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Digital interventions for cardiometabolic disease in South Asians - a case study for opportunities, risks and inequalities in digital health

The NHS needs to use digital technologies, such as apps and websites, to help deliver healthcare. This can help some people, but some people may be disadvantaged. It is possible that delivering healthcare digitally, i.e. using digital health interventions, could widen current health inequalities. One group that may be disadvantaged by digital health is South Asian people.

Our three-year project focuses on digital health interventions for cardiovascular disease and diabetes. South Asians are particularly likely to develop cardiovascular disease and diabetes, so it is especially important that interventions aimed at treatment or prevention of these illnesses are suitable for these individuals, and lessons learned are likely to be relevant to other populations.

We will see if people of South Asian backgrounds use digital health interventions for cardiovascular disease or diabetes differently to the majority population, and if they do, try to find out why that is the case, and what can be done to reduce differences. We will do this by reviewing published research and policy documents to find out whether existing data show different uptake, use and effectiveness of digital health interventions for cardiovascular disease or diabetes in South Asians; what previous work has been done on reasons for any differences; and what work has been done to try and overcome any differences.

We will hold focus groups and undertake individual interviews to try and understand whether, how and why people from South Asian backgrounds use technology and how this might differ from the majority population. We will also hold focus groups and undertake surveys to understand factors in healthcare and society that contribute to differences in uptake, use and effect.

We will explore how much of any difference is due to ethnicity, and how much is due to other factors which can be changed,such as education, deprivation, health literacy or digital literacy, cultural factors or health beliefs. We will structure our findings to show what changes are needed by individuals, by health care systems, and by society as a whole to enable digital health interventions to work for everybody. Our findings will improve existing and future digital health policies for CVD and DM for South Asians and the broader population.

We will use this information to make suggestions on policy on development, evaluation and implementation of digital health interventions. Patients and public have identified digital health, especially in black and minority ethnic people (including South Asians), as important for research and a concern for health inequalities. Patients and public are part of our study team and involved throughout the project, particularly in focus groups. Results will be disseminated via a study website, and our research and NHS networks. By consultation with stakeholders, we will ensure results are publicised.