D3-Transdisciplinary Framework for Public Health in the Post-Platform Era

Engagements with personal digital data are growing in recent decades, as many digital technologies offer any interested user the opportunity to track their habits and practices. Yet, far from being objective and neutral conduits of knowledge, digital data is often politicised, invested with particular values, norms, and assumptions about human experiences. Digital health technologies, in particular, are often found to be coded through biomedical understandings of health and the individualism of Western ethics. Such politics of data knowledge inevitably has implications on the ways people in different socio-cultural contexts make sense of their health, bodies, and correspondingly, experience spaces of health through engagements with digital data. Drawing on diaries and diary-interviews with users of digital food-tracking devices in Singapore, this paper develops the idea of ‘epistemological tensions’ to theorise the socio-cultural differences in digital practices beyond the dominant focus on Anglo-American experiences. The findings suggest that people’s engagements with digital health technologies can be experienced as ‘glitchy’ and fraught with epistemological tensions, as they constantly position their healthy eating practices between algorithmic advice offered by these technologies, and the socio-cultural norms of health and eating that they subscribe to. In negotiating such tensions, people are also found to express agency that has spatial and temporal implications on their health practices. In sum, this paper underscores the importance of critically situating, instead of simply scrutinising, everyday geographies of datafication. Doing so can yield more contextually nuanced insight into the potential and limits of digital technologies in mediating health geographies in different social and cultural contexts.

Digital health technologies enabling the transition from pregnancy to early parenthood: A scoping review.

The rapid expansion of artificial intelligence (AI) and digital health technologies has made data sovereignty a critical policy concern. In Saudi Arabia, Vision 2030 emphasizes technological innovation, economic diversification, and resilient digital infrastructures, positioning data governance as a foundation for national transformation. This review examines how data sovereignty strategies can support the Kingdom’s digital health transformation while ensuring compliance with international standards. Using a qualitative approach, the study synthesizes policy documents, institutional reports, and peer-reviewed literature. The analysis identifies both enablers and barriers: strong institutions such as the Saudi Data and Artificial Intelligence Authority (SDAIA) and the National Data Management Office (NDMO), alignment of the Personal Data Protection Law (PDPL) with frameworks like the GDPR, but also challenges including rigid intellectual property rules, fragmented cloud data governance, and weak sector-specific policies. The study’s objectives are to clarify these challenges, assess their impact on generative AI adoption, and recommend reforms that align with Vision 2030’s innovation goals. Policy recommendations include adaptive IP frameworks, sector-specific governance models, inter-agency coordination, and public–private partnerships to expand access to lawful datasets. The findings demonstrate that data sovereignty, when strategically designed, functions not as a barrier but as an enabler of secure, scalable, and ethically responsible innovation in healthcare and beyond. This work contributes actionable insights for policymakers, regulators, and researchers in Saudi Arabia and offers lessons for other nations navigating the balance between sovereignty and competitiveness in the digital era.

Irritable bowel syndrome (IBS) is a common chronic gastrointestinal disorder that impairs bowel functions and patients' overall quality of life. IBS-focused digital health technologies (DHTs), including online health resources and mobile health (mHealth) apps, have recently proliferated for patient use. However, research exploring patients' experiences with navigating, adopting, or using commercial or publicly available DHTs for IBS self-management is limited. This study aims to explore the user experiences and decision-making of patients with IBS as they navigate, adopt, and use diverse DHTs for disease self-management. We conducted virtual semistructured focus group interviews to explore the experiences of patients with IBS using DHTs, including their perspectives on design and features, their decision-making process in using DHTs, and recommendations for improving user experience and uptake, given the heterogeneous nature of these tools. Canada-based patients with IBS who were using or had used mHealth apps to manage symptoms were recruited through purposive sampling from previous IBS-related studies. Discussions were transcribed verbatim, and inductive thematic analysis was performed using NVivo (version 14; Lumivero). A modified version of the Expanded Unified Theory of Acceptance and Use of Technology (UTAUT2) model was applied to guide the interpretation of the dynamic relationship between the influences on participants' decisions regarding DHT use. Among the 8 participants (all female; mean age 55.3, SD 13.5 years), two themes were identified: (1) uncertainty impacts the trustworthiness of DHTs, and (2) influences that drive the decision-making process to adopt and use DHTs. The observed influences aligned with the constructs of the UTAUT2 model (performance expectancy, effort expectancy, social influence, facilitating conditions, hedonic motivation, price value, and habit), with the addition of trust and risk in participants' decision-making. Digital health literacy and patient engagement were also raised as crucial components of participants' experiences and perspectives on DHTs. Findings of this study highlight the current landscape of digital health in IBS and existing gaps and challenges for patients in navigating, adopting, and using DHTs for IBS self-management. While DHTs were generally viewed positively for their value and potential, patients with IBS consider several coexisting factors and trade-offs in their decision-making. Further investigations on the influences on and perspectives toward DHTs could enhance future development and iterations of these tools and improve patient confidence and uptake.

Background:Digital Health Technologies (DHTs) are increasingly expanding conventional rheumatology care, offering new modalities for patient engagement and treatment management. Understanding the factors influencing their adoption and usage among patients in...

As digital health technology becomes more pervasive, machine learning (ML) provides a robust way to analyze and interpret the myriad of collected features. The purpose of this preliminary work was to use ML classification to assess the benefits and relevance of neurocognitive features both tablet-based assessments and self-reported metrics, as they relate to Parkinson’s Disease (PD) and its stages [Hoehn and Yahr (H&Y) Stages 1–5]. Further, this work aims to compare perceived versus sensor-based neurocognitive abilities. In this study, 75 participants (n = 50 PD; n = 25 control) completed 14 tablet-based neurocognitive functional tests (e.g., motor, memory, speech, executive, and multifunction), functional movement assessments (e.g., Berg Balance Scale), and standardized health questionnaires (e.g., PDQ-39). Decision tree classification of sensor-based features allowed for the discrimination of PD from healthy controls with an accuracy of 92.6%, and early and advanced stages of PD with an accuracy of 73.7%; compared to the current gold standard tools [e.g., standardized health questionnaires (78.3% accuracy) and functional movement assessments (70% accuracy)]. Significant features were also identified using decision tree classification. Device magnitude of acceleration was significant in 12 of 14 tests (85.7%), regardless of test type. For classification between diagnosed and control populations, 17 motor (e.g., device magnitude of acceleration), 9 accuracy (e.g., number of correct/incorrect interactions), and 8 timing features (e.g., time to between interactions) were significant. For classification between early (H&Y Stages 1 and 2) and advanced (H&Y Stages 3, 4, and 5) stages of PD, 7 motor, 12 accuracy, and 14 timing features were significant. Finally, this work depicts that perceived functionality of individuals with PD differed from sensor-based functionalities. In early-stage PD was shown to be 21.6% lower than sensor-based scores with notable perceived deficits in memory and executive function. However, individuals in advanced stages had elevated perceptions (1.57x) for executive and behavioral functions compared to early-stage populations. Machine learning in digital health systems allows for a more comprehensive understanding of neurodegenerative diseases and their stages and may also depict new features that influence the ways digital health technology should be configured.

BackgroundThe potential benefits of incorporating digital technologies into health care are well documented. For example, they can improve access for patients living in remote or underresourced locations. However, despite often having the greatest health needs, people who are older or living in more socially deprived areas may be less likely to have access to these technologies and often lack the skills to use them. This puts them at risk of experiencing further health inequities. In addition, we know that digital health inequities associated with older age may be compounded by lower socioeconomic status. Yet, there is limited research on the intersectional barriers and facilitators for engagement with digital health technology by older people who are particularly marginalized.ObjectiveThis study aimed to explore factors influencing engagement with digital health technologies among people at the intersection of being older and socially deprived.MethodsWe conducted semistructured interviews with people who were 70 years or older, living in a socially deprived area, or both. Chronic kidney disease was our clinical context. We thematically analyzed interview transcripts using the Unified Theory of Acceptance and Use of Technology as a theoretical framework.ResultsWe interviewed 26 people. The majority were White British (n=20) and had moderate health and digital literacy levels (n=10 and n=11, respectively). A total of 13 participants were 70 years of age or older and living in a socially deprived area. Across participants, we identified 2 main themes from the interview data. The first showed that some individuals did not use digital health technologies due to a lack of engagement with digital technology in general. The second theme indicated that people felt that digital health technologies were “not for them.” We identified the following key engagement factors, with the first 2 particularly impacting participants who were both older and socially deprived: lack of opportunities in the workplace to become digitally proficient; lack of appropriate support from family and friends; negative perceptions of age-related social norms about technology use; and reduced intrinsic motivation to engage with digital health technology because of a perceived lack of relevant benefits. Participants on the intersection of older age and social deprivation also felt significant anxiety around using digital technology and reported a sense of distrust toward digital health care.ConclusionsWe identified factors that may have a more pronounced negative impact on the health equity of older people living in socially deprived areas compared with their counterparts who only have one of these characteristics. Successful implementation of digital health interventions therefore warrants dedicated strategies for managing the digital health equity impact on this group. Future studies should further develop these strategies and investigate their effectiveness, as well as explore the influence of related characteristics, such as educational attainment and ethnicity.

Chronic pain is a highly prevalent condition, estimated to affect as many as 30% of people worldwide. The need for more innovative solutions for chronic pain management is clear, and digital health technology (DHT) may be the best way to address this challenge. Much of the digital health research focusing on chronic pain focuses on patient-facing solutions; however, DHT for health care professionals (HCPs) is equally important to support evidence-based practice, which, in turn, improves patient outcomes. Despite this, no review has investigated the availability of professional-facing DHT for chronic pain management. This scoping review aims to identify the available professional-facing DHTs for chronic pain management. Specifically, the objectives were to investigate the components of the DHTs as well as development methods, user features, outcomes, and HCP perspectives on DHTs for chronic pain care. Databases, including MEDLINE, Embase, CINAHL, PsycINFO, and Inspec, were searched using comprehensive search strategies. Two independent reviewers screened titles and abstracts for inclusion of studies in the review and conducted full-text screening. Any conflicts in each stage of the screening process were first resolved through discussion and then through a third independent reviewer. Data extraction and quality assessment were completed using the Template for Intervention Description and Replication (TiDIER) checklist and Quality Assessment for Diverse Studies. Qualitative analysis involved inductive content analysis of user features and thematic synthesis of HCP perspectives. In total, 52 studies were included in the review, reporting on 44 professional-facing DHTs. The included DHTs were intended for remote patient monitoring, clinical decision support, assessment and diagnosis, education of HCPs, or a combination. The most common target population for DHT use was multidisciplinary care teams; the most common setting for implementation was primary care. Approximately half (26/44, 59%) of the professional-facing DHTs had a connected patient-facing system. Inductive content analysis of the user features produced 4 themes: guiding initial consultation, supporting chronic pain management, facilitating ongoing patient management, and supporting routine clinical duties. The thematic synthesis of HCP perspectives produced the following 4 themes, reflecting factors affecting the use of DHTs in chronic pain care: additional value, integration into clinical workflow, ease of navigation, and trust in the DHTs. Most (43/52, 83%) of the included studies did not adequately report appropriate stakeholder involvement in a proper co-design of DHTs; only 7% (3/44) of the DHTs were reported to have been developed with guidance from a system development framework. There are various DHTs available for HCPs to use in the management of chronic pain. The included studies neither reported adequate stakeholder involvement in the DHT development nor any specific frameworks to guide rigorous co-design. Therefore, future research should focus on developing professional-facing DHTs with active involvement of stakeholders in the design process. RR2-10.2196/51311.

BackgroundDuring the COVID-19 pandemic, the rapid deployment of digital health technologies (DHTs), exemplified by the Health Code, quickly integrated many older adults, many of whom lacked digital readiness, into the digital society. This accelerated integration revealed a range of challenges faced by older adults in using DHTs. To effectively implement digital epidemic control measures while meeting the daily needs of the elderly, the Chinese government needs to adopt pragmatic policy responses to bridge the digital health divide.ObjectiveThis study investigates the barriers faced by older adults in using the Health Code and other DHTs during the COVID-19 pandemic, analyzes the policy measures implemented by the government to address these barriers, and summarizes China’s practical experiences in promoting digital health equity.MethodsThis study employed a multi-method qualitative research design, sequentially combining individual interviews and document analysis to comprehensively explore the research questions. Guided by the Unified Theory of Acceptance and Use of Technology, semi-structured interviews were conducted with 23 older adults residing in rural areas of Zhejiang Province to explore the factors that hinder their use of the Health Code and other DHTs. Informed by the Digital Health Equity Thematic Framework, framework analysis was applied to 92 policy documents to analyze governmental responses addressing these barriers. Finally, the results of the individual interviews and document analysis were integrated to achieve a comprehensive understanding of the barriers faced by older adults and the corresponding policy measures addressing them.ResultsThe interviews identified three major themes influencing older adults’ use of DHTs: Preparedness, Receptiveness, and Willingness, along with nine sub-themes. In response to these barriers, the government introduced a series of policy measures targeting five domains: Individual, Community/Social, Systems, Policy, and DHTs. By integrating the results from both phases of the study, we identified three user types based on technology-related barriers— non-users, conditional users, and independent users— and summarized three categories of policy tools: alternative-based tools, nudge-based tools, and boost-based tools.ConclusionsChina’s experience offers two key insights for advancing global digital health equity: first, assessing disparities in access, use, and benefits is essential to develop tailored, differentiated policy measures for diverse user groups; second, establishing a multi-stakeholder governance system, facilitated by the “3 C” framework (Create, Co-design, Collaborate), can promote collaboration and co-creation of inclusive digital health solutions.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12939-025-02720-y.

BackgroundAboriginal and Torres Strait Islander (Indigenous) peoples living in remote Australia experience a heavy burden of ill health and multiple barriers to accessing health care. Digital health technologies (DHTs) have the potential to help overcome some of these challenges and increase access to comprehensive primary health care (CPHC), thereby improving equity of health outcomes. However, little is known about the community and provider preferences for the use of digital technologies for improving health and wellness.ObjectiveThe study aims to co-design, implement, and evaluate how DHTs can improve access to CPHC in remote Indigenous communities in the Northern Territory (NT), Australia.MethodsThis multiphased project will take a participatory action research approach to co-design and optimize digital health solutions with local community members and health service staff in 2 communities. Our mixed methods approach will include pre- and postimplementation focus group discussions, interviews, quantitative analysis of CPHC utilization administrative data, and surveys administered by Indigenous community-based researchers to understand the use of digital devices and connectivity, eHealth literacy, preferences for different attributes of DHTs using best-worst scaling, and consumer satisfaction and experiences with DHT interventions. Priority DHTs will be selected for implementation based on consumer and health staff preferences. Focus group discussions and interview data will explore community and health service staff preferences, experiences, and satisfaction with implemented DHTs. A realist approach will be taken to identify how DHT interventions work, for whom, and in what circumstances, so that the understanding of why some interventions work while others do not is expanded. Economic analyses will be conducted to calculate the incremental costs and benefits of implemented DHT interventions. The scalability of digital health solutions will be tested in two additional communities. Project partners include key funding, service, and support agencies in the NT and nationally.ResultsAs of November 2024, we have selected two implementation sites. Digital health initiatives are underway at the implementation sites, and evaluation activities are progressing. The initial findings from these sites have informed our scalability assessment in an additional two sites.ConclusionsKnowledge translation is integral to the study design, which involves partnering with consumers, CPHC service providers, and a range of key stakeholders to inform health service providers and policy makers about which DHTs work for which groups of consumers, and under what circumstances, to improve access to CPHC. This unique study will accommodate consumer and provider preferences regarding the use of DHTs to improve CPHC access and address the lack of knowledge about how to deploy digital solutions to best support CPHC in remote Indigenous Australia.International Registered Report Identifier (IRRID)DERR1-10.2196/68892

Health care is at a turning point. We are shifting from protocolized medicine to precision medicine, and digital health systems are facilitating this shift. By providing clinicians with detailed information for each patient and analytic support for decision-making at the point of care, digital health technologies are enabling a new era of precision medicine. Genomic data also provide clinicians with information that can improve the accuracy and timeliness of diagnosis, optimize prescribing, and target risk reduction strategies, all of which are key elements for precision medicine. However, genomic data are predominantly seen as diagnostic information and are not routinely integrated into the clinical workflows of electronic medical records. The use of genomic data holds significant potential for precision medicine; however, as genomic data are fundamentally different from the information collected during routine practice, special considerations are needed to use this information in a digital health setting. This paper outlines the potential of genomic data integration with electronic records, and how these data can enable precision medicine.

Digital health technology is receiving increasing attention in cardiology. The rise of accessibility of digital health tools including wearable technologies and smart phone applications used in medical practice has created a new era in healthcare. The coronavirus pandemic has provided a new impetus for changes in delivering medical assistance across the world. This Consensus document discusses the potential implementation of digital health technology in older adults, suggesting a practical approach to general cardiologists working in an ambulatory outpatient clinic, highlighting the potential benefit and challenges of digital health in older patients with, or at risk of, cardiovascular disease. Advancing age may lead to a progressive loss of independence, to frailty, and to increasing degrees of disability. In geriatric cardiology, digital health technology may serve as an additional tool both in cardiovascular prevention and treatment that may help by (i) supporting self‐caring patients with cardiovascular disease to maintain their independence and improve the management of their cardiovascular disease and (ii) improving the prevention, detection, and management of frailty and supporting collaboration with caregivers. Digital health technology has the potential to be useful for every field of cardiology, but notably in an office‐based setting with frequent contact with ambulatory older adults who may be pre‐frail or frail but who are still able to live at home. Cardiologists and other healthcare professionals should increase their digital health skills and learn how best to apply and integrate new technologies into daily practice and how to engage older people and their caregivers in a tailored programme of care.

Background:Recently, the interest and research in artificial intelligence (AI) in healthcare has increased exponentially [1, 2]. AI encompass the development of computer systems or software that can perform tasks that...

ObjectiveA digital divide exists for people from rural and regional areas where they are less likely and confident to engage in digital health technologies. The aim of this study was to evaluate the digital health literacy and engagement of people from rural and regional communities, with a focus on identifying barriers and facilitators to using technology.ResultsForty adults living in rural/regional areas completed a survey consisting of the eHealth Literacy Scale (eHEALS) with additional items surveying participants’ experience with a range of digital health technologies. All participants had used at least one digital health technology. Most (80%) participants had an eHEALS score of 26 or above indicating confidence in online health information. Commonly reported barriers to digital health technology use centred on product complexity and reliability, awareness of resources, lack of trust, and cost. Effective digital health technology use is becoming increasingly important, there may be a need to prioritise and support people with lower levels of digital health literacy. We present opportunities to support community members in using and accessing digital health technology.

BackgroundTuberculosis (TB) treatment remains a critical global health challenge, as traditional standard of care (SoC) approaches face limitations in accessibility and efficacy. While digital health technologies (DHTs) offer promising solutions to address these gaps, limited evidence exists on their comparative effectiveness.ObjectiveThis study systematically evaluates and compares the impact of diverse DHTs on improving TB treatment outcomes and adherence, aiming to identify optimal strategies across different patient populations.MethodsA systematic search was conducted across PubMed, Cochrane Library, Embase, and Web of Science from database inception through February 28, 2025, with no language restrictions. Eligible studies included randomized controlled trials comparing DHTs with SoC for TB treatment. The primary outcome was treatment success, defined as completion or cure. A random-effects network meta-analysis was performed, calculating odds ratios (OR) and 95% credibility intervals (CrI) to assess treatment effects. Surface under the cumulative ranking curve (SUCRA) values were used to rank intervention effectiveness. This study is registered with PROSPERO (International Prospective Register of Systematic Reviews; CRD42025601199).ResultsFrom 2420 screened studies, 27 randomized controlled trials involving 23,283 patients and eight DHT interventions were included. The network meta-analysis revealed that digital health platforms showed marginal improvements in treatment success (OR=3.44; 95% CrI 0.95-11.67; SUCRA=0.913; P=.05). Compared with SoC, video directly observed treatment (VDOT) significantly improved treatment success (OR=2.39; 95% CrI 1.18-4.75; SUCRA=0.848; P=.01). Medication event reminder monitors significantly enhanced treatment adherence (OR=3.13; 95% CrI 1.55-7.05; SUCRA=0.891; P=.003).ConclusionsResults underscore the significant potential of DHTs to improve TB treatment management. VDOT emerged as the most effective intervention for enhancing treatment success, while medication event reminder monitors demonstrated efficacy in sustaining adherence. Digital health platforms showed promise but require additional validation. Caution is warranted due to potential heterogeneity across studies, which may affect generalizability. This research offers actionable insights for stakeholders aiming to optimize TB management through strategic DHT integration.