 00:07:13,970 --> 00:07:21,350 is that there are multiple ways of understanding this phenomena. Loneliness can be understood as something internal, subjective, cognitive, 65 00:07:21,650 --> 00:07:28,130 and as something related to the external social world shaped by networks, identity and social structures. 66 00:07:30,270 --> 00:07:33,630 A common distinction is now made between loneliness on one hand, 67 00:07:33,840 --> 00:07:39,030 which is generally perceived to be a painful, subjective experience, such as can be felt, 68 00:07:39,030 --> 00:07:47,820 for example, even in the middle of a crowd and social isolation, which is generally understood as an objectively measurable, limited social network. 69 00:07:48,720 --> 00:07:54,540 So measuring loneliness can therefore be done by asking people about how they're feeling the subjective experiences. 70 00:07:54,900 --> 00:08:00,060 And we can measure social isolation by quantifying social contacts or activities. 71 00:08:02,350 --> 00:08:07,690 So let's move on to think about loneliness and health. Why is loneliness a problem for health? 72 00:08:08,350 --> 00:08:11,800 Well, loneliness is now known as a global public health issue, 73 00:08:12,640 --> 00:08:20,860 which has been exacerbated by measures of lockdown and social distancing during the pandemic, but was already understood as being a policy problem. 74 00:08:20,860 --> 00:08:27,160 For example, in the UK, the UK government made significant steps to address loneliness as a national policy problem. 75 00:08:27,550 --> 00:08:32,290 Back in 2018, when they appointed the first so-called Minister for loneliness. 76 00:08:32,590 --> 00:08:39,819 They added loneliness as an important priority to a ministerial portfolio, and they launched a document, 77 00:08:39,820 --> 00:08:45,250 a policy called a Connected Society, a Strategy for Tackling Loneliness, laying the foundations for change. 78 00:08:46,150 --> 00:08:54,910 The strategy highlighted the adverse health consequences of loneliness, which were linked to early deaths on a par with smoking and obesity, 79 00:08:55,390 --> 00:09:03,310 and they were associated with increased risk of coronary heart disease, stroke, depression, cognitive decline and Alzheimer's disease. 80 00:09:04,540 --> 00:09:14,170 So loneliness is well known as a health issue. Let's move on now to think about the connections between loneliness and technology. 81 00:09:15,880 --> 00:09:20,870 Now, the relationship between technology and loneliness is frequently represented as a dualism. 82 00:09:21,340 --> 00:09:25,450 That is, it has both positive and negative characteristics. 83 00:09:25,720 --> 00:09:35,230 There are two sides to this relationship with technology understood as having the power to both cause and cure loneliness and social isolation. 84 00:09:37,390 --> 00:09:41,680 So technology is understood as being able to take us away from people. 85 00:09:42,280 --> 00:09:46,660 There's an image here of a man sat amidst a whole crowd of people. 86 00:09:47,020 --> 00:09:51,220 Yet he's not engaging with them. He's staring down at the glowing screen of his phone. 87 00:09:53,030 --> 00:09:57,709 But technology can also connect us at a distance. We can be in touch with. 88 00:09:57,710 --> 00:10:02,120 We can see. We can hear. We can be in communication with people that we love. 89 00:10:02,270 --> 00:10:10,300 That people we miss when they're far away from us. There's some interesting work by a team headed up by Nowland, 90 00:10:10,630 --> 00:10:16,720 who published an article about the relationship between social internet use and loneliness. 91 00:10:17,170 --> 00:10:24,430 They their work is psychologically informed. And they captured that this dualism in their representation of the relationship between, 92 00:10:24,430 --> 00:10:29,260 in their case, social internet use and loneliness as bidirectional and dynamic. 93 00:10:29,980 --> 00:10:34,630 So when used for social connections, the internet can enhance relationships. 94 00:10:35,260 --> 00:10:40,630 But what is used to withdraw from social internet interaction, It can exacerbate loneliness. 95 00:10:42,640 --> 00:10:49,240 Let's just pause and clarify this word technology as well, because I've used it a lot already without defining it. 96 00:10:50,500 --> 00:10:58,360 Technology covers a whole range of things. It includes devices, it includes connectivity, if you like, the networks or assemblages that people use. 97 00:10:58,840 --> 00:11:04,330 It includes technology that mediates connections that might be connecting with a person in particular, 98 00:11:04,360 --> 00:11:10,170 such as when you have a zoom call or interacting with people more widely, for example, via social media. 99 00:11:11,020 --> 00:11:14,560 It might also include technology that doesn't connect people to each other. 100 00:11:14,980 --> 00:11:20,380 But instead of this connection in and of itself providing company. 101 00:11:21,850 --> 00:11:29,590 So one example is robot pets that are used perhaps infrequently, but they are certainly in circulation. 102 00:11:30,010 --> 00:11:33,250 Another example is Paro. The robot seal. 103 00:11:33,760 --> 00:11:41,620 Paro is a robot which looks like a cuddly, white, fluffy seal but is used in dementia care. 104 00:11:41,830 --> 00:11:48,860 It can offer companionship and Paro learns to respond to certain words and gestures. 105 00:11:49,060 --> 00:11:52,480 So it creates some companionship and interaction with an individual. 106 00:11:53,020 --> 00:11:59,980 But interestingly, it's used particularly in dementia care, to facilitate interaction between the people around the robot. 107 00:12:00,370 --> 00:12:05,200 So it's not just a relationship or companionship that's provided between the robot and the individual, 108 00:12:05,500 --> 00:12:09,370 but it stimulates connections with people that are in the vicinity. 109 00:12:09,700 --> 00:12:14,760 People look at Paro, they they offer to touch it, to pick it up, to pass it around. 110 00:12:14,770 --> 00:12:19,920 It stimulates conversation. So it's a mediating technology as well. 111 00:12:21,700 --> 00:12:27,370 So we've talked about loneliness, we've talked about health and we've talked about loneliness, We've talked about technology. 112 00:12:28,480 --> 00:12:32,860 Let's just put these together and think about loneliness, health and technology. 113 00:12:34,560 --> 00:12:41,340 Despite the ambivalence that's apparent about loneliness in technology and the pros and cons, 114 00:12:42,120 --> 00:12:46,620 technology of all sorts of kinds has been and is being used to address loneliness 115 00:12:47,070 --> 00:12:50,700 with a view to addressing the health concerns associated with loneliness. 116 00:12:52,260 --> 00:12:55,290 Now, the research that's been done in this field is quite mixed. 117 00:12:55,290 --> 00:12:57,930 The evidence, quite the evidence is quite mixed. 118 00:12:58,470 --> 00:13:03,930 The research includes studies undertaken during the pandemic as well as research that was done previously. 119 00:13:05,310 --> 00:13:10,770 Much of the research findings are much of the ways in which the research is presented are broadly optimistic. 120 00:13:12,420 --> 00:13:17,040 Although some of the evidence is quite mixed as to whether or not technology can really address 121 00:13:17,040 --> 00:13:21,060 loneliness and indeed therefore address the health outcomes associated with loneliness. 122 00:13:23,340 --> 00:13:30,090 I mentioned earlier some of the different ways of thinking about loneliness, the diverse theoretical underpinnings of how loneliness is understood. 123 00:13:30,810 --> 00:13:35,730 Now, regardless of how you understand loneliness, presence is a potential solution. 124 00:13:36,420 --> 00:13:40,320 TelePresence is potentially made possible by technology, 125 00:13:41,160 --> 00:13:48,630 so telepresence or virtual presence involves human connection at a distance, usually via video and audio technology. 126 00:13:49,200 --> 00:13:58,980 Virtual presence differs from what is known as co presence or physical presence, which is often synonymous with real or spatial presence. 127 00:13:59,500 --> 00:14:07,920 That's when we are with someone in physical proximity, sharing time and space, as opposed to virtual presence where we're separated by distance. 128 00:14:09,450 --> 00:14:15,570 Now, if I was interested in finding out if technology worked to solve loneliness and improve health, 129 00:14:15,900 --> 00:14:22,260 I'd be doing the kind of research that measured loneliness and evaluated the effect of using technologies on those measures. 130 00:14:23,520 --> 00:14:30,749 But this research study, virtual presence, is concerned not just with do technology's work to address loneliness, 131 00:14:30,750 --> 00:14:37,290 although, of course that's a really important question. But what do those technologies mean and how is loneliness understood? 132 00:14:38,340 --> 00:14:42,420 In other words, we're interested in the dialectics of loneliness and technology. 133 00:14:43,080 --> 00:14:46,100 By studying the technologies designed to address loneliness, 134 00:14:46,110 --> 00:14:52,260 we sought to understand more about the contemporary meanings of loneliness in the UK and reciprocally, 135 00:14:52,320 --> 00:14:55,440 how technologies were shaped by understandings of loneliness. 136 00:14:58,320 --> 00:15:04,830 So this methodology owes a lot to Carol Becky's approach of what's the problem represented to be. 137 00:15:06,030 --> 00:15:10,770 Carol Becky is a political scientist and she approaches policy as discourse. 138 00:15:11,490 --> 00:15:17,280 She rejects the idea that problems such as loneliness are simply naturally occurring and need to be solved, 139 00:15:17,670 --> 00:15:23,340 but instead understands those problems is constituted in certain ways in the discourse. 140 00:15:24,360 --> 00:15:27,690 This isn't to suggest that loneliness and other problems are not real, 141 00:15:27,930 --> 00:15:33,060 but rather that the ways in which those problems are framed and described deserves to be analysed, 142 00:15:33,300 --> 00:15:38,550 not least because the framing of a problem generates certain solutions and negates others. 143 00:15:39,630 --> 00:15:45,170 So what's the problem represented today? Represented to be started by examining, 144 00:15:45,420 --> 00:15:53,100 examining a policy solution in order to better understand the nature of the problem that that solution is intended to address. 145 00:15:54,990 --> 00:15:58,150 So Bucky's approach is summarised in a series of questions. 146 00:15:58,170 --> 00:16:01,649 The first question is what's the problem represented? 147 00:16:01,650 --> 00:16:11,580 Be it a specific policy or policies? The next question one should go on to ask with this approach is what deep seated presumptions, 148 00:16:12,120 --> 00:16:18,060 presuppositions or assumptions or conceptual logics underlie this representation of the problem? 149 00:16:19,380 --> 00:16:23,100 The next question is How is this representation of the problem come about? 150 00:16:24,300 --> 00:16:28,440 And then we need to ask what is left unproblematic in this problem? 151 00:16:28,440 --> 00:16:33,840 Representation? Where are the silences? Can the problem be conceptualised differently? 152 00:16:35,040 --> 00:16:39,780 Next, we need to ask what effects are produced by this representation of the problem? 153 00:16:41,400 --> 00:16:47,040 And finally, how and where has this representation of the problem been produced, disseminated and defended? 154 00:16:47,580 --> 00:16:58,780 How has it been? Or how can it be disrupted or replaced? A simple example that Becky gives in illustrating her approach is to talk about policies that 155 00:16:58,780 --> 00:17:04,150 promote training for women as a means to increase their numbers in positions of influence. 156 00:17:05,260 --> 00:17:07,959 So offering training for women, for example, 157 00:17:07,960 --> 00:17:19,720 to achieve board membership implicitly represents the problem of the lack of women on boards to be women's lack of training to study this policy. 158 00:17:19,930 --> 00:17:26,100 Therefore, there is a need to interrogate critically how women's lack of training is problematise the premises. 159 00:17:26,110 --> 00:17:29,890 This representation of the so-called problem rests upon and its effects. 160 00:17:31,330 --> 00:17:38,560 As a result of this approach, the focus for policy analysis shifts from interrogating taken for granted, 161 00:17:38,740 --> 00:17:43,090 shifts to interrogating taken for granted concepts and categories. 162 00:17:43,540 --> 00:17:47,620 We start to ask how a problem comes about and how it becomes known as the problem. 163 00:17:49,850 --> 00:17:54,740 So if we apply this methodological approach to our concern with technology and loneliness, 164 00:17:55,160 --> 00:18:01,040 that leads us to ask if the solution is telepresence technologies, what is the problem? 165 00:18:04,760 --> 00:18:08,990 That's the methodological approach that underpins the virtual presence study. 166 00:18:09,410 --> 00:18:12,770 But how can we study this kind of thing empirically? 167 00:18:13,520 --> 00:18:18,500 What I'm going to do next in this talk is to explain the approach we took to our empirical data. 168 00:18:19,670 --> 00:18:28,040 So what we did was we looked at two different telepresence technologies that were created by Norwegian Start-Up Company called No Isolation. 169 00:18:29,780 --> 00:18:34,760 One technology is called Av1, and it's a distance learning avatar. 170 00:18:36,170 --> 00:18:43,910 The creation of this device was inspired by the experiences of a young person with cancer who could not attend school, 171 00:18:44,600 --> 00:18:48,230 was living with childhood cancer was an extremely difficult experience. 172 00:18:48,560 --> 00:18:55,820 One of the difficulties that was perhaps a little bit of surprise or unexpected expected to the family of this young person was 173 00:18:55,820 --> 00:19:01,550 that they really missed going to school and they felt that this was something that could be addressed through this technology. 174 00:19:02,300 --> 00:19:10,430 So Av1 was designed. It's a small robot like device that physically represents the young person or child in that classroom. 175 00:19:11,510 --> 00:19:16,010 It looks a bit like a sort of head and shoulders and the young person. 176 00:19:16,160 --> 00:19:19,310 So it sits in the classroom, perhaps on the young person's desk. 177 00:19:19,670 --> 00:19:28,550 The young person, the child is at home or in hospital perhaps, and they connect to the robot via an app on their own smartphone or tablet. 178 00:19:30,200 --> 00:19:37,099 So the robot has got audio visual, so the young person or child can see and hear the activities of the classroom and 179 00:19:37,100 --> 00:19:40,760 they can interact with their classmates and their teacher through the avatar. 180 00:19:41,570 --> 00:19:44,090 The student at home isn't visible from the classroom. 181 00:19:44,120 --> 00:19:54,469 That's deliberate, deliberate design of this technology because many people in perhaps in hospital or undergoing lots of treatment may not. 182 00:19:54,470 --> 00:20:01,460 Their appearance may change and they may not want to be visible. So it actually offers them a way of not having to make themselves visible. 183 00:20:02,150 --> 00:20:07,280 But they can interact through the robot, can move and turn in different directions. 184 00:20:07,580 --> 00:20:14,300 They can speak with a robot. There's a whisper function so they can talk quietly to their classmates of the teacher, to her. 185 00:20:14,810 --> 00:20:20,270 And there's a kind of it's not a hands up where there's a light up function to indicate they want some attention. 186 00:20:20,570 --> 00:20:24,290 And there are a couple of facial expressions that can be created using different lights. 187 00:20:25,930 --> 00:20:33,670 So that's our first telepresence technology, allowing the young person or child who's unable to go to school to have a telepresence in that classroom. 188 00:20:35,080 --> 00:20:37,720 The second technology we looked at is called COPE. 189 00:20:38,020 --> 00:20:46,720 It's a one button large screen computer designed for older people who are not comfortable with or able to use devices such as touch screens. 190 00:20:47,830 --> 00:20:56,980 Comp resembles a kind of a large TV connects from the other person's homes that sits in the other person's home, and it connects to family members, 191 00:20:57,100 --> 00:21:04,240 younger family members who are perhaps at a distance via those family members, smartphones or tablets they connect via an app. 192 00:21:05,380 --> 00:21:08,980 Now, comp has been deliberately designed to have very limited functions, 193 00:21:08,980 --> 00:21:15,910 so it's easy for people to use so it can receive but not transmit video calls, photos and text messages. 194 00:21:17,500 --> 00:21:22,899 Although originally designed for individual family use, some individual family use, 195 00:21:22,900 --> 00:21:30,370 a provision has also been created by no isolation for use by institutions, 196 00:21:30,610 --> 00:21:36,430 nursing home providers and so on to connect with large groups of people at the same time. 197 00:21:40,040 --> 00:21:44,089 So both these devices are described as telepresence technologies. 198 00:21:44,090 --> 00:21:51,770 They both, in different ways offer presence at a distance to combat loneliness and isolation and no isolation. 199 00:21:51,770 --> 00:21:52,309 The company, 200 00:21:52,310 --> 00:21:59,450 the Start-Up Company that designed and developed these technologies has a social mission to bring people together through warm technology. 201 00:21:59,480 --> 00:22:09,230 That's their strapline on their website. And they've identified that social isolation and loneliness strikes certain groups in society hardest. 202 00:22:09,710 --> 00:22:16,550 Those over the age of 80. Hence the design and development of camp and children and young people with long term illness. 203 00:22:16,580 --> 00:22:22,360 Hence the design and development of HIV one. So we've got these two devices. 204 00:22:23,020 --> 00:22:27,790 They're both designed deliberately to address social isolation and loneliness. 205 00:22:30,070 --> 00:22:38,920 And we were interested in looking not just at representations of loneliness in policies, as Carol Becky's approach might guide us to do. 206 00:22:39,460 --> 00:22:46,030 But the practices that people engaged in as they sought to address loneliness and to adopt these telepresence solutions. 207 00:22:47,800 --> 00:22:54,790 So our team has got a track record of looking at the adoption of different technologies in health and social care. 208 00:22:54,790 --> 00:23:02,260 And we took a socio technical approach, that is, we investigated the interactions between people and technologies. 209 00:23:02,590 --> 00:23:05,470 We were concerned with how technologies were used, 210 00:23:05,830 --> 00:23:11,530 how people interpret them and how they used shaped and changed the activities of the people who use them. 211 00:23:12,640 --> 00:23:20,590 So we extended Bucky's approach to considering not only how the problem of loneliness and the solution of technology were represented in policy, 212 00:23:21,070 --> 00:23:25,480 but how it was represented in practices of adoption of those technologies. 213 00:23:27,700 --> 00:23:33,130 So our methodological approach was to unpack the cultural dialectic between loneliness and technology, 214 00:23:33,550 --> 00:23:39,100 and in particular to ask the research questions. How are loneliness technologies perceived, 215 00:23:39,100 --> 00:23:46,990 used and negotiated in a culture in which technology is considered both a cause of and a solution to loneliness? 216 00:23:47,770 --> 00:23:53,740 We also asked, How is the relationship between loneliness and technology been articulated by policymakers, 217 00:23:53,920 --> 00:23:59,830 the media and users of telepresence technologies during and since the COVID 19 pandemic? 218 00:24:01,620 --> 00:24:06,569 So I'm now going to go on and just say a little bit about our empirical study and our 219 00:24:06,570 --> 00:24:12,930 empirical data as a way of showing how this methodology can be put into practice. 220 00:24:14,220 --> 00:24:20,040 So we studied the adoption of these two technologies. Komp and AVI one between 2020 and 2022. 221 00:24:20,940 --> 00:24:25,620 We also studied the broader social and policy context for the adoption of these 222 00:24:25,620 --> 00:24:30,660 technologies in the UK by tracing efforts to address loneliness by politicians, 223 00:24:30,840 --> 00:24:33,990 policymakers, campaigners and service providers. 224 00:24:34,740 --> 00:24:38,790 And we studied immediate representations of loneliness and technology. 225 00:24:41,360 --> 00:24:45,590 So the data that we collected, we created a large dataset. 226 00:24:46,300 --> 00:24:49,970 We looking to look at the adoption of telepresence technologies. 227 00:24:50,300 --> 00:24:57,620 We interviewed people concerned with adopting or taking up, spreading or putting into place Av1 and COB. 228 00:24:58,670 --> 00:25:07,280 Most of those people for Av1 were working in education and they were working in mainstream schools, including primary school and secondary schools. 229 00:25:07,820 --> 00:25:12,200 We also spoke to specialist education providers, including what is to hospitals, 230 00:25:12,200 --> 00:25:16,760 school, a special education adviser and somebody involved in alternative provision. 231 00:25:17,300 --> 00:25:25,280 We also spoke to charities, a number of charities sponsored a V ones for children, young people with particular conditions. 232 00:25:25,610 --> 00:25:31,610 And we spoke to people in local authorities and councils involved in commissioning and evaluating Av1. 233 00:25:32,690 --> 00:25:33,799 When it came to comp, 234 00:25:33,800 --> 00:25:40,520 most of our interviewees were working within local authorities or councils somewhere in the NHS and some others were in charities. 235 00:25:41,510 --> 00:25:48,200 We also observed the discussions about the potential to implement and adopt these technologies 236 00:25:48,200 --> 00:25:53,600 between the technology developer and potential purchasers or commissioners of the technology. 237 00:25:54,110 --> 00:25:56,150 We also did a lot of document analysis, 238 00:25:56,160 --> 00:26:02,270 some of the documents produced by the adopters to support the implementation and evaluation of the technologies, 239 00:26:02,630 --> 00:26:07,700 but also some of the factsheets and briefings created by the technology providers. 240 00:26:09,280 --> 00:26:09,429 Well, 241 00:26:09,430 --> 00:26:18,490 we didn't do was talk directly to the end users of the technologies we didn't interview older people using com or children and young people using av1. 242 00:26:19,570 --> 00:26:26,049 The reason we didn't do that was we already have quite a lot of data from another part of the study from those end users, 243 00:26:26,050 --> 00:26:34,810 and that's already very rich and provides a lot of useful information and data around the experience of using the technologies. 244 00:26:34,840 --> 00:26:40,959 Our focus in this part of the study was on the sense people made of the technologies as 245 00:26:40,960 --> 00:26:45,580 they sought to make it available to people who needed it rather than the end users. 246 00:26:46,780 --> 00:26:52,140 So the second group of data was around policies and actions to address loneliness. 247 00:26:52,150 --> 00:26:57,130 And here we interviewed people working at a more strategic level to address loneliness. 248 00:26:57,490 --> 00:27:01,420 So we spoke to charities, to businesses, to politicians, to campaigners, 249 00:27:01,420 --> 00:27:07,000 to think tanks and to some independent consultants who were working on these issues of loneliness and technology. 250 00:27:07,780 --> 00:27:14,230 We also attended various events. There's a loneliness week in the UK and we attended a number of events. 251 00:27:14,650 --> 00:27:21,160 We also listened to a range of different media around loneliness, including podcasts, 252 00:27:21,430 --> 00:27:25,270 short films, short books, as well as reading lots of policy documents. 253 00:27:25,960 --> 00:27:28,630 And when it came to looking at the political debates, 254 00:27:28,630 --> 00:27:37,540 we looked at all of the House of Commons debates and House of Lords debates about loneliness that took place during the period of our study. 255 00:27:37,550 --> 00:27:45,460 We found eight debates in the House of Commons and one in the House of Lords, and we pulled out the Hansard transcripts and analysed those. 256 00:27:46,930 --> 00:27:51,910 The final bit of our data was around media representations of technology and loneliness. 257 00:27:52,330 --> 00:28:00,580 And what we did was we sampled media stories about technology and loneliness before and after the COVID 19 pandemic, 258 00:28:01,000 --> 00:28:05,980 and we collected 141 newspaper articles from within the UK. 259 00:28:06,040 --> 00:28:13,930 That's our dataset there. So it's a large dataset and a mixed dataset, and we spent quite a lot of time analysing that, as you can imagine. 260 00:28:14,410 --> 00:28:18,040 We did thematic analysis initially of each of those different sections, 261 00:28:18,280 --> 00:28:22,630 and then we pulled that together by using the what's the problem represent to be approach. 262 00:28:24,310 --> 00:28:28,600 So I've taken quite a while to talk about our methodology and methods as something 263 00:28:28,600 --> 00:28:34,570 that I think will be interesting to the MSCI Translational Health Science students. 264 00:28:34,920 --> 00:28:40,540 And I'm just going to move on briefly to talk about our findings as well. 265 00:28:42,340 --> 00:28:52,780 So our findings were in summary, we found that there is this a huge emphasis on connection and participation, 266 00:28:53,650 --> 00:28:59,770 and there are different dimensions on how telepresence was understood to work to address loneliness. 267 00:29:01,270 --> 00:29:10,030 The importance of fostering individual connections was found throughout our data and underpinned much of the work that our participants engaged in. 268 00:29:10,300 --> 00:29:16,960 Whether that was around developing and adopting technologies or around promoting loneliness, policies and campaigns. 269 00:29:18,400 --> 00:29:22,600 The technologies we studied were designed specifically to make connections between people 270 00:29:22,600 --> 00:29:28,900 unable to be together in person due to distance caused by the social isolation of old age. 271 00:29:29,230 --> 00:29:35,020 Those people that using comp or that imposed by a long term illness, those people using av1. 272 00:29:35,980 --> 00:29:44,379 And then, of course, the pandemic caused new concerns about a wider range of people likely to suffer from loneliness and social 273 00:29:44,380 --> 00:29:51,880 isolation in lockdown and caused great efforts to provide people with a range of technological devices, 274 00:29:51,880 --> 00:29:57,940 skills and support to facilitate connections, including funds made available by the government. 275 00:29:59,290 --> 00:30:05,710 And for example, comp, although designed to address loneliness through personal connections, 276 00:30:05,980 --> 00:30:12,850 was also put to use in connecting people with health and other services made inaccessible by pandemic restrictions. 277 00:30:14,650 --> 00:30:18,850 So we found that in addition to the importance of individual connections, telepresence, 278 00:30:18,850 --> 00:30:23,770 telepresence technologies also facilitated social collective connections, 279 00:30:24,340 --> 00:30:30,760 allowing people to participate in a range of activities at a distance, including school work and leisure activities. 280 00:30:31,690 --> 00:30:36,760 TelePresence became widely used to enable people to share in social events at a distance. 281 00:30:37,930 --> 00:30:46,930 Participating in social events using telepresence technologies shifted the focus from individual connections to connections between groups, 282 00:30:46,930 --> 00:30:54,370 including families and classes. So one participant reported the benefits of comp for one older person unable to visit their 283 00:30:54,370 --> 00:31:00,910 younger family members in terms of allowing them to be and I quote ten part of the family again, 284 00:31:01,540 --> 00:31:05,979 because they're in their house and they're seeing the kids paint or cook or, you know, sing songs to them. 285 00:31:05,980 --> 00:31:07,450 It's been part of that again. 286 00:31:08,200 --> 00:31:14,890 That was a quote from an interview with a charity officer about the benefits that they had reported to them of the use of comp. 287 00:31:16,450 --> 00:31:18,579 So connections between social groups, 288 00:31:18,580 --> 00:31:26,050 but also implicated in the use of av1 because the technology provided a telepresence connection between student and class, 289 00:31:26,560 --> 00:31:30,310 but also mediated a social relationship between family in school. 290 00:31:31,630 --> 00:31:42,190 Families, of course, were involved in supporting the technology required for the telepresence connection and through social agreements 291 00:31:42,190 --> 00:31:48,309 about the use of av1 in allowing any fears of unwarranted surveillance or recording of classroom activities, 292 00:31:48,310 --> 00:31:51,940 which was a common concern with with with the use of AP one. 293 00:31:54,280 --> 00:31:57,370 The connection that Av1 offered was therefore collective, 294 00:31:57,430 --> 00:32:02,290 although it was conceived as a device to help a child or young person to maintain 295 00:32:02,290 --> 00:32:07,330 social contact during long term absence from school during due to health concerns, 296 00:32:08,050 --> 00:32:15,550 Av1 was understood by those involved in adopting it as a way for young people to participate in social life beyond the home and family, 297 00:32:15,940 --> 00:32:18,310 including engaging in formal education, 298 00:32:18,640 --> 00:32:27,190 but also in participating in the life stages of childhood and adolescence and the associated transitions and comparison comp, 299 00:32:27,700 --> 00:32:37,120 although it offered some connection between groups, was less able to facilitate or replace in-person groups, for example, during the pandemic. 300 00:32:38,020 --> 00:32:45,250 Instead, platforms such as Zoom were more commonly used for what might be described as scalable sociability, 301 00:32:46,230 --> 00:32:51,220 like initially designed as a kind of 1 to 1 connection or a one to a group connection. 302 00:32:53,260 --> 00:33:01,930 So with this relationship between technology and loneliness frequently represented as a dualism providing both human connection and disconnection, 303 00:33:02,410 --> 00:33:05,380 a further dualism seemed to emerge from our data. 304 00:33:05,410 --> 00:33:14,790 If the solution of technology for loneliness in relation to youth and old age technology was more frequently regarded as troublesome or troublesome, 305 00:33:14,790 --> 00:33:20,560 more risky for younger people than older people in relation to a range of social problems such as bullying, 306 00:33:20,860 --> 00:33:24,430 in addition to and in relate and interrelated with loneliness. 307 00:33:25,330 --> 00:33:31,420 So concerns about younger people using technology for kind of odd reasons was much more apparent. 308 00:33:31,900 --> 00:33:39,580 Whereas or exposing young technology, exposing younger people to inauthentic or damaging, for example, online relationships, 309 00:33:40,060 --> 00:33:48,280 whereas old people were seen to were expected to use technology for good reasons, enabling them to be more connected. 310 00:33:49,840 --> 00:33:53,350 Technology in all shapes and forms, including the telephone, 311 00:33:53,350 --> 00:33:58,149 was much more frequently represented in Our data is necessary for older people to address 312 00:33:58,150 --> 00:34:03,580 loneliness and led to support for older people in accessing and using technology. 313 00:34:03,580 --> 00:34:07,900 Whereas for younger people it was, it was more often represented as problematic. 314 00:34:09,730 --> 00:34:14,380 So the design and use of the telepresence technologies, which were the focus of our study, 315 00:34:14,410 --> 00:34:21,610 indicated that this dualism could be mapped onto the different dimensions of the problem of loneliness, connection and participation. 316 00:34:22,180 --> 00:34:29,490 Comp provided individual connections indicating that the problem of loneliness for older people interpreted through the design of com, 317 00:34:29,500 --> 00:34:36,700 was more akin to emotional isolation assumptions about ageing as being perhaps leaving people 318 00:34:36,700 --> 00:34:43,479 in a more static place and one that includes experiences of loss of emotional relationships. 319 00:34:43,480 --> 00:34:48,730 For example. Three Bereavement are in contrast with assumptions that younger people require 320 00:34:48,730 --> 00:34:53,680 participation in social life to undergo the dynamic processes of childhood development. 321 00:34:54,130 --> 00:34:58,810 Av1 was designed to enable participation, thus addressing social isolation. 322 00:35:00,070 --> 00:35:07,120 This very design and use of telepresence technologies indicates the duality of how understandings of loneliness shape technology, 323 00:35:07,120 --> 00:35:12,870 design and use for different ages and how such technologies shape understandings of loneliness. 324 00:35:15,310 --> 00:35:20,470 Some other important findings from our research was the link between loneliness and other 325 00:35:22,000 --> 00:35:28,420 social and indeed health problems encapsulated in the phrase Loneliness doesn't come alone. 326 00:35:29,950 --> 00:35:35,079 What does that mean? Well, loneliness and social isolation were not the only concerns of the participants 327 00:35:35,080 --> 00:35:38,830 in this study and whether or not the only problems represented in our data. 328 00:35:39,370 --> 00:35:45,610 We found that representations of loneliness in policy and campaigns were associated with other health and social problems, 329 00:35:46,210 --> 00:35:53,560 and attempts to address loneliness and social isolation through technology were inextricably linked with the situations in which people were 330 00:35:53,560 --> 00:36:03,520 experiencing loneliness and other associated problems and were affected by challenges related to the deployment or adoption of technologies. 331 00:36:07,820 --> 00:36:18,260 So for example, using comp with an older person, they may well have multiple health problems to address as well as that loneliness. 332 00:36:18,890 --> 00:36:26,240 Av1 might well be used with a child with a health problem who is missing school but may also have a difficult family situation and 333 00:36:26,240 --> 00:36:34,490 those dynamics needed to be addressed and managed and what were relevant to the use or indeed non-use of the different technologies. 334 00:36:36,690 --> 00:36:44,790 Now, one of the interesting reports that we found when we looked at documents was a report that came out from from about loneliness in London. 335 00:36:45,480 --> 00:36:48,090 And this was work commissioned by the deputy mayor of London. 336 00:36:48,690 --> 00:36:56,400 And they looked to reconceptualize severe loneliness as something that wasn't just likely to affect anybody. 337 00:36:57,270 --> 00:37:01,620 Some of the policies and media representations of loneliness were very much trying to 338 00:37:01,620 --> 00:37:07,020 address the stigma that loneliness has by talking about how anyone could could get lonely. 339 00:37:07,560 --> 00:37:13,320 But actually that the work that was commissioned by the deputy mayor of London looked at how some 340 00:37:13,320 --> 00:37:18,810 people were more likely to experience loneliness in others and to have greater adverse effects. 341 00:37:19,290 --> 00:37:26,640 So it wasn't just that loneliness is something that can be distributed evenly across the life stages or randomly occur to people, 342 00:37:27,630 --> 00:37:30,060 but there was something that was unequally distributed. 343 00:37:30,990 --> 00:37:37,980 This research, based in London, associated severe loneliness with acute poverty, with being single or living alone, 344 00:37:38,250 --> 00:37:46,740 with being deaf and disabled, with going through life changes or being new to London and feeling different or experiencing prejudice. 345 00:37:47,910 --> 00:37:55,830 So we can see that if we reconceptualize loneliness as something that isn't just randomly happening to people, 346 00:37:56,130 --> 00:38:00,960 but perhaps intersects with other kinds of difficulties and disadvantages. 347 00:38:01,470 --> 00:38:09,660 Loneliness itself, as well as the solutions to loneliness, need to be taken, need to take account of the context into which they're being introduced. 348 00:38:13,340 --> 00:38:19,459 We also found across our data representations of the benefits of technology that enabled connection 349 00:38:19,460 --> 00:38:24,590 and participation were interwoven with acknowledgements of the limitations of technology. 350 00:38:25,310 --> 00:38:31,250 So these might be technical glitches where you can't connect, you can't get a signal you've run out of data. 351 00:38:31,580 --> 00:38:36,080 But there are also represent more structural concerns about access to technology. 352 00:38:36,980 --> 00:38:39,950 So, hey, we might be thinking a bit more broadly about company V1, 353 00:38:39,950 --> 00:38:45,350 which are deliberately designed to be easy to use and not rely on, for example, having Wi-Fi or broadband, 354 00:38:46,220 --> 00:38:53,060 but actually thinking about other forms of technology use and technological solutions to loneliness and thinking 355 00:38:53,060 --> 00:38:58,850 about digital exclusion intersecting with some of those other problems associated with severe loneliness, 356 00:38:58,850 --> 00:39:01,310 for example, those identified in the London report. 357 00:39:04,260 --> 00:39:09,840 So there's the limitations of technology itself that come perhaps with all technological solutions. 358 00:39:10,140 --> 00:39:16,230 But then there's also particular limitations associated with telepresence connections. 359 00:39:17,040 --> 00:39:25,380 Representations of telepresence connections in general were compared unfavourably at times with in-person connections and was sometimes, 360 00:39:25,650 --> 00:39:31,260 although perhaps valued as temporary substitutes for pathways to real connections. 361 00:39:32,040 --> 00:39:36,390 TelePresence was frequently compared with in-person or face to face presence, 362 00:39:36,720 --> 00:39:42,150 and the full range of human connections, including touch, were noticeable by their loss. 363 00:39:44,190 --> 00:39:46,320 So there were limitations to technology. 364 00:39:48,210 --> 00:39:56,430 We think back to Karabakh is what's the problem represent to be approach and think about what was silent in our data and in the policy discourse. 365 00:39:56,970 --> 00:40:02,340 There was a relative silence in the discourse about loneliness as something to be endured. 366 00:40:03,060 --> 00:40:09,090 There were few representations of loneliness as perhaps some kind of existential component of human existence, 367 00:40:09,840 --> 00:40:14,880 something that might be endured or that might perhaps allow creativity or connection with nature. 368 00:40:14,970 --> 00:40:20,760 If we think back to the idea of loneliness and solitude as having but perhaps some positive aspects. 369 00:40:21,660 --> 00:40:31,140 Instead, loneliness in policy terms is represented as a social problem, to be solved, to be ended, not something that should be endured. 370 00:40:32,950 --> 00:40:39,040 The consequences of this representation of loneliness include the growth of campaigns and interventions to solve the problem, 371 00:40:39,040 --> 00:40:42,310 including technological interventions. And indeed, 372 00:40:42,370 --> 00:40:47,799 subsequent opportunities arise from this focus for growth and profit organisations 373 00:40:47,800 --> 00:40:52,180 involved in providing solutions and indeed researching solutions to loneliness. 374 00:40:55,700 --> 00:41:00,529 So campaigning work to change policy and raise awareness within a range of organisations has 375 00:41:00,530 --> 00:41:05,330 emerged from the representations of loneliness as a problem that can be alleviated by technology. 376 00:41:06,140 --> 00:41:08,990 And because of the complexity of the adoption of innovations, 377 00:41:08,990 --> 00:41:14,330 which involves an interplay between organisational contacts and policy contacts on the technologies, 378 00:41:14,810 --> 00:41:19,580 we've seen a certain amount of work undertaken to influence and change that broader context. 379 00:41:23,000 --> 00:41:27,110 So analysis of the relationships between loneliness and technology in our data have 380 00:41:27,110 --> 00:41:32,360 allowed us to trace representations of certain concerns and aspirations about society, 381 00:41:32,990 --> 00:41:39,650 the potential harm of technology as a cause of loneliness, the connections made by policymakers and campaigners with other social problems, 382 00:41:40,010 --> 00:41:43,400 and the way in which loneliness was understood more widely as a social problem 383 00:41:43,790 --> 00:41:48,210 indicates different assumptions about what makes for good collective social life. 384 00:41:48,980 --> 00:41:53,780 How people responded to the problem of loneliness indicated, to some extent their ideas. 385 00:41:53,810 --> 00:41:59,480 What makes for a successful society and indeed their assumptions about the resources and connections that are possible. 386 00:42:00,320 --> 00:42:06,139 Providing technology to increase social connections indicates a belief that there are beneficial relationships 387 00:42:06,140 --> 00:42:12,650 ready to be made and assumptions that technology will be readily adopted and allow people to be connected. 388 00:42:14,330 --> 00:42:23,300 So to wrap up, we've analysed how the problem of loneliness is represented through policy and practice of using telepresence technologies, 389 00:42:23,780 --> 00:42:30,919 and I've provided you with some detail of the methodology we've used and the methods we've used in the virtual present study. 390 00:42:30,920 --> 00:42:38,630 To address this. I've given you some highlights of our findings around how telepresence can enable connection and participation, 391 00:42:39,260 --> 00:42:44,120 but also note that new forms of connection can lead to new forms of disconnection. 392 00:42:44,840 --> 00:42:49,220 CO presence seems to remain a priority, particularly post-COVID. 393 00:42:50,570 --> 00:42:56,209 Being with someone physically still remains a priority and still has a great importance, 394 00:42:56,210 --> 00:42:59,690 despite the advantages of being able to connect at a distance. 395 00:43:00,770 --> 00:43:02,870 Technology is never problem free. 396 00:43:05,540 --> 00:43:15,380 Loneliness is no longer a subjective experience to be injured, but has developed into a social health and policy problem to be resolved. 397 00:43:16,730 --> 00:43:20,510 So the relationship between loneliness and technology that we frequently understand is a 398 00:43:20,510 --> 00:43:26,120 dualism offering both connection and disconnection can also be understood as a duality, 399 00:43:26,570 --> 00:43:31,790 with the use of technology informed by and informing how the problem of loneliness is understood. 400 00:43:33,170 --> 00:43:39,950 So I conclude by saying that our analysis shows how loneliness is no longer regarded as simply a subjective, 401 00:43:39,950 --> 00:43:47,270 painful experience, integral to human nature, but is a social, societal and policy problem that demands resolution. 402 00:43:47,630 --> 00:43:55,520 And in this sense, loneliness is perhaps rewritten as social isolation in the social and political handling of the problem. 403 00:43:56,960 --> 00:43:58,460 Thank you very much for listening.