Applying the Digital Health Social Justice Guide

Introduction

Digital health, the use of apps, text-messaging, and online interventions, can revolutionize healthcare and make care more equitable. Currently, digital health interventions are often not designed for those who could benefit most and may have unintended consequences. In this paper, we explain how privacy vulnerabilities and power imbalances, including racism and sexism, continue to influence health app design and research. We provide guidelines for researchers to design, report and evaluate digital health studies to maximize social justice in health.

Methods

From September 2020 to April 2021, we held five discussion and brainstorming sessions with researchers, students, and community partners to develop the guide and the key questions. We additionally conducted an informal literature review, invited experts to review our guide, and identified examples from our own digital health study and other studies.

Results

We identified five overarching topics with key questions and subquestions to guide researchers in designing or evaluating a digital health research study. The overarching topics are: 1. Equitable distribution; 2. Equitable design; 3. Privacy and data return; 4. Stereotype and bias; 5. Structural racism.

Conclusion

We provide a guide with five key topics and questions for social justice digital health research. Encouraging researchers and practitioners to ask these questions will help to spark a transformation in digital health toward more equitable and ethical research. Future work needs to determine if the quality of studies can improve when researchers use this guide.

Activism in changing times: Reinvigorating community psychology: Introduction to the Special Thematic Section

The field of community psychology has for decades concerned itself with the theory and practice of bottom-up emancipatory efforts to tackle health inequalities and other social injustices, often assuming a consensus around values of equality, tolerance and human rights. However, recent global socio-political shifts, particularly the individualisation of neoliberalism and the rise of intolerant, exclusionary politics, have shaken those assumptions, creating what many perceive to be exceptionally hostile conditions for emancipatory activism. This special thematic section brings together a diverse series of articles which address how health and social justice activists are responding to contemporary conditions, in the interest of re-invigorating community psychology’s contribution to emancipatory efforts. The current article introduces our collective conceptualisation of these ‘changing times’, the challenges they pose, and four openings offered by the collection of articles. Firstly, against the backdrop of neoliberal hegemony, these articles argue for a return to community psychology’s core principle of relationality. Secondly, articles identify novel sources of disruptive community agency, in the resistant identities of nonconformist groups, and new, technologically-mediated communicative relations. Thirdly, articles prompt a critical reflection on the potentials and tensions of scholar-activist-community relationships. Fourthly, and collectively, the articles inspire a politics of hope rather than of despair. Building on the creativity of the activists and authors represented in this special section, we conclude that the environment of neoliberal individualism and intolerance, rather than rendering community psychology outdated, serves to re-invigorate its core commitment to relationality, and to a bold and combative scholar-activism.