Addressing equity in eHealth interventions for healthcare system users & patients, literature review
Bibliographic record
Abstract
Abstract Objective eHealth has great potential to improve access to health information and care but important barriers to equity still exist and a real digital divide threatens its use. It is therefore necessary to build a conceptual framework on digital health interventions aiming at promoting equity and to analyse the strategies and recommendations that arise through the literature. Such a conceptual framework has not been identified in the literature yet. Methods We carried out a scoping literature review of the scientific literature since 2000 in Western countries, in Scopus, PubMed, PsycArticles, SocIndex and PBSC. Results Strategies that take into account equity in eHealth for healthcare system users and patients can be presented in light of the five key action areas of the Ottawa Charter for Health Promotion. They deal with the policy level, the individual one, aim at creating supportive environments, at using the community level for eHealth promotion and focus on health services. Individuals-oriented interventions are the most reported, thus revealing a lack of systematic thinking and certainly a lack of understanding of the whole spectrum of health determinants. Conclusions Following Gibbons’ expression of “compunetics” (Information and Communication Technologies & ethics), interventions that truly consider the unintended consequences of eHealth on social and geographic health inequalities are absolutely necessary. The conceptual model analysing the whole literature on this interaction makes it easy to understand the types of interventions that are or could be carried out to tackle equity issues in digital health interventions. Its recommendations become easy to implement in the field and can be extremely helpful for decision-making. Key messages Strategies that take into account equity in eHealth for healthcare system users and patients can be presented in light of the five key action areas of the Ottawa Charter for Health Promotion. The conceptual model we elaborated makes it easy to understand the types of interventions that could be carried out to tackle equity issues in digital health interventions.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.021 | 0.098 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.003 |
| Bibliometrics | 0.020 | 0.016 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.005 | 0.006 |
| Open science | 0.002 | 0.004 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".