Engagement and Intersectionality in Digital Self-Management Interventions for Asthma and Chronic Obstructive...

Area of Science:

• Digital Health
• Health Informatics
• Respiratory Medicine

Background:

• Digital health interventions (DHIs) support self-management for chronic respiratory conditions like asthma and COPD.
• Understanding patient engagement with DHIs is vital for optimizing design, outcomes, and addressing health inequalities.
• This review uses the AMUsED framework and layered vulnerabilities for a nuanced analysis of digital engagement.

Purpose of the Study:

• To evaluate how diverse patient groups engage with digital self-management interventions for asthma and COPD.
• To examine the reporting and analysis of demographic, outcome, and usage data in digital health research.
• To assess the extent to which current practices support equitable evaluation of digital interventions.

Main Methods:

• Systematic identification of empirical studies reporting demographic, clinical outcome, and usage data.
• Review of usage measures for numerical comparability across interventions.
• Descriptive thematic analysis combined with patient and public involvement.

Main Results:

• Twenty-seven studies met inclusion criteria; only four comparable usage measures were consistently identified.
• While age, sex, and disease severity were reported, data on ethnicity and socioeconomic status were underrepresented.
• Most studies (62.9%) did not combine demographic, outcome, and usage data in their analyses, revealing limited engagement characterization and inconsistent conceptualization of healthcare support.

Conclusions:

• This review highlights structural gaps in reporting and analysis within digital self-management research for respiratory conditions.
• Recommendations are provided for more equitable and analytically rigorous digital health research.
• Strengthening reporting practices with richer usage data and intersectional analyses is essential for tailoring DHIs to diverse patient populations.