Expanding a Behavioral View on Digital Health Access: Drivers and Strategies to Promote Equity (Preprint)

Abstract

UNSTRUCTURED The potential and threat of digital tools to achieve health equity has been highlighted for over a decade but success in achieving equitable access to health technologies remains challenging. Our paper addresses renewed concerns regarding equity in digital health access that were deepened during the COVID-19 pandemic. Utilizing behavioral, equity, and access frameworks allowed for a unique and comprehensive exploration of current drivers of digital health inequities. This paper presents a compilation of strategies that have the potential for actionable impact on digital health equity. Multi-level factors drive unequal access, so strategies require action from tool developers, individual delivery agents, organizations, and systems to effect change. Strategies were shaped with a behavioral medicine focus as the field has a unique role in improving digital health access – arguably, all digital tools require the user (individual, provider, health system) to change behavior by engaging with the technology to generate impact. The paper presents a model that emphasizes using multi-level strategies across stages of design, delivery, dissemination, and sustainment to advance digital health access and foster health equity.