Mair Jacqueline Louise, Hashim Jumana, Thai Linh, Tai E Shyong, Ryan Jillian C, Kowatsch Tobias, Müller-Riemenschneider Falk, Edney Sarah Martine
Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise (CREATE), 1 Create Way, Singapore, 138602, Singapore.
Behavioural and Implementation Science Interventions, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore, 117597, Singapore.
Transl Behav Med. 2025 Jan 16;15(1). doi: 10.1093/tbm/ibaf010.
Digital health (DH) technologies provide scalable and cost-effective solutions to improve population health but face challenges of uneven adoption and high attrition, particularly among vulnerable and minority groups.
This study explores factors influencing DH adoption in a multicultural population and identifies strategies to improve equitable access.
Using a Patient and Public Involvement approach, lay facilitators engaged adults at public eateries in Singapore to discuss motivations and barriers to DH adoption. A semi-structured guide facilitated discussions, followed by an optional socio-demographic survey. Data were analyzed through inductive thematic analysis and mapped to behavior change theory to identify mechanisms of action (MoA) and behavior change techniques (BCTs) to support adoption.
Facilitators engaged 118 participants between November 2022 and February 2023. Five key themes were identified from the discussions: (a) awareness of DH solutions, (b) weighing benefits against burdens, (c) accessibility, (d) trust in DH developers and technology, and (e) the impact of user experience. These themes were mapped to 13 MoA and 26 BCTs, informing five key strategies to enhance DH adoption: community-based promotion of credible DH solutions and digital literacy training, brief counselling at opportune moments in healthcare settings, variable rewards tied to personal values, policies ensuring accessibility and regulation, and gamified, user-friendly designs emphasizing feedback and behavioral cues.
Designing and implementing DH solutions that are accessible, trustworthy, and motivating-integrated within healthcare services and promoted through community efforts-can address barriers to adoption by diverse communities and may help to narrow the digital divide.
数字健康（DH）技术为改善人群健康提供了可扩展且具成本效益的解决方案，但面临采用不均衡和高流失率的挑战，尤其是在弱势群体和少数族裔群体中。
本研究探讨影响多元文化人群采用数字健康的因素，并确定改善公平获取的策略。
采用患者和公众参与方法，外展促进者在新加坡的公共餐馆与成年人讨论采用数字健康的动机和障碍。一份半结构化指南推动了讨论，随后进行了可选的社会人口学调查。通过归纳主题分析对数据进行分析，并映射到行为改变理论，以确定支持采用的行动机制（MoA）和行为改变技术（BCTs）。
2022年11月至2023年2月期间，促进者与118名参与者进行了交流。从讨论中确定了五个关键主题：（a）对数字健康解决方案的认知，（b）权衡利弊，（c）可及性，（d）对数字健康开发者和技术的信任，以及（e）用户体验的影响。这些主题被映射到13个行动机制和26个行为改变技术，形成了五个增强数字健康采用的关键策略：基于社区推广可靠的数字健康解决方案和数字素养培训，在医疗环境中的适当时机进行简短咨询，与个人价值观挂钩的可变奖励，确保可及性和监管的政策，以及强调反馈和行为提示的游戏化、用户友好设计。
设计和实施易于获取、值得信赖且具有激励性的数字健康解决方案，并将其整合到医疗服务中，通过社区努力进行推广，可以解决不同社区采用数字健康的障碍，并可能有助于缩小数字鸿沟。
