Table 1 Challenges related to digital determinants of health experienced by different vulnerable groups
Digital determinant of health | Older adults | Migrants | Mental health service users | High users of health services | The unemployed |
|---|---|---|---|---|---|
(1) Access to digital resources | Lack of basic computer skills Lack of suitable devices to use digital health services Lack of support and training to take advantage of digital health services Hearing disability reducing the capability to use remote option | Lack of strong electronic identification (e-ID) Insufficient local language skills to use digital health services Lack of specific digital skills required for digital health services. | Inadequate digital skills to take advantage of a variety of digital health services | Inadequate digital skills to access and use digital health services Insufficient English language skills challenging the Internet use Poor health complicates learning and using digital health services Learning to use digital health services requires too much effort | Usability issues challenge finding information on the websites of some health services Dysfunctional, too old or otherwise inappropriate devices hinder the possibilities of using digital health services Dysfunctional internet connections at home |
(2) Use of digital resources for health seeking | Digital health services are not applicable for all health care needs | Handling more demanding and complex issues is poorly managed in a digital environment Risk of being misunderstood in a digital environment due to language issues | In the digital environment, interaction and communication are perceived poor Lack of private space complicates the use of digital health services | Lack of private space induces privacy issues and difficulties to concentrate on discussing with a health professional | |
(3) Digital health literacy | |||||
(4) Beliefs about potential of digital health to be helpful or harmful | Fear of using and making mistakes in digital health services Distrust for the quality of remote health services | Security concerns and lack of trust in digital health platforms Fear of making mistakes that can have serious consequences | Security issues complicate the use of digital health services Lack of an incentive to go out of the house when using digital health services | Insufficient data security skills | |
(5) Values and cultural norms/preferences for use of digital resources | Preferring face-to-face services when living next to a service provider Lack of interest to use computer or smartphones Hesitative attitude towards digital health services | In a digital environment, valued nonverbal and personal communication is lacking | Preferring face-to-face consultation because remote feels unusual | Digital health services are not seen to have added value Identifying the service needs remotely by a health care professional requires more time and patients’ effort “An old-school mind” preferring face-to-face services | Preferring face-to-face consultations because seeing a person’s face makes communication easier Lack of interest in using or learning how to use digital devices |
6) Integration of digital resources into community and health infrastructure | Lack of awareness of available digital health services and their value | Lack of digital health services and websites in participants’ native language | Remote option is not always available in health services | Not being informed about a remote option for health services | Digital health consultations not always available Information transfer between different systems does not always function properly Not always possible to interact with the service provider |