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Community-Driven, Bioethics-Informed Approaches to Digital Inclusion.

Meghan Reading Turchioe1, Elise Li Zheng2, Niurka Suero-Tejeda3

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Summary
This summary is machine-generated.

Digital health tools can improve atrial fibrillation (AF) detection in underserved communities. A community-centered approach is vital to overcome barriers like mistrust and the digital divide, ensuring equitable access and engagement.

Keywords:
atrial fibrillationbioethicscommunity healthdigital healthhealth equity

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Area of Science:

  • Digital Health
  • Cardiovascular Health
  • Health Equity

Background:

  • Atrial fibrillation (AF) is difficult to detect due to its episodic nature, with digital health offering continuous monitoring solutions.
  • Black and Latino populations face higher cardiovascular disease risks and experience disparities in AF detection and treatment.
  • Barriers to digital health adoption in these communities include limited access, clinician bias, healthcare system mistrust, and low tool utilization.

Purpose of the Study:

  • Identify facilitators and barriers to technology-based AF surveillance among Black and Latino adults with cardiovascular disease and stakeholders.
  • Examine ethical considerations of distributive justice and trust-building in digital health adoption.
  • Propose strategies to address disparities in digital health for AF surveillance.

Main Methods:

  • Conducted semistructured interviews with 25 diverse stakeholders (patients, caregivers, clinicians, CHWs) from April to September 2023.
  • Explored behavioral, environmental, and system-based factors influencing digital health adoption using a socioecological framework.
  • Analyzed interview data through directed content analysis.

Main Results:

  • Identified barriers: low self-efficacy, financial/language constraints, privacy concerns, and healthcare mistrust.
  • Identified facilitators: community health workers (CHWs) providing support, family/community involvement, and health motivation.
  • Emphasized addressing financial/logistical barriers, building trust via community engagement, and tailoring interventions for underserved populations.

Conclusions:

  • Digital health devices can enhance AF detection and management in underserved communities.
  • A community-centered strategy is essential to bridge the digital divide and build trust.
  • Leveraging CHWs and trusted community settings promotes access, engagement, and equity in digital health for AF surveillance.