Digital Health Interventions for All? Examining Inclusivity Across All Stages of The Digital Health Intervention Research Process


Krukowski RA, Ross KM, Western MJ, et al. Digital health interventions for all? Examining inclusivity across all stages of the digital health intervention research process. Trials. 2024;25(1):98. doi:10.1186/s13063-024-07937-w

This article provides a commentary on the barriers and potential solutions for appropriately conducting digital health research in diverse populations. The article reiterates the importance of increasing diversity across all phases of research to prevent digital interventions from widening, rather than bridging existing health disparities. To have research that accurately represents the population, diverse samples need to be recruited. Some potential barriers at the recruitment stage are trust concerns and a lack of awareness of the recruitment effort. The authors suggest broadening recruitment strategies and making specific strategies to inform multiple communities about the purpose of the research. During the initial enrollment process, lack of internet access, proper technology, and lengthy screening processes prevent individuals from enrolling in digital health studies. Those who do make it through recruitment face extensive time commitments that interfere with daily life, an inability to maintain the response requirements outlined in the study design, or difficulty understanding the content provided by the intervention. To reduce these barriers the authors suggested using more flexible protocols, getting end-user feedback on content, and focusing on strategies to increase user engagement e.g. quizzes. Once the data is collected, it is important to note that effectiveness measures are infrequently tailored to culturally diverse populations and provide inadequate support. The authors suggest that new definitions of effectiveness should include measures of inclusivity. This would require testing new digital health interventions in populations that more accurately represent the end users of the intervention. Finally, the authors acknowledge the insufficient incentives, human connection, and time for most working adults to engage in digital health research. They suggest testing retention strategies with diverse subgroups and providing updated recommendations for future research.