Bitomsky Laura, Pfitzer Estelle, Nißen Marcia, Kowatsch Tobias
School of Medicine, University of St Gallen, St Gallen, Switzerland.
Department of Management, Economics, and Technology, ETH Zürich, Zürich, Zürich, Switzerland.
BMJ Open. 2025 Jun 26;15(6):e099306. doi: 10.1136/bmjopen-2025-099306.
BACKGROUND: Health disparities persist, posing significant health, social and economic challenges. Digital health technologies (DHTs) present a promising opportunity to address these inequities and advance health equity. Despite this potential, a comprehensive and structured overview of existing frameworks and guidelines on advancing health equity and a clear understanding of the potential of DHTs in their implementation to systematically close the healthcare gap is yet to be done. OBJECTIVE: To this end, our objectives are twofold: first, to identify frameworks and guidelines that promote health equity and second, to pinpoint the role of DHTs as an avenue for their implementation. We conducted a scoping review informed by Arksey and O'Malley's five-stage framework, methodological guidelines by the Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. SOURCES OF EVIDENCE: A comprehensive search was conducted across seven databases on 6 December 2023: PubMed, EMBASE, Cochrane, PsycINFO, Scopus, Web of Science and WISO. ELIGIBILITY CRITERIA: We included primary and secondary studies published in English between 2010 and 2023 focusing on advancing health equity for priority populations. CHARTING METHODS: For the analysis, we applied multistaged coding approaches to answer our twofold objective. RESULTS: The search identified 6419 studies, of which 38 met our final inclusion criteria and were included in this review. We extracted 559 recommendations on advancing health equity and synthesised these into 82 distinct recommendations across five levels of initiative and 19 areas of initiative. Thereby, 24% of the included studies explicitly mentioned the use of (digital) technology with 10 impact opportunities on advancing health equity. CONCLUSION: Our synthesis offers key insights into the advancement of health equity across different levels of initiative and the role of DHTs in their implementation. This offers practitioners and researchers alike a comprehensive overview to make health equity advancement more tangible and actionable. REGISTRATION DETAILS: https://osf.io/94pht.
背景：健康差距持续存在，带来了重大的健康、社会和经济挑战。数字健康技术（DHTs）为解决这些不平等问题和促进健康公平提供了一个有前景的机会。尽管有这种潜力，但对于现有的促进健康公平的框架和指南，尚未进行全面且结构化的概述，也尚未清晰了解DHTs在其实施过程中系统缩小医疗差距的潜力。 目的：为此，我们的目标有两个：第一，识别促进健康公平的框架和指南；第二，明确DHTs作为其实施途径的作用。我们依据阿克西和奥马利的五阶段框架、乔安娜·布里格斯研究所的方法指南以及系统评价和元分析扩展版的范围综述优先报告项目进行了一项范围综述。 证据来源：2023年12月6日，我们在七个数据库中进行了全面检索：PubMed、EMBASE、Cochrane、PsycINFO、Scopus、科学网和WISO。 纳入标准：我们纳入了2010年至2023年期间以英文发表的、专注于促进优先人群健康公平的初级和二级研究。 图表绘制方法：为了进行分析，我们应用多阶段编码方法来回答我们的双重目标。 结果：检索到6419项研究，其中38项符合我们的最终纳入标准并被纳入本综述。我们提取了559条关于促进健康公平的建议，并将其综合为82条不同的建议，涵盖五个倡议级别和19个倡议领域。因此，24%的纳入研究明确提到了（数字）技术的使用以及10个促进健康公平的影响机会。 结论：我们的综合分析提供了关于不同倡议级别上促进健康公平以及DHTs在其实施中的作用的关键见解。这为从业者和研究人员提供了一个全面的概述，以使健康公平的推进更加切实可行。 注册详情：https://osf.io/94pht 。
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