Evidence map›Paper›PMID 40167046›Full record

ArticleTranslational behavioral medicine2025

Understanding and overcoming barriers to digital health adoption: a patient and public involvement study.

Jacqueline Louise Mair, Jumana Hashim, Linh Thai, E Shyong Tai, Jillian C Ryan, Tobias Kowatsch, Falk Müller-Riemenschneider, Sarah Martine Edney

Abstract read
In one paragraph

Article in Translational behavioral medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

28 citing papers in PubMed, 1 synthesis or guideline pooled it.

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  14. [Digital transformation in healthcare to strengthen patient autonomy].Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Jacqueline Louise MairFuture Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise (CREATE), 1 Create Way, Singapore, 138602, Singapore.ORCID 0000-0002-1466-8680
Jumana HashimBehavioural and Implementation Science Interventions, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore, 117597, Singapore.ORCID 0000-0001-5663-2398
Linh ThaiSaw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, Singapore, 117549, Singapore.ORCID 0000-0002-2230-0712
E Shyong TaiFuture Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise (CREATE), 1 Create Way, Singapore, 138602, Singapore.ORCID 0000-0003-2929-8966
Jillian C RyanPainted Dog Research, 658 Newcastle Street, Leederville, WA 6007, Australia.
Tobias KowatschInstitute for Implementation Science in Health Care, University of Zurich, Universitätstrasse 84, 8006, Zurich, Switzerland.ORCID 0000-0001-5939-4145
Falk Müller-RiemenschneiderSaw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, Singapore, 117549, Singapore.ORCID 0000-0003-1402-7477
Sarah Martine EdneySaw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, Singapore, 117549, Singapore.ORCID 0000-0002-3925-517X

Funding

Campus for Research Excellence and Technological Enterprise ITS009-0007National Research FoundationPrime Minister's Office
6 · The paper itself

Abstract

backgroundDigital health (DH) technologies provide scalable and cost-effective solutions to improve population health but face challenges of uneven adoption and high attrition, particularly among vulnerable and minority groups. PURPOSE: This study explores factors influencing DH adoption in a multicultural population and identifies strategies to improve equitable access.

methodsUsing a Patient and Public Involvement approach, lay facilitators engaged adults at public eateries in Singapore to discuss motivations and barriers to DH adoption. A semi-structured guide facilitated discussions, followed by an optional socio-demographic survey. Data were analyzed through inductive thematic analysis and mapped to behavior change theory to identify mechanisms of action (MoA) and behavior change techniques (BCTs) to support adoption.

resultsFacilitators engaged 118 participants between November 2022 and February 2023. Five key themes were identified from the discussions: (a) awareness of DH solutions, (b) weighing benefits against burdens, (c) accessibility, (d) trust in DH developers and technology, and (e) the impact of user experience. These themes were mapped to 13 MoA and 26 BCTs, informing five key strategies to enhance DH adoption: community-based promotion of credible DH solutions and digital literacy training, brief counselling at opportune moments in healthcare settings, variable rewards tied to personal values, policies ensuring accessibility and regulation, and gamified, user-friendly designs emphasizing feedback and behavioral cues.

conclusionDesigning and implementing DH solutions that are accessible, trustworthy, and motivating-integrated within healthcare services and promoted through community efforts-can address barriers to adoption by diverse communities and may help to narrow the digital divide.

Indexed as

Digital TechnologyPatient ParticipationAdultBehavior TherapyDigital HealthFemaleHumansMaleMiddle AgedMotivationSingaporedigital dividehealth behaviorhealth promotionminority groupspublic health

Identifiers

PMID40167046
PMCPMC11959363

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.