Holmes Fee Casey, Hicklen Rachel Scarlett, Jean Sidney, Abu Hussein Nebal, Moukheiber Lama, de Lota Michelle Foronda, Moukheiber Mira, Moukheiber Dana, Anthony Celi Leo, Dankwa-Mullan Irene
Healthcare Consultant, Newton, Massachusetts, United States of America.
Research Medical Library, MD Anderson Cancer Center, Houston, Texas, United States of America.
PLOS Digit Health. 2023 Oct 12;2(10):e0000314. doi: 10.1371/journal.pdig.0000314. eCollection 2023 Oct.
Healthcare has long struggled to improve services through technology without further widening health disparities. With the significant expansion of digital health, a group of healthcare professionals and scholars from across the globe are proposing the official usage of the term "Digital Determinants of Health" (DDOH) to explicitly call out the relationship between technology, healthcare, and equity. This is the final paper in a series published in PLOS Digital Health that seeks to understand and summarize current knowledge of the strategies and solutions that help to mitigate the negative effects of DDOH for underinvested communities. Through a search of English-language Medline, Scopus, and Google Scholar articles published since 2010, 345 articles were identified that discussed the application of digital health technology among underinvested communities. A group of 8 reviewers assessed 132 articles selected at random for the mention of solutions that minimize differences in DDOH. Solutions were then organized by categories of policy; design and development; implementation and adoption; and evaluation and ongoing monitoring. The data were then assessed by category and the findings summarized. The reviewers also looked for common themes across the solutions and evidence of effectiveness. From this limited scoping review, the authors found numerous solutions mentioned across the papers for addressing DDOH and many common themes emerged regardless of the specific community or digital health technology under review. There was notably less information on solutions regarding ongoing evaluation and monitoring which corresponded with a lack of research evidence regarding effectiveness. The findings directionally suggest that universal strategies and solutions can be developed to address DDOH independent of the specific community under focus. With the need for the further development of DDOH measures, we also provide a framework for DDOH assessment.
长期以来，医疗保健行业一直在努力通过技术改善服务，同时又不进一步扩大健康差距。随着数字健康的大幅扩展，一群来自全球的医疗保健专业人员和学者提议正式使用“健康的数字决定因素”（DDOH）这一术语，以明确指出技术、医疗保健和公平之间的关系。这是发表在《公共科学图书馆·数字健康》上的一系列文章中的最后一篇，旨在理解和总结当前关于有助于减轻DDOH对投资不足社区负面影响的策略和解决方案的知识。通过搜索2010年以来发表的英文医学文献数据库、Scopus数据库和谷歌学术文章，共识别出345篇讨论数字健康技术在投资不足社区应用的文章。一组8名评审人员对随机挑选的132篇文章进行了评估，以确定其中是否提及了最小化DDOH差异的解决方案。然后，将解决方案按照政策、设计与开发、实施与采用以及评估与持续监测等类别进行整理。接着按类别对数据进行评估，并总结研究结果。评审人员还寻找了各种解决方案中的共同主题以及有效性证据。通过这项有限的范围审查，作者们发现，这些论文中提到了许多解决DDOH问题的方案，并且无论所审查的具体社区或数字健康技术如何，都出现了许多共同主题。关于持续评估和监测的解决方案的信息明显较少，这与缺乏有效性的研究证据相对应。研究结果从方向上表明，可以制定通用的策略和解决方案来解决DDOH问题，而与所关注的具体社区无关。鉴于需要进一步制定DDOH措施，我们还提供了一个DDOH评估框架。
