Presentation
DH9 - Exploring Digital Health Equity Design Approaches and Outcomes Beyond Usability Through the Lens of Digital Determinants of Health
SessionPoster Session 2
DescriptionIn recent years, the rapid evolution of Digital Health Technology (DHT) has ushered in transformative changes in healthcare, marked by increased development and implementation of these tools in healthcare systems. DHT has played a pivotal role in bridging longstanding gaps in healthcare access, empowering patients in self-management, health information access, and providing swift access to essential resources. However, amidst the positive impact of DHT, there has been concern about its potential contribution to existing health disparities for marginalized groups. The proliferation of telehealth, mobile applications, and chatbot/AI tools for health support has prompted a growing body of literature highlighting apprehensions regarding its impact on digital health equity.
Addressing health disparities requires innovative and inclusive approaches that prioritize the experiences and needs of those most affected. This is particularly critical for Black communities, who face systemic barriers such as limited access to quality healthcare, a higher prevalence of chronic diseases, and socio-economic challenges that impede overall well-being. As technology becomes increasingly integral to healthcare delivery, it is essential to not only consider but “center the needs, values, and desires of Black bodies and lives” in the design and development of new technologies. Black-Centered Design (BCD) emerges as a transformative framework that places the voices, values, and lived experiences of Black individuals at the forefront of the design process. Industrial engineer Woodrow W. Winchester III defines BCD as an approach that uses the nuanced complexities of Black identity as a guiding ethos for creating more equitable and just technological tools and systems. In comparison to traditional Human-Centered Design (HCD), which focuses on making systems usable and useful by centering users' needs and requirements , BCD offers a more inclusive, culturally specific approach that reimagines mainstream technological practices for marginalized populations. Although scholars have begun to substantiate the need for BCD approaches, few have focused on how we can systematically evaluate its effectiveness within the health domain.
In response to this imperative, a relatively novel framework, the Digital Determinants of Health (DDoH), has emerged. This framework offers guidance on addressing and mitigating digital health disparities by incorporating contextual considerations specific to digital health technology. With a focus on individual, interpersonal, community, and societal factors, the DDoH framework provides a comprehensive lens through which to explore the multifaceted relationship between digital health technology and equity concerns.
The objective of this review is to compare design approaches used in the development and implementation of digital health technologies aimed at addressing health equity in the black community. To explore the development of digital health technologies oriented to the health needs of Black communities, we conducted a comprehensive literature search on relevant equity-centered design methods including Human-Centered Design (HCD) and Afrofuturism for/with Black communities using PubMed, Scopus, Google Scholar, and ACM databases. Twenty articles met inclusion criteria. We employed a critical narrative review method, utilizing thematic analysis and narrative synthesis to summarize how these design methods are implemented and how they begin to evaluate to address various health and wellness conditions. This review provides a comparative analysis of the application, strengths, and weaknesses of these HCD and BCD methods, along with their impact on health equity. Primarily studies using BCD methods such as Afrofuturism resulted in more idea generation of the design of tools. For the ideas generated this approach applied to various mediums of interventions typically underexplored with black communities, such as wearable technologies and fabulation. By embedding cultural specificity and future-oriented thinking, these designs go beyond usability—they reflect the aspirations and needs of Black communities, envisioning healthier futures that center on equity and inclusivity. In majority of the studies included that utilized HCD approaches, usability testing was often conducted as the evaluation method, while this is common practice within the human factor's domain, this pushes us to question what usability really means for black health technology. The future-focused approach of Afrofuturism ensures that designs are not constrained by present limitations and uses but are instead proactive in addressing systemic barriers.
Addressing health disparities requires innovative and inclusive approaches that prioritize the experiences and needs of those most affected. This is particularly critical for Black communities, who face systemic barriers such as limited access to quality healthcare, a higher prevalence of chronic diseases, and socio-economic challenges that impede overall well-being. As technology becomes increasingly integral to healthcare delivery, it is essential to not only consider but “center the needs, values, and desires of Black bodies and lives” in the design and development of new technologies. Black-Centered Design (BCD) emerges as a transformative framework that places the voices, values, and lived experiences of Black individuals at the forefront of the design process. Industrial engineer Woodrow W. Winchester III defines BCD as an approach that uses the nuanced complexities of Black identity as a guiding ethos for creating more equitable and just technological tools and systems. In comparison to traditional Human-Centered Design (HCD), which focuses on making systems usable and useful by centering users' needs and requirements , BCD offers a more inclusive, culturally specific approach that reimagines mainstream technological practices for marginalized populations. Although scholars have begun to substantiate the need for BCD approaches, few have focused on how we can systematically evaluate its effectiveness within the health domain.
In response to this imperative, a relatively novel framework, the Digital Determinants of Health (DDoH), has emerged. This framework offers guidance on addressing and mitigating digital health disparities by incorporating contextual considerations specific to digital health technology. With a focus on individual, interpersonal, community, and societal factors, the DDoH framework provides a comprehensive lens through which to explore the multifaceted relationship between digital health technology and equity concerns.
The objective of this review is to compare design approaches used in the development and implementation of digital health technologies aimed at addressing health equity in the black community. To explore the development of digital health technologies oriented to the health needs of Black communities, we conducted a comprehensive literature search on relevant equity-centered design methods including Human-Centered Design (HCD) and Afrofuturism for/with Black communities using PubMed, Scopus, Google Scholar, and ACM databases. Twenty articles met inclusion criteria. We employed a critical narrative review method, utilizing thematic analysis and narrative synthesis to summarize how these design methods are implemented and how they begin to evaluate to address various health and wellness conditions. This review provides a comparative analysis of the application, strengths, and weaknesses of these HCD and BCD methods, along with their impact on health equity. Primarily studies using BCD methods such as Afrofuturism resulted in more idea generation of the design of tools. For the ideas generated this approach applied to various mediums of interventions typically underexplored with black communities, such as wearable technologies and fabulation. By embedding cultural specificity and future-oriented thinking, these designs go beyond usability—they reflect the aspirations and needs of Black communities, envisioning healthier futures that center on equity and inclusivity. In majority of the studies included that utilized HCD approaches, usability testing was often conducted as the evaluation method, while this is common practice within the human factor's domain, this pushes us to question what usability really means for black health technology. The future-focused approach of Afrofuturism ensures that designs are not constrained by present limitations and uses but are instead proactive in addressing systemic barriers.
Event Type
Poster Presentation
TimeTuesday, April 14:45pm - 6:15pm EDT
LocationFrontenac Foyer