Sustainability in Participatory Digital Health: Identifying Key Influencing Factors Across Contexts

Summary

Information and communication technology including Apps and tools based on artificial intelligence present new opportunities and challenges for the achievement of sustainability.

We aimed to identify factors influencing sustainability in participatory digital health solutions to advance the understanding of sustainability as applied to participatory digital health solutions, including current prioritisation and risks.

We collected from the literature factors relevant to sustainability in digital health and evaluated the relevance of these factors in five real-world participatory digital health case studies taken from the literature.

We identified five groups of factors: individual, technological context, social norms, data, and digital health solutions factors. Individual and technological context factors were considered to have the highest impact in the five case studies, while social norms, data, and algorithms showed variability. Key findings include the importance of digital literacy and robust technology access, as seen in telemedicine during climate emergencies, and challenges such as low digital self-efficacy and algorithmic bias. Our results underscore the need for improved data integration, transparency, and algorithmic fairness, emphasizing tailored, context-specific strategies to enhance adoption, scalability, and alignment with sustainability goals.

Our findings suggest that for achievement of sustainability in the participatory digital health ecosystem, individual and context factors generally are considered more important than factors relating to social norms, and those relating to data and algorithms.