Document Type

Article

Publication Date

2024

DOI

10.2196/51355

Publication Title

Journal of Medical Internet Research

Volume

26

Pages

e51355 (1-16)

Abstract

The potential and threat of digital tools to achieve health equity has been highlighted for over a decade, but the success of achieving equitable access to health technologies remains challenging. Our paper addresses renewed concerns regarding equity in digital health access that were deepened during the COVID-19 pandemic. Our viewpoint is that (1) digital health tools have the potential to improve health equity if equitable access is achieved, and (2) improving access and equity in digital health can be strengthened by considering behavioral science-based strategies embedded in all phases of tool development. Using behavioral, equity, and access frameworks allowed for a unique and comprehensive exploration of current drivers of digital health inequities. This paper aims to present a compilation of strategies that can potentially have an actionable impact on digital health equity. Multilevel factors drive unequal access, so strategies require action from tool developers, individual delivery agents, organizations, and systems to effect change. Strategies were shaped with a behavioral medicine focus as the field has a unique role in improving digital health access; arguably, all digital tools require the user (individual, provider, and health system) to change behavior by engaging with the technology to generate impact. This paper presents a model that emphasizes using multilevel strategies across design, delivery, dissemination, and sustainment stages to advance digital health access and foster health equity.

Rights

© 2024 Maura M Kepper, Lauren A Fowler, Isabelle S Kusters, Jean W Davis, Manal Baqer, Sara Sagui-Henson, Yunyu Xiao, Adati Tarfa, Jean C Yi, Bryan Gibson, Kristin E Heron, Nicole M Alberts, Marissa Burgermaster, Veronica PS Njie-Carr, Lisa M Klesges.

This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0) (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research (ISSN 1438-8871), is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.

Original Publication Citation

Kepper, M. M., Fowler, L. A., Kusters, I. S., Davis, J. W., Baqer, M., Sagui-Henson, S., Xiao, Y., Tarfa, A., Yi, J. C., Gibson, B., Heron, K. E., Alberts, N. M., Burgermaster, M., Njie-Carr, V. P., & Klesges, L. M. (2024). Expanding a behavioral view on digital health access: Drivers and strategies to promote equity. Journal of Medical Internet Research, 26(1), 1-16, Article e51355. https://doi.org/10.2196/51355

ORCID

0000-0002-7452-876X (Heron)

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