什么才算是照顾? 对数字健康模型的结构性批评
Xi Wang1, Fuwen Yang2, Julie Trafford1
1School of Community and Public Health, Faculty of Health & Environmental Sciences, Auckland University of Technology, Auckland, New Zealand.
Digital health
|January 22, 2026
概括
数字健康工具往往承诺赋权,但可能会掩盖健康的社会决定因素 (SDoH). 真正的代理需要解决权力结构和结构不平等,而不仅仅是更聪明的应用程序.
科学领域:
- 数字健康数字健康
- 公共卫生 公共卫生
- 社会技术理论 社会技术理论
背景情况:
- 数字健康技术普遍存在,有望通过信息获取来赋予用户权力.
- 当前的设计模型 (信息赤字,KAP,健康素养,nudging) 经常假设理性用户,忽视现实世界的约束.
- 这些模型可以无意中掩盖健康的社会决定因素 (SDoH) 对用户代理的影响.
研究的目的:
- 批判性地检查占主导地位的数字健康设计框架的认识论和伦理限制.
- 在这些模型中挑战用户自主性的假设.
- 突出结构性和社会因素如何限制真正的卫生机构.
主要方法:
- 对四种主要的数字健康设计模型进行批判性分析.
- 借鉴关键的公共卫生文献.
- 应用社会技术理论来理解用户与技术的互动.
主要成果:
- 主导的数字健康框架往往无法解释SDoH,如财务压力和时间贫困.
- 这些模型可以模拟代理,而不是促进真正的用户控制.
- 专注于个人行为忽略了健康中的系统力量动态.
结论:
- 数字健康设计必须超越优化个人行为,以解决权力不平衡问题.
- 更公平的数字健康治理需要面对谁定义健康和设计算法的问题.
- 弥合数字沟需要结构性干预,如参与式监督和公平系统的再分配设计.
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