Digital health interventions are designed to help people avoid, recover from, or cope with disease and disability, or to improve the quality and safety of healthcare. Unfortunately, they pose a risk of producing intervention-generated inequalities (IGI) by disproportionately benefiting more advantaged people. This talk will outline characteristics of health-related interventions known to produce IGI and explain why digital health interventions are particularly vulnerable to this phenomenon. The talk will provide examples in which digital health interventions produced inequality because they were more accessible to, heavily used by, adhered to, or effective for those from socioeconomically advantaged groups. The talk will then describe a methodological framework called “Equitable PRAXIS,” which aims to center equality in future digital health intervention design and evaluation. Participation and Representation refer to the necessity for meaningful participation of marginalized groups in research. Appropriate Methods and Interventions mean targeting methods, instruments, and interventions to reach and engage marginalized people. ConteXtualization and Structural Competence mean avoiding individualization of systematic disparities and targeting social conditions that produce inequities. Investigation of Systematic Differences highlights that experiences of people marginalized according to specific traits differ from those not so marginalized, and thus encourages studying these differences and investigating and preventing IGI. Finally, using a case study from dialysis care, the talk will provide guidance for operationalizing this framework in digital health.

Bio: Dr. Tiffany Veinot, MLS, PhD, FACMI is Joan C. Durrance Collegiate Professor at the University of Michigan (UM)’s School of Information. She is also a Full Professor at the Schools of Public Health and Medicine at UM, and Visiting Professor at Oxford University’s Nuffield Department of Primary Care Health Sciences. Her research focuses on “community health informatics,” or the use of information systems and services to improve the health of marginalized populations and reduce health disparities. She has over 100 published, peer-reviewed papers, and her published papers have garnered 17 honors and awards in health informatics, human-computer interaction, and information science. Veinot has held over $15.5 million in extramural research funding as Principal Investigator or Co-Principal Investigator, with funding from agencies in three countries, including the Patient-Centered Outcomes Research Institute (PCORI), Centers for Disease Control and Prevention (CDC), National Science Foundation (NSF), The British Academy, and the Canadian Institutes for Health Research. As part of this, she is currently co-PI of the CDC’s national Chronic Kidney Disease (CKD) Surveillance System. Veinot has also served as co-Investigator for extramural research funding totaling over $6.1 million. She is a founding faculty member and former Director of the Master’s of Health Informatics (MHI) Program at the University of Michigan, which was launched in 2012. She is also on the Editorial Boards of the Journal of the American Medical Informatics Association (JAMIA), International Journal of Medical Informatics and Journal of the Association of Information Science and Technology (JASIST).