Tackling the digital divide: evaluating and enhancing digital health intervention readiness amongst low-SES populations

解决数字鸿沟：评估和加强低社会经济地位人群的数字健康干预准备情况

• 批准号: 2872648
• 金额: --
• 依托单位: University of Bath
• 依托单位国家: 英国
• 项目类别: Studentship
• 财政年份: 2023
• 资助国家: 英国
• 起止时间: 2023 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=studentship-2872648
• 关键词: Tackling; digital; divide; evaluating; enhancing

Digital health interventions (DHIs) utilise digital technologies such as mobile phones, the internet, television, and environmental sensors to modify health behaviours. The short-term benefits of DHIs for improving health are well established and they are often posited as a cost-effective means of improving population health at scale. However, there is increasing recognition that digital technologies can widen rather than reduce health inequalities. This PhD will investigate the determinants of DHI efficacy and the extent to which they can be modified in underserved populations. Specifically, the work seeks to define a multidimensional construct that captures one's 'digital health readiness', create a valid instrument to measure it, and develop a brief intervention to enhance it. This work supports the Economic and Social Research Council aim of exploring public health and behaviour to keep people healthy, with a particular focus on deprived populations.Research approach & frameworksIn recognition of the broad range of environmental and cultural factors that influence health behaviours, an interdisciplinary approach will be adopted with supervision from colleagues in health, sociology, and psychology. The research will be framed using the COM-B framework, accepting that behaviour is a combination of individual capability, opportunities and motivation. It will seek to answer the following research questions:1. What are the psychosocial mechanisms that underpin inequalities of use and benefit in DHIs?2. Can a new multidimensional scale that evaluates the these mechanisms and accurately predicts DHI readiness be developed?3. Can a brief 'pre-intervention' improve DHI readiness for lower-SES DHI users applied to weight-related behaviours?Methodologies and study designA scoping review will be conducted to identify the most pertinent psychosocial mechanisms that underpin the digital divide in weight-related behaviours. As part of the review, a conceptual model will be developed setting out the key components (including moderating, mediating and control variables) likely to predict or explain DHI efficacy (study 1). Using this model, a DHI-readiness scale will be developed using best practice methodologies. Scale development will comprise three phases: [1] Item development - using items identified in the scoping review and content validity assessed by both experts and users; [2] Scale development - testing the refined scale with results analysed using Exploratory Factor Analysis; item difficulty, item discrimination, and inter-item and item-total correlations will also be assessed (study 2); and, [3] Scale evaluation - Confirmatory Factor Analysis and other statistical tests will be conducted to test model fit and the dimensionality of the scale items; concurrent, construct and predictive validity, as well as test-retest reliability will be assessed (study 3). Next, a 'pre-intervention' will be co-produced with users and stakeholders to improve DHI-readiness in prospective users using a person-based approach (study 4). Finally, the efficacy of the pre-intervention will be tested in a pilot randomised controlled trial to assess improvements in DHI readiness, and subsequent engagement with, and efficacy of, DHIs (study 5). ImpactWe will collaborate on the project with Swindon Borough Council; a letter of support is attached from the Director of Public Health is available. The research will have academic impact by providing a comprehensive model of the determinants of DHI efficacy to support the development of better, more effective interventions less likely to widen health inequalities. It will also have societal impact by broadening the reach of DHIs to underserved populations. The findings of this research will be disseminated to the NHS, Directors of Public Health, third sector providers and researchers through a combination of research digests, peer-review publications, social media, workshops, and conferences.

数字健康干预措施（DHIS）利用数字技术，例如手机，互联网，电视和环境传感器来修改健康行为。 DHIS对改善健康的短期益处已得到很好的确立，通常被认为是提高人口健康的一种经济有效手段。但是，人们越来越认识到数字技术可以扩大而不是减少健康不平等。该博士将研究DHI功效的决定因素以及在服务不足的人群中可以修改的程度。具体而言，该作品旨在定义一种捕获一个人的“数字健康准备就绪”的多维结构，创建了一种有效的工具来衡量它，并制定了简短的干预措施来增强它。这项工作支持经济和社会研究委员会探索公共卫生和行为以保持人们健康的目的，特别关注被剥夺的人群。研究方法和框架对影响健康行为的各种环境和文化因素的认识，将在健康，社会学和心理学中的同事的监督中采用跨学科的方法。该研究将使用COM-B框架进行构建，接受该行为是个人能力，机遇和动力的结合。它将寻求回答以下研究问题：1。在DHIS中使用和受益于使用不平等的社会心理机制是什么？2。可以评估这些机制并准确预测DHI准备就绪的新的多维量表吗？3。将对适用于与体重相关的行为应用的低SES DHI使用者的简短“干预前”能够改善DHI准备情况吗？方法和研究设计范围审查将进行确定，以确定与体重相关行为中数字鸿沟的最相关的心理心理机制。作为综述的一部分，将开发一个概念模型，以阐明可能预测或解释DHI功效的关键组件（包括调节，中介和控制变量）（研究1）。使用此模型，将使用最佳实践方法来开发DHI-RERVINESS量表。规模开发将构成三个阶段：[1]项目开发 - 使用专家和用户评估的范围审查和内容有效性中确定的项目； [2]量表开发 - 使用探索性因素分析分析的结果测试精制量表；项目的难度，项目歧视以及项目间和项目 - 统计相关性也将得到评估（研究2）； [3]量表评估 - 将进行验证性因素分析和其他统计检验，以测试模型拟合和规模项目的维度；将评估并发，结构和预测有效性以及重测的可靠性（研究3）。接下来，使用基于人的方法来改善潜在用户的DHI-RERVISENS（研究4），将与用户和利益相关者共同生产“干预前”（研究4）。最后，干预前的功效将在试验随机对照试验中进行测试，以评估DHI准备就绪的改善，并随后与DHIS的互动和功效（研究5）。 ImpactWe将与Swindon Borough Council合作。提供公共卫生主管的支持信。这项研究将通过提供DHI疗效决定因素的全面模型来支持更好，更有效的干预措施的发展，从而扩大健康不平等的可能性。通过扩大DHI的覆盖范围，它将产生社会影响。这项研究的发现将通过研究摘要，同行评审出版物，社交媒体，讲习班和会议的结合，将NHS，公共卫生，第三部门提供者和研究人员传播到NHS，第三部门提供者和研究人员。