Ferretti Agata, Vayena Effy, Blasimme Alessandro
Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.
PLOS Digit Health. 2023 Aug 4;2(8):e0000315. doi: 10.1371/journal.pdig.0000315. eCollection 2023 Aug.
As digital technologies such as smartphones and fitness bands become more ubiquitous, individuals can engage in self-monitoring and self-care, gaining greater control over their health trajectories along the life-course. These technologies appeal particularly to young people, who are more familiar with digital devices. How this digital transformation facilitates health promotion is therefore a topic of animated debate. However, most research to date focuses on the promise and peril of digital health promotion (DHP) in high-income settings, while DHP in low- and middle-income countries (LMICs) remain largely unexplored. This narrative review aims to fill this gap by critically examining key ethical challenges of implementing DHP in LMICs, with a focus on young people. In the existing literature, we identified potential impediments as well as enabling conditions. Aspects to consider in unlocking the potential of DHP include (1) addressing the digital divide and structural injustice in data-related practices; (2) engaging the target population and responding to their specific needs given their economic, cultural, and social contexts; (3) monitoring the quality and impact of DHP over time; and (4) improving responsible technology governance and its implementation. Addressing these concerns could result in meaningful health benefits for populations lacking access to more conventional healthcare resources.
随着智能手机和健身手环等数字技术越来越普及,个人可以进行自我监测和自我护理,在人生历程中对自己的健康轨迹有更大的掌控权。这些技术尤其吸引更熟悉数字设备的年轻人。因此,这种数字转型如何促进健康成为一个激烈辩论的话题。然而,迄今为止,大多数研究集中在高收入环境中数字健康促进(DHP)的前景和风险,而低收入和中等收入国家(LMICs)的数字健康促进在很大程度上仍未得到探索。本叙述性综述旨在通过批判性地审视在低收入和中等收入国家实施数字健康促进的关键伦理挑战来填补这一空白,重点关注年轻人。在现有文献中,我们确定了潜在障碍以及有利条件。释放数字健康促进潜力时需要考虑的方面包括:(1)解决数据相关实践中的数字鸿沟和结构性不公正问题;(2)鉴于目标人群的经济、文化和社会背景,让目标人群参与进来并回应他们的特定需求;(3)长期监测数字健康促进的质量和影响;(4)改善负责任的技术治理及其实施。解决这些问题可能会给缺乏更多传统医疗资源的人群带来有意义的健康益处。