Scoping review: exploring the equity impact of current digital health design practices

Abstract

ABSTRACT Background Digital health interventions designed through human-centered design (HCD) have shown potential to impact health equity. This scoping review aims to understand how HCD approaches in digital health impact health equity. Methodology A scoping review was undertaken. Searches were conducted on PubMed, EMBASE, Web of Science, AMC Digital Library, ProQuest Thesis and Dissertations and Global Medicus Index databases. Results A total of 6169 references were identified, and 40 of them fulfilled the inclusion criteria for analysis. The application of HCD methodologies varied greatly as did the digital health interventions. The HCD methodologies had an impact on health equity for those individuals included in the development of the digital health tools, but beyond those persons, the impact was harder to establish. Conclusion There is optimism for the role that HCD in digital health can have in reducing health inequities; however, the evidence is not robust. Most projects failed to scale up to maturity or failed to apply evaluation mechanisms to assess the health equity impact. Recommendations include rigorous application of HCD methodologies, scaling digital health tools beyond pilot projects, and embedding evaluation to determine the impact on health equity.