Digital behavioral technology, vulnerability and justice: towards an integrated approach

Herzog, Lisa; Kellmeyer, Philipp; Wild, Verina

doi:10.1080/00346764.2021.1943755

Cited by 15 publications

(17 citation statements)

References 53 publications

(52 reference statements)

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“…Erste Arbeiten weisen außerdem darauf hin, dass Menschen mit prekärem sozialem Hintergrund schlechtere Möglichkeiten zur Integration digitaler Technologien zur Gesundheitsprävention in ihren Alltag haben. Selbst wenn prinzipiell Zugang zur Technologie besteht, können oder wollen manche Personen entsprechende Apps angesichts vieler anderer Verpflichtungen und Belastungen nicht priorisieren [14,[59][60][61]. Die Betonung von Eigenverantwortung für Gesundheit bei gleichzeitig fehlenden psychischen, sozialen und praktischen Freiheitsgraden -und ohne Sensibilität für die strukturellen (teilweise historisch gewachsenen) Benachteiligungen -kann also zusätzlichen Druck und Belastung bedeuten, was zu einer Verschärfung sozialer Gesundheitsungerechtigkeiten führen kann.…”

Section: Verschärfen Mhealth-technologien Soziale Gesundheitsungerech...unclassified

Mobile health technologies, social justice and population-based vulnerabilities

Jansky

Machleid

Wild

2023

Bundesgesundheitsbl

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ZusammenfassungMobile Gesundheitstechnologien (mHealth) fördern den Trend hin zu Eigenverantwortung und Selbstmanagement. Ziel des Beitrags ist es, am Beispiel von Diabetes mellitus Typ 2 (T2DM) die Diskussion zu mHealth, Eigenverantwortung und Gerechtigkeit – welche es bisher nur in Ansätzen gibt – aus einer Public-Health-ethischen Perspektive zu vertiefen. Dabei zeigt sich, dass mHealth im Bereich T2DM soziale Gesundheitsgerechtigkeit einerseits verbessern, andererseits aber auch soziale Gesundheitsungerechtigkeiten verschärfen kann. Aus einer gerechtigkeitsfokussierten, Public-Health-ethischen Perspektive auf T2DM-mHealth ist es notwendig, besser zu verstehen, ob und wie vulnerable Bevölkerungsgruppen bei mHealth-Entwicklung und -Einsatz mitbedacht werden, wie sie die Nutzung der Technologie erleben, welche sozialepidemiologischen Auswirkungen der zunehmende Einsatz von mHealth haben kann, welche gesundheitlichen Ungleichheiten im Bereich T2DM ungerecht sind, inwieweit die Eigenverantwortung in die Hände der Nutzenden gelegt werden soll und wo die Grenzen der Eigenverantwortung liegen. Die Berücksichtigung der sozialen Diversität und der sozialen Determinanten von Gesundheit ist ein stetiger Prozess und muss alle Phasen der Entwicklung und des Einsatzes von mHealth durchziehen.

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Section: Verschärfen Mhealth-technologien Soziale Gesundheitsungerech...unclassified

Mobile health technologies, social justice and population-based vulnerabilities

Jansky

Machleid

Wild

2023

Bundesgesundheitsbl

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“… 22 , 23 However, in our view and according to other authors, these issues are less in the spotlight of public discussion and research. 2 , 24 , 26 Furthermore, such research on the ethical and societal aspects of CHTs refers to rather sparse empirical evidence and proposes to conceptualize such unintended effects more precisely and better document them. 23 Although systematic review articles of the growing amount of empirical research have been published, and systematize the research base according to themes on the user level, like motivations, reasons for continuance, and effects of CHT use, 27 they lack an ethical perspective.…”

Section: Introductionmentioning

confidence: 99%

“…Another objective is to systematize those effects better and relate them to societal trends based on the (more) theoretical literature on self-tracking. For this purpose, we use a user typology not only as a tool to think about the ethical issues of CHT effects, especially regarding individual or group-related vulnerabilities, 2 , 26 but also as a starting point for investigating them more systematically. Such research is essential in order to find measures for the protection of CHTs users from unintended harm, and to counteract the widening of inequalities through digital health technologies.…”

Section: Introductionmentioning

confidence: 99%

“…Such research is essential in order to find measures for the protection of CHTs users from unintended harm, and to counteract the widening of inequalities through digital health technologies. 15 , 26 Our focus on the negative psycho-social effects, which to date have been somewhat neglected (in both regulatory and ethical debates), does not mean that we are not aware of the potential positive effects of CHT use for health and wellbeing. We want to contribute to a nuanced view 28 on both the promising and the ‘dark’ side 25 , 29 of CHT use.…”

Section: Introductionmentioning

confidence: 99%

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User types, psycho-social effects and societal trends related to the use of consumer health technologies

et al. 2023

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Objective The term consumer health technologies we use in this paper refers to fitness and health apps, wearables and other self-tracking devices that collect health-related data. Our paper aims to bridge the gap between the growing literature base of sociological research and ethical reflection on the (non-intended) effects of consumer health technology use on the psycho-social level, such as stress, responsibilization or a loss of intuitive sense for signs of health or illness. Special consideration should be given to vulnerable individuals, as the positive and negative effects of consumer health technology use may be unequally distributed. This perspective may help to guide policymaking and the responsible development of consumer health technologies. Methods Using a narrative review approach, we refer to empirical and theoretical studies dealing with user types and effects related to the use of consumer health technologies. We provide an overview of consumer health technology user typologies and evidence of the unintended psycho-social effects of consumer health technology use. On this basis, we propose a user typology that may serve as a future tool for ethical reflection on negative side effects. Results Evidence of the potential negative side effects of consumer health technology use, as presented in the literature, is inconclusive due to the high diversity of consumer health technology users and the way they use consumer health technologies. Our proposed user typology aims to more comprehensively document the diversity of users by incorporating the way in which users identify with and use their self-tracked data, attitudes towards the new technology and social interactions via consumer health technologies, and the purpose and self-determinedness of consumer health technology use. Conclusions More systematic and quantitative empirical research on the effects of consumer health technology use in diverse settings and with diverse user types is necessary to inform public health policy. In addition to evidence-based certification of medical consumer health technologies, more practical and flexible ways to protect users from side effects may have to be developed and adopted, especially regarding the increasing number of non-medical consumer health technologies.

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“…My question is motivated by the ethical debate on mHealth that has only paid little attention to the implications of mHealth for structural injustice ( Herzog et al , 2022 ), particularly in the domain of public health ( Sauerborn et al , 2022 ). To answer this question, I am going to draw from the normative framework for structural injustice by Madison Powers and Ruth Faden ( Powers and Faden, 2006 , 2019 ).…”

Section: Introductionmentioning

confidence: 99%

Commercial mHealth Apps and Unjust Value Trade-offs: A Public Health Perspective

Rossmaier

2022

Public Health Ethics

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Mobile health (mHealth) apps for self-monitoring increasingly gain relevance for public health. As a mobile technology, they promote individual participation in health monitoring with the aim of disease prevention and the mitigation of health risks. In this paper, I argue that users of mHealth apps must engage in value trade-offs concerning their fundamental dimensions of well-being when using mobile health apps for the self-monitoring of health parameters. I particularly focus on trade-offs regarding the user’s self-determination as well as their capacity to form personal attachments. Depending on the user’s level of advantage or disadvantage, value trade-offs can pose a threat to the users’ sufficient fulfillment of the dimensions of well-being. As such, value trade-offs can entrench existing structural injustices and prevent disadvantaged users to benefit from this technology. I argue that value trade-offs are, to some, a type of injustice that can drive disadvantaged users away from a sufficiency threshold of well-being, risk users to fall below the threshold, or have an accumulative effect on different dimensions of the user’s well-being.

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Digital behavioral technology, vulnerability and justice: towards an integrated approach

Cited by 15 publications

References 53 publications

Mobile health technologies, social justice and population-based vulnerabilities

Mobile health technologies, social justice and population-based vulnerabilities

User types, psycho-social effects and societal trends related to the use of consumer health technologies

Commercial mHealth Apps and Unjust Value Trade-offs: A Public Health Perspective

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