Petretto Donatella Rita, Carrogu Gian Pietro, Gaviano Luca, Berti Roberta, Pinna Martina, Petretto Andrea Domenico, Pili Roberto
Department of Education, Philosophy and Psychology, University of Cagliari, Cagliari, Italy.
IERFOP Onlus, Cagliari, Italy.
J Public Health Res. 2024 Jan 17;13(1):22799036231220352. doi: 10.1177/22799036231220352. eCollection 2024 Jan.
With the progressive digitization of health services and the current spread of Telemedicine and e-Health, it became clear that promoting Digital health equity (DHE) is necessary to support health potential, to avoid that some individuals can incur in unintended inequities. In this paper, we address the complex causal process(es) that may generate risk of inequities, considering the so-called "Digital Determinants of health" (DDoH) and their relationship with determinants of health (DoH).
We conducted a scoping review, according to methodological framework proposed in PRISMA-ScR guidelines, on the definition of DDoH (Scopus, Pubmed and Web of Science electronic databases). Inclusion criteria: papers on the definition of DDoH, no time limits, all study designs eligible.
There is an agreement on the link between DDoHs and "digital divide" and on their effects on a wide range of health, functioning outcomes, both as barriers and as facilitators. Authors proposed to modify or integrate with DDoHs the "Rainbow model" or other conceptual models on DoH. To promote DHE, authors suggest considering a multidimensional complex causal model, with interdependence among the different levels and the mutually reinforcing effects.
To study DDoH and their relationship with main determinants of health could be a way to address the complex causal model in the promotion of DHE. However, as they act in a multidimensional causal context, any intervention may consider the interdependence among different involved levels, within them, and the mutually reinforcing effects. Further research is needed to gain a more complete picture of the field.
随着医疗服务的逐步数字化以及当前远程医疗和电子健康的普及，显然促进数字健康公平（DHE）对于支持健康潜力、避免一些人遭遇意外的不公平现象是必要的。在本文中，我们探讨了可能产生不公平风险的复杂因果过程，考虑了所谓的“健康数字决定因素”（DDoH）及其与健康决定因素（DoH）的关系。
我们根据PRISMA - ScR指南中提出的方法框架，对DDoH的定义进行了范围综述（Scopus、Pubmed和科学网电子数据库）。纳入标准：关于DDoH定义的论文，无时间限制，所有研究设计均符合条件。
关于DDoH与“数字鸿沟”之间的联系及其对广泛的健康、功能结果的影响，无论是作为障碍还是促进因素，存在共识。作者提议用DDoH修改或整合“彩虹模型”或其他关于DoH的概念模型。为促进DHE，作者建议考虑一个多维复杂因果模型，不同层面之间相互依存且相互强化。
研究DDoH及其与健康主要决定因素的关系可能是解决促进DHE过程中复杂因果模型的一种方式。然而，由于它们在多维因果背景下起作用，任何干预都可能考虑不同相关层面内部及其之间的相互依存关系和相互强化作用。需要进一步研究以更全面地了解该领域。
