scholarly journals Digital Health Equity and COVID-19 – The Innovation Curve Cannot Reinforce the Social Gradient of Health (Preprint)

2020 ◽  
Author(s):  
Allison Crawford ◽  
Eva Serhal

UNSTRUCTURED Digital health innovations have been rapidly implemented and scaled to provide solutions to some health delivery challenges posed by the Covid-19 pandemic. This has enabled ongoing access to vital health services while minimizing potential exposure to infection and maintaining social distancing. However, these solutions may have unintended consequences on health equity. Poverty, access to digital health, poor engagement with digital health for some communities, and barriers to digital health literacy are some of the factors that can contribute to poor health outcomes. We present the Digital Health Equity Framework, which can be used to consider health equity factors. Along with person-centered care, digital health equity should be incorporated into health provider training, and should be championed the individual, institutional, and social levels. Important future directions will be to develop measurement-based approaches to digital health equity, and to use these findings to further validate and refine this model.

10.2196/19361 ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. e19361 ◽  
Author(s):  
Allison Crawford ◽  
Eva Serhal

Digital health innovations have been rapidly implemented and scaled to provide solutions to health delivery challenges posed by the coronavirus disease (COVID-19) pandemic. This has provided people with ongoing access to vital health services while minimizing their potential exposure to infection and allowing them to maintain social distancing. However, these solutions may have unintended consequences for health equity. Poverty, lack of access to digital health, poor engagement with digital health for some communities, and barriers to digital health literacy are some factors that can contribute to poor health outcomes. We present the Digital Health Equity Framework, which can be used to consider health equity factors. Along with person-centered care, digital health equity should be incorporated into health provider training and should be championed at the individual, institutional, and social levels. Important future directions will be to develop measurement-based approaches to digital health equity and to use these findings to further validate and refine this model.


2019 ◽  
Author(s):  
LaPrincess C Brewer ◽  
Karen L Fortuna ◽  
Clarence Jones ◽  
Robert Walker ◽  
Sharonne N Hayes ◽  
...  

UNSTRUCTURED The rapid proliferation of health informatics and digital health innovations has revolutionized clinical and research practices. There is no doubt that these fields will continue to have accelerated growth and a substantial impact on population health. However, there are legitimate concerns about how these promising technological advances can lead to unintended consequences such as perpetuating health and health care disparities for underresourced populations. To mitigate this potential pitfall, it is imperative for the health informatics and digital health scientific communities to understand the challenges faced by disadvantaged groups, including racial and ethnic minorities, which hinder their achievement of ideal health. This paper presents illustrative exemplars as case studies of contextually tailored, sociotechnical mobile health interventions designed with community members to address health inequities using community-engaged research approaches. We strongly encourage researchers and innovators to integrate community engagement into the development of data-driven, modernized solutions for every sector of society to truly achieve health equity for all.


10.2196/14512 ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. e14512 ◽  
Author(s):  
LaPrincess C Brewer ◽  
Karen L Fortuna ◽  
Clarence Jones ◽  
Robert Walker ◽  
Sharonne N Hayes ◽  
...  

The rapid proliferation of health informatics and digital health innovations has revolutionized clinical and research practices. There is no doubt that these fields will continue to have accelerated growth and a substantial impact on population health. However, there are legitimate concerns about how these promising technological advances can lead to unintended consequences such as perpetuating health and health care disparities for underresourced populations. To mitigate this potential pitfall, it is imperative for the health informatics and digital health scientific communities to understand the challenges faced by disadvantaged groups, including racial and ethnic minorities, which hinder their achievement of ideal health. This paper presents illustrative exemplars as case studies of contextually tailored, sociotechnical mobile health interventions designed with community members to address health inequities using community-engaged research approaches. We strongly encourage researchers and innovators to integrate community engagement into the development of data-driven, modernized solutions for every sector of society to truly achieve health equity for all.


2015 ◽  
Vol 35 ◽  
pp. 140-159 ◽  
Author(s):  
Paul Kei Matsuda

ABSTRACTThis article provides an overview of theoretical and research issues in the study of writer identity in written discourse. First, a historical overview explores how identity has been conceived, studied, and taught, followed by a discussion of how writer identity has been conceptualized. Next, three major orientations toward writer identity show how the focus of analysis has shifted from the individual to the social conventions and how it has been moving toward an equilibrium, in which the negotiation of individual and social perspectives is recognized. The next two sections discuss two of the key developments—identity in academic writing and the assessment of writer identity. The article concludes with a brief discussion of the implications and future directions for teaching and researching identity in written discourse.


2022 ◽  
Vol 3 ◽  
Author(s):  
Raoul Nuijten ◽  
Pieter Van Gorp ◽  
Juup Hietbrink ◽  
Pascale Le Blanc ◽  
Astrid Kemperman ◽  
...  

In general, individuals with lower socioeconomic status (SES) are less physically active and adhere to poorer diets than higher SES individuals. To promote healthier lifestyles in lower SES populations, we hosted a digital health promotion program among male vocational students at a school in The Netherlands. In a pilot study, we evaluated whether this target audience could be engaged with an mHealth app using lottery-based incentives that trigger feelings of anticipated regret. Especially, we studied the social and interpersonal aspects of regret lotteries in a within-subject experimental design. In this design, subjects either participated in a social variant (i.e., with students competing against their peers for a chance at a regret lottery), or an individual variant (i.e., with subjects solely individually engaged in a lottery). Additionally, we studied the impact of different payout schedules in a between-subject experimental design. In this design, participants were assigned to either a short-term, low-value payout schedule, or a long-term, high-value payout schedule. From a population of 72 male students, only half voluntarily participated in our 10-week program. From interviews, we learned that the main reason for neglecting the program was not related to the lottery-based incentives, nor to the prizes that were awarded. Instead, non-enrolled subjects did not join the program, because their peers were not joining. Paradoxically, it was suggested that students withheld their active participation until a larger portion of the sample was actively participating. From the subjects that enrolled in the program (N = 36, males, between 15 and 25 years of age), we found that a large proportion stopped interacting with the program over time (e.g., after roughly 4 weeks). Our results also indicated that students performed significantly more health-related activities when assigned to the social regret lottery, as opposed to the individual variant. This result was supported by interview responses from active participants: They mainly participated to compete against their peers, and not so much for the prizes. Hence, from this study, we obtained initial evidence on the impact of social and competitive aspects in lottery-based incentives to stimulate engagement levels in lower SES students with an mHealth app.


2021 ◽  
Vol 12 ◽  
Author(s):  
Carol Ann Podgorski ◽  
Sharon D. Anderson ◽  
Jasneet Parmar

The biopsychosocial model has been applied through collaborative care dementia models to the diagnosis, symptom management, and treatment of dementia with a focus specifically on the person with dementia. Because individuals with dementia are increasingly dependent upon others particularly as the illness advances, dementia care requires the involvement and commitment of others, usually family, along with support from community-based resources. Hence, the quality and effectiveness of a person's dementia care are shaped in large part by the foundation of family relationships and the social and community networks in which they are embedded. While most current dementia care models incorporate biopsychosocial principles and recognize the essential role that family members play as caregivers, they fail to consider a patient's family system and relationships as potential risk factors or social determinants for care outcomes. This paper introduces a biopsychosocial-ecological framework to dementia care that is person-centered and “family-framed” in that it targets factors that influence care considerations at both the individual and relational levels of the social ecological networks that the patient and their family members occupy. We use this model to illustrate how current dementia care practices tend to focus exclusively on the individual patient and caregiver levels but fail to identify and address important relational considerations that cut across levels. We call for the need to add assessment of family relational histories of persons with dementia and family members who care for them in order to better meet the needs of the patient and the caregiver and to prevent harm. This model accentuates the need for interprofessional education on family assessments and caregiver-centered care, as well as interdisciplinary, collaborative models of dementia care that assume more accountability for meeting the needs of family caregivers in addition to those of persons with dementia.


2020 ◽  
pp. 089484532097444
Author(s):  
David L. Blustein ◽  
Whitney Erby ◽  
Tera Meerkins ◽  
Isaac Soldz ◽  
Gabriel Nnamdi Ezema

Significant resources have been invested by multiple entities and institutions into exposing more students and adults to science, technology, education, and mathematics (STEM) education and careers. These efforts have coalesced into a major educational and career development movement within the past few decades. In this article, we present a critical analysis of the STEM movement that seeks to inform dialogue and debate regarding the nature and potential impacts of STEM career development. The article identifies the inherent assumptions about equity, self-determination, meaning, and purpose that underlie the STEM movement, while also acknowledging its many important positive contributions. The potential unintended consequences of STEM interventions and programs as well as the social messaging that accompanies these efforts are reviewed. Future directions for research, practice, and public policy that are informed by this critical analysis conclude this article.


1992 ◽  
Vol 86 (1) ◽  
pp. 70-86 ◽  
Author(s):  
Robert Huckfeldt ◽  
John Sprague

As agents of electoral mobilization, political parties occupy an important role in the social flow of political communication. We address several questions regarding party mobilization efforts. Whom do the parties seek to mobilize? What are the individual and aggregate characteristics and criteria that shape party mobilization efforts? What are the intended and unintended consequences of partisan mobilization, both for individual voters and for the electorate more generally? In answering these questions we make several arguments. First, party efforts at electoral mobilization inevitably depend upon a process of social diffusion and informal persuasion, so that the party canvass serves as a catalyst aimed at stimulating a cascading mobilization process. Second, party mobilization is best seen as being environmentally contingent upon institutional arrangements, locally defined strategic constraints, and partisan divisions within particular electorates. Finally, the efforts of party organizations generate a layer of political structure within the electorate that sometimes competes with social structure and often exists independently from it.


1999 ◽  
Vol 58 (3) ◽  
pp. 201-206 ◽  
Author(s):  
Claude Flament

This paper is concerned by a possible articulation between the diversity of individual opinions and the existence of consensus in social representations. It postulates the existence of consensual normative boundaries framing the individual opinions. A study by questionnaire about the social representations of the development of intelligence gives support to this notion.


1999 ◽  
Vol 4 (4) ◽  
pp. 205-218 ◽  
Author(s):  
David Magnusson

A description of two cases from my time as a school psychologist in the middle of the 1950s forms the background to the following question: Has anything important happened since then in psychological research to help us to a better understanding of how and why individuals think, feel, act, and react as they do in real life and how they develop over time? The studies serve as a background for some general propositions about the nature of the phenomena that concerns us in developmental research, for a summary description of the developments in psychological research over the last 40 years as I see them, and for some suggestions about future directions.


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