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21/571 Digital health inclusion and inequalities


A recent scoping review published by Public Health Wales NHS Trust on digital technology and health inequalities examines how the lack of access, skills and motivation for using digital technologies could contribute to worse health outcomes for some and the widening of health inequalities.

The review identifies evidence to show that many groups which are already socio-economically disadvantaged and subject to worse health outcomes are also subject to digital exclusion and finds that digital exclusion mainly affects older people, rural communities and people on low incomes. The review reports that there is an absence of evidence about differences in the way different social groups engage with digital technologies but states that concepts such as digital literacy and health literacy are likely to be important in the success of digital health initiatives.

The Public Health Research (PHR) Programme is interested in funding research on digital health inclusion and health inequalities particularly in the areas that have been highlighted in the scoping review as lacking in evidence. The PHR Programme is primarily interested in receiving applications for evaluations of interventions that take a whole community or population-level approach.

The PHR Programme is not interested in receiving applications which evaluate the effectiveness of apps.  

Research areas of interest include (but are not limited to):

  • Research into digital health inclusion strategies, the efficacy of these approaches and the link to health outcomes for individuals, for communities and between population sub-groups.
  • Research on the potential impact that the increasing use of digital technology is having on health inequalities.
  • Studies that address the relationship between digital technology, its use, its non-use, and the outcomes amongst different population groups. This can include comparative approaches that look at the impact on different groups in terms of the levels of digital exclusion and data poverty and health outcomes.
  • Studies that take a local or a regional approach and account for geographical differences.
  • Research exploring the use of emerging technologies like wearables for health purposes and the impact on health inequalities.

Other, related aspects that the PHR Programme recognises as important for research include (but are not limited to):

  • Investigations examining cultural competency of the design of digital tools, apps, wearables, etc.
  • Research into the effectiveness of digital service provision.
  • Impact of digital service provision on, for example, inclusion, stigma, trust, differences within and between groups receiving the same or similar services and inequalities.
  • Evaluation of interventions aimed at increasing digital skills and capacity and the impact on wellbeing.
  • Research on health outcomes and cost benefits following implementation of digital support infrastructure, such as free or subsidised broadband or free or subsidised data.

A range of study designs and outcome measures can be used. Researchers will need to identify and justify the most suitable methodological approach. Researchers will also need to specify key outcomes and how these will be measured in the short, medium and long term. Primary outcomes must be health related. Cost-effectiveness is always of interest to policy makers and the PHR Programme encourages researchers to consider including economic considerations in their application. The PHR Programme expects researchers to carefully define and justify the choice of the population being studied and how demographic variations at local levels will be accounted for.

The PHR Programme welcomes involvement from the target population groups and relevant organisations in the design of the evaluation and in the research team. We will consider inclusion of experts as costed members of the study team if appropriately justified. Researchers should demonstrate the relevance of their proposed research to key stakeholders including local and national policy makers, service users, designers and service providers. Researchers are encouraged to develop links and networks with other sectors such as education services. Researchers must be familiar with the Public Health Wales NHS Trust scoping review. They are also expected to be aware of other studies in this area and ensure their proposed research is complementary.

For further information on submitting an application to the PHR Programme, please refer to the supporting information for applicants submitting stage 1 and stage 2 applications.