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.