Public Health and Southgate Institute for Health, Society and Equity, Flinders University, Sturt Road, 5042 Adelaide, Australia.
School of Medicine, University of Tasmania, Churchill Avenue, 7005 Hobart, Australia.
Health Promot Int. 2021 Aug 30;36(4):1105-1115. doi: 10.1093/heapro/daaa145.
The provision of population-oriented, on-demand digital health services in many countries exemplifies the perceived utility of digital health services in supporting population health. Yet, limited knowledge exists regarding the equity of these services. Using mixed-method research, we recruited users of a health website and general practice patients to surveys (n = 441) and telephone interviews (n = 40). We contribute specific evidence investigating barriers to access, use and benefit from digital health services within an equity framework that incorporates social determinant factors, eHealth Literacy and trust. Our research highlights the foundational role of trust in predicting use, showcases which groups are unlikely to benefit from population-oriented digital health services, and proposes strategies to enhance the equity of these services. The theoretical framework we developed serves as a roadmap for future health promotion research and action by outlining the complex and interrelated pathways that can promote and threaten digital health equity.
在许多国家，以人口为导向、按需提供的数字卫生服务是数字卫生服务在支持人口健康方面的实用性的体现。然而，关于这些服务的公平性，我们的了解有限。本研究采用混合方法，招募了一个健康网站的用户和普通科医生的患者，进行了调查（n=441）和电话访谈（n=40）。我们在包含社会决定因素、电子健康素养和信任的公平框架内，提供了具体证据，调查了数字卫生服务获取、使用和受益的障碍。我们的研究强调了信任在预测使用方面的基础性作用，展示了哪些群体不太可能从以人口为导向的数字卫生服务中受益，并提出了增强这些服务公平性的策略。我们开发的理论框架为未来的健康促进研究和行动提供了路线图，概述了可以促进和威胁数字卫生公平性的复杂和相互关联的途径。
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