On misempowerment & mobile health

Mobile health tools often claim to empower their users by giving them the knowledge they need to take control of their health. However, this notion of empowerment, what we refer to as the knowledge-control paradigm, only superficially engages with the concept and leaves out the different ways in which people come to be empowered. We first identify two distinct elements of empowerment: psychological empowerment, which pertains to beliefs about one's power and control over their health, and relational empowerment, which is connected with one's actual power to control their health, as well as the ability to hold those in positions of power (the empowered) accountable. The knowledge-control paradigm is incapable of creating empowered individuals in the relational sense, and it is only when knowledge is coupled with both the means and the motivations to control health and/or hold the empowered to account, that one can be considered empowered. Mobile health tools that overemphasize knowledge as the empowering mechanism often misempower their users, that is, they create a belief in users about their power to control their health that does not align with their actual capacity to do so. This mismatch between beliefs and reality can have far reaching consequences as with knowledge, ability, control, and power comes responsibility. We worry not only that the misempowered will be viewed as more responsible for their health than the circumstances permit, but also, that these individuals will lose the ability to hold those in positions of power accountable..