SOMA: a preventive health governance framework for adaptive, consumer-facing digital health guidance

This paper introduces SOMA, a conceptual preventive health governance framework for adaptive, consumer-facing digital health guidance, designed to support everyday preventive health self-governance. Non-communicable and lifestyle-sensitive chronic diseases account for the majority of global mortality, yet existing consumer-facing digital health tools rarely provide coherent, governed preventive guidance that integrates multimodal personal health data, scientific evidence, user-defined goals, real-world feasibility, relational support, and explicit safety constraints within a unified architecture. SOMA conceptualizes preventive health self-governance as the iterative, user-governed process through which individuals interpret their evolving health state, define goals and feasibility constraints, receive evidence-informed guidance, and act within boundaries that reduce the risk of unsafe or inappropriate digital health guidance. The framework theorizes an architecture of five interdependent components: a Digital Twin Core synthesizing a multimodal Health State Vector across biological, wearable, subjective, behavioral, and contextual layers; a Scientific Intelligence Core evaluating evidence quality, uncertainty, and applicability; a Relational Avatar Core supporting disclosure, trust calibration, and user-facing communication; a Personal Health Governance Profile embedding user-defined goals, feasibility constraints, and autonomy preferences; and a Continuous Learning Engine updating the model based on outcomes, evidence, and user feedback, all bounded by non-negotiable Safety and Medical Escalation Boundaries. The theoretical contribution lies in integrating previously siloed approaches (digital health twin logic, evidence-weighted scientific intelligence, relational guidance, behavioral self-governance theory, and personal health governance) into a unified preventive architecture whose governance properties emerge from the structured interdependence of its components. Five testable hypotheses are derived from the architecture to guide a staged empirical validation programme. SOMA is a conceptual framework that has not been empirically validated and makes no claims regarding clinical effectiveness, disease prevention, or deployment readiness.