数字赋能残疾儿童身体活动与健康：国际政策架构与核心内容及行动战略研究

doi:10.3969/j.issn.1006-9771.2024.04.002

摘要/Abstract

摘要：

目的探讨数字赋能残疾儿童身体活动与健康的国际政策架构、核心内容与行动战略。

方法采用世界卫生组织(WHO)健康服务体系6大构成要素的理论，对世界卫生组织(WHO)和联合国教科文组织(UNESCO)、国际电信联盟(ITU)和联合国儿童基金会(UNICEF)发布的有关数字赋能、人工智能、数字健康以及身体活动与健康、高品质的体育教育、包容性教育等相关国际组织的核心政策文件进行系统的内容分析，确定与数字赋能残疾儿童身体活动与健康相关的国际政策架构与核心内容和行动战略。

结果根据WHO健康服务体系6大构成要素的理论，数字赋能残疾儿童身体活动与健康的政策架构主要涉及服务提供、健康人力资源、健康信息系统、医疗产品和技术、健康筹资、领导力与数字治理6个领域。实施数字赋能残疾儿童身体活动与健康的主要行动战略涉及6大项：强化法律和政策支持提升数字治理能力、建立跨部门的协作机制、强化数字技术持续创新、构建数字赋能的残疾儿童身体活动与健康的服务体系、建立并实施数字赋能相关技术和伦理标准、促进儿童的数字融合，以及改善残疾儿童的身体活动与健康服务的监测和质量控制。

结论本研究基于WHO健康服务体系6大构成要素的理论，从服务提供、健康人力资源、健康信息系统、医疗产品和技术、健康筹资、领导力与数字治理6个领域，对WHO、UNESCO、ITU和UNICEF发布的相关政策文件进行内容分析，构建了数字赋能残疾儿童身体活动与健康的政策架构，分析了相关政策的核心内容以及主要行动战略。本研究为制定相关的国家和地方性政策，推动数字赋能技术在残疾儿童身体活动和健康领域的应用具有重要的意义。

关键词: 残疾儿童, 数字赋能, 身体活动, 健康

Abstract:

Objective To explore the framework, core content and strategic action of international policies concerning the digital empowerment of physical activity and health among children with disabilities.

Methods Employing the World Health Organization (WHO) health service system's six building blocks as a theoretical basis, this study conducted a systematic content analysis of core policy documents issued by key international organizations including the WHO, United Nations Educational, Scientific and Cultural Organization (UNESCO), International Telecommunication Union (ITU), and United Nations International Children's Emergency Fund (UNICEF). These documents cover topics related to digital empowerment, artificial intelligence, digital health, physical activity and health, high-quality physical education, and inclusive education. The analysis aimed to identify the international policy framework, core content and strategic action related to the digital empowerment of physical activity and health for children with disabilities.

Results The policy framework for digital empowerment of physical activity and health in children with disabilities encompasses six key areas, aligned with the WHO health service system's six building blocks: service provision, health workforce, health information systems, medical products and technology, health financing, leadership and digital governance. Key strategic actions for implementing digital empowerment include strengthening legal and policy support to enhance digital governance capabilities, establishing cross-sectoral collaboration mechanisms, fostering continuous innovation in digital technology, building a comprehensive service system for digital empowerment in physical activity and health, establishing and enforcing relevant technological and ethical standards, promoting digital community inclusion, and improving the monitoring and quality control of services related to physical activity and health for children with disabilities.

Conclusion Based on the WHO health service system's six building blocks, this study provides a detailed analysis of international policies from WHO, UNESCO, ITU and UNICEF, and constructs a comprehensive policy framework for the digital empowerment of physical activity and health in children with disabilities. It highlights the core contents and main strategic actions necessary for policy development and the application of digital technologies in the field of physical activity and health for children with disabilities. The findings underscore the importance of national and local policy development of digital empowerment technologies to support the physical activity and health of children with disabilities.

Key words: children with disabilities, digital empowerment, physical activity, health

中图分类号:

G804.8

魏晓微. 数字赋能残疾儿童身体活动与健康：国际政策架构与核心内容及行动战略研究[J]. 《中国康复理论与实践》, 2024, 30(4): 381-388.

WEI Xiaowei. Research on international policies of digital empowerment of physical activity and health in children with disabilities: framework, core content, and strategic action[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(4): 381-388.

图/表 1

表1

数字赋能残疾儿童身体活动与健康国际政策架构"

健康服务体系构成要素	核心内容	具体说明
服务提供	1.远程服务 2.智能服务 3.个性化服务	1.利用远程医疗技术提供健康咨询、身体活动咨询、运动方案指导以及康复指导 2.应用AI技术、大数据、云计算等开发智能化身体活动以和健康管理系统 3.根据残疾儿童的具体需求提供个性化服务
健康人力资源	1.提升数字健康素养 2.数字相关技术能力	1.为服务提供者和残疾儿童提供培训 2.提高他们的数字健康素养和ICT使用能力
健康信息系统	1.AI和大数据技术应用 2.实时监测和远程指导 3.跨行业数据共享 4.监测与研究	1.利用AI和大数据技术分析健康数据，实现实时健康监控和远程指导 2.通过AI、大数据和互联网技术以及云计算技术，提供实时的身体活动和健康服务监测和远程指导 3.促进跨行业数据共享，支持综合健康管理 4.基于大数据和AI以及互联网技术，通过云计算，实施活动和健康的监测
医疗产品和技术	1.智能产品和设备 2.辅助技术 3.信息无障碍环境 4.ICT应用	1.开发并推广使用智能健康监测设备 2.开发并推广使用智能辅助技术 3.在学校、社区、医疗或康复机构等创建无障碍的数字环境 4.广泛应用ICT支持残疾儿童的身体活动和健康
健康筹资	1.提供可及和可负担的数字赋能身体活动和健康的服务 2.确保可持续性资金支持	1.为残疾儿童提供可及和可负担的数字赋能的身体活动和健康相关的服务 2.寻求政府、私营部门和国际组织的资金支持，确保数字健康项目的持续开发和实施
领导力与治理	1.数字治理能力与治理机制 2.完善并实施数字治理相关政策 3.跨部门和行业协作	1.建立有效的数字治理结构，并且提升数字治理能力 2.制定政策、标准和指导原则，确保数字健康项目的质量、安全和效果 3.通过数字技术的应用，提升跨部门和跨行业的协作能力

表1

参考文献 35

[1]	CARBONE P S, SMITH P J, LEWIS C, et al. Promoting the participation of children and adolescents with disabilities in sports, recreation, and physical activity[J]. Pediatrics, 2021, 148(6): e2021054664.
[2]	POPA C E, DOBRESCU T. The effectiveness of therapeutic physical exercises in improving balance and coordination in children with Down syndrome[J]. Revista Romaneasca pentru Educatie Multidimensionala, 2017, 9(3): 89-102. doi: 10.18662/rrem
[3]	BORLAND R L, CAMERON L A, TONGE B J, et al. Effects of physical activity on behaviour and emotional problems, mental health and psychosocial well-being in children and adolescents with intellectual disability: A systematic review[J]. J Appl Res Intellect Disabil, 2022, 35(2): 399-420. doi: 10.1111/jar.v35.2
[4]	KARA O K, GURSEN C, CETIN S Y, et al. The effects of power exercises on body structure and function, activity and participation in children with cerebral palsy: an ICF-based systematic review[J]. Disabil Rehabil, 2023, 45(22): 3705-3718. doi: 10.1080/09638288.2022.2138575
[5]	YANG W, LIANG X, SIT C H. Physical activity and mental health in children and adolescents with intellectual disabilities: a meta-analysis using the RE-AIM framework[J]. Int J Behav Nutr Phys Act, 2022, 19(1): 80. doi: 10.1186/s12966-022-01312-1 pmid: 35799257
[6]	库雪婷, 王斌. 智力和发展性残疾儿童青少年身体活动效益:基于ICF的系统综述[J]. 中国康复理论与实践, 2022, 28(12): 1416-1425. doi: 10.3969/j.issn.1006-9771.2022.12.006
	KU X T, WANG B. Health benefits of physical activity for children and adolescents with intellectual and developmental disabilities: a systematic review using ICF[J]. Chin J Rehabil Theory Pract, 2022, 28(12): 1416-1425.
[7]	World Health Organization. WHO guidelines on physical activity and sedentary behaviour[M]. Geneva: World Health Organization, 2020.
[8]	杨亚茹, 卢雁. 运用世界卫生组织康复胜任力架构研究适应体育教师学科教学内容知识[J]. 中国康复理论与实践, 2022, 28(5): 559-567. doi: 10.3969/j.issn.1006-9771.2022.05.011
	YANG Y R, LU Y. Exploring pedagogical content knowledge of adaptive physical education for teachers using WHO rehabilitation competency framework[J]. Chin J Rehabil Theory Pract, 2022, 28(5): 559-567.
[9]	World Bank Group. Bridging the disability divide through digital technologies[EB/OL]. (2016-03-06)[2024-01-23]. https://thedocs.worldbank.org/en/doc/123481461249337484-0050022016/original/WDR16BPBridgingtheDisabilityDividethroughDigitalTechnologyRAJA.pdf.
[10]	LEE H K, JIN J. The effect of a virtual reality exergame on motor skills and physical activity levels of children with a developmental disability[J]. Res Dev Disabil, 2023, 132(6): 104386. doi: 10.1016/j.ridd.2022.104386
[11]	AHN S N. Combined effects of virtual reality and computer game-based cognitive therapy on the development of visual-motor integration in children with intellectual disabilities: a pilot study[J]. Occup Ther Int, 2021, 2021(5): 6696779.
[12]	EBRAHIMISANI S, SOHRABI M, TAHERI H, et al. Effects of virtual reality training intervention on predictive motor control of children with DCD: a randomized controlled trial[J]. Res Dev Disabil, 2020, 107(12): 103768. doi: 10.1016/j.ridd.2020.103768
[13]	United Nations. General comment No. 25 (2021) on children's rights in relation to the digital environment[EB/OL]. (2021-03-02)[2024-01-22]. https://www.ohchr.org/en/documents/general-comments-and-recommendations/general-comment-no-25-2021-childrens-rights-relation.
[14]	World Health Organization. Global strategy on digital health 2020-2025[M]. Geneva: World Health Organization, 2021.
[15]	UNESCOQ. Quality Physical Education (QPE): guidelines for policy makers[EB/OL]. (2015-07-21)[2023-12-20]. https://unesdoc.unesco.org/ark:/48223/pf0000231101.
[16]	KAELIN V C, VALIZADEH M, SALGADO Z, et al. Artificial Intelligence in rehabilitation targeting the participation of children and youth with disabilities: scoping review[J]. J Med Internet Res, 2021, 23(11): e25745. doi: 10.2196/25745
[17]	KAELIN V C, VALIZADEH M, SALGADO Z, et al. Capturing and operationalizing participation in pediatric rehabilitation research using artificial intelligence: a scoping review[J]. Front Rehabil Sci, 2022, 3(4): 855240. doi: 10.3389/fresc.2022.855240
[18]	DADA S, VAN DER WALT C, MAY A A, et al. Intelligent assistive technology devices for persons with dementia: a scoping review[J]. Assist Technol, 2022(4): 1-14.
[19]	BUITRAGO J A, BOLAÑOS A M, CAICEDO BRAVO E. A motor learning therapeutic intervention for a child with cerebral palsy through a social assistive robot[J]. Disabil Rehabil Assist Technol, 2020, 15(3): 357-362. doi: 10.1080/17483107.2019.1578999 pmid: 30806105
[20]	LAI B, YOUNG R, CRAIG M, et al. Improving social isolation and loneliness among adolescents with physical disabilities through group-based virtual reality gaming: feasibility pre-post trial study[J]. JMIR Form Res, 2023, 7(6): e47630. doi: 10.2196/47630
[21]	CHEN Y, FANCHIANG H D, HOWARD A. Effectiveness of virtual reality in children with cerebral palsy: a systematic review and meta-analysis of randomized controlled trials[J]. Phys Ther, 2018, 98(1): 63-77. doi: 10.1093/ptj/pzx107 pmid: 29088476
[22]	WARNIER N, LAMBREGTS S, PORT I V. Effect of virtual reality therapy on balance and walking in children with cerebral palsy: a systematic review[J]. Dev Neurorehabil, 2020, 23(8): 502-518. doi: 10.1080/17518423.2019.1683907
[23]	WINGO B C, YANG D, DAVIS D, et al. Lessons learned from a blended telephone/e-health platform for caregivers in promoting physical activity and nutrition in children with a mobility disability[J]. Disabil Health J, 2020, 13(1): 100826. doi: 10.1016/j.dhjo.2019.100826
[24]	FULLER D, COLWELL E, LOW J, et al. Reliability and validity of commercially available wearable devices for measuring steps, energy expenditure, and heart rate: systematic review[J]. JMIR Mhealth Uhealth, 2020, 8(9): e18694. doi: 10.2196/18694
[25]	WHITE L, VOLFSON Z, FAULKNER G, et al. Reliability and validity of physical activity instruments used in children and youth with physical disabilities: a systematic review[J]. Pediatr Exerc Sci, 2016, 28(2): 240-263. doi: 10.1123/pes.2015-0123 pmid: 26695088
[26]	BREMER E, ARBOUR-NICITOPOULOS K P, TSUI B, et al. Feasibility and utility of a fitbit tracker among ambulatory children and youth with disabilities[J]. Pediatr Exerc Sci, 2023, 35(4): 249-257. doi: 10.1123/pes.2022-0121
[27]	World Health Organization. Global action plan on physical activity 2018-2030: more active people for a healthier world[M]. Geneva: World Health Organization, 2018.
[28]	International Telecommunication Union. ICTs for a Sustainable World #ICT4SDG[EB/OL]. (2019-10-30)[2023-12-23]. https://www.sakan.org.za/Docs/ICT4SDG.pdf.
[29]	UNICEF. Policy guidance on AI for children[EB/OL]. (2020-09-11)[2024-01-20]. https://www.unicef.cn/media/17926/file/Policy%20guidance%20on%20AI%20for%20children.pdf.
[30]	World Health Organization. WHO guideline: recommendations on digital interventions for health system strengthening[EB/OL]. (2019-06-06)[2024-01-09]. https://www.who.int/reproductivehealth/publications/digital-interventions-health-system-strengthening/en/.
[31]	RIMMER J A, ROWLAND J L. Physical activity for youth with disabilities: a critical need in an underserved population[J]. Dev Neurorehabil, 2008, 11(2): 141-148. doi: 10.1080/17518420701688649 pmid: 18415819
[32]	LAI B, WADSWORTH D, SPRING K, et al. Validity and reliability of a telehealth physical fitness and functional assessment battery for ambulatory youth with and without mobility disabilities: observational measurement study[J]. JMIR Rehabil Assist Technol, 2024, 11(12): e50582. doi: 10.2196/50582
[33]	PARK S B, JU Y, KWON H, et al. Effect of a cognitive function and social skills-based digital exercise therapy using iot on motor coordination in children with intellectual and developmental disability[J]. Int J Environ Res Public Health, 2022, 19(24): 16499. doi: 10.3390/ijerph192416499
[34]	国际电信联盟. 保护上网儿童父母和教育工作者指南[EB/OL]. (2020-07-21)[2023-09-11]. https://www.itu.int/dms_pub/itu-s/opb/gen/S-GEN-COP.EDUC-2020-PDF-C.pdf.
[35]	STRATH S J, KAMINSKY L A, AINSWORTH B E, et al. Guide to the assessment of physical activity: clinical and research applications: a scientific statement from the American Heart Association[J]. Circulation, 2013, 128(20): 2259-2279. doi: 10.1161/01.cir.0000435708.67487.da pmid: 24126387