Hans-Henrik Dassow

Public health requires collaborations across several disciplines to meet population health needs. Increasing technological advancements have accelerated the transformation of public health to digital public health (DiPH), including new domains to develop, maintain, and improve evidence-based digital technologies. However, having various disciplines collaborating can create unique challenges if there is no mutual understanding of DiPH. This chapter aims to illustrate and discuss interdisciplinary approaches and collaborations in DiPH research and practice. First, we will give an overview of the concept of interdisciplinarity and draw on the practical challenges of interdisciplinary research and best practice examples for promoting such competencies. Second, we will describe traditional public health core functions and their relationship with other disciplines in the social, natural, and environmental sciences and humanities. Third, we will highlight how the extension to DiPH influenced the so-called system of sub-disciplines that form public health. Fourth, we will use a case study on mental health and medical apps to highlight essential strengths and limitations of selected sub-disciplines in DiPH (epidemiology, psychology, philosophy, law, computer science, and implementation science). Finally, we provide seven key recommendations that should promote and foster effective interdisciplinary collaborations in DiPH.

A rapidly increasing number of digital technologies have emerged with the aim of improving public health. To assess these technologies, a framework is needed that incorporates a public health perspective and takes the complexity of the technology, the context in which it operates, and its implementation into account. Existing frameworks focus on health technologies, public health, or digital technologies. A framework for digital public health that supports developers, evaluators, policymakers, and researchers in systematically developing and evaluating digital public health interventions is missing. We combined a scoping review of existing public health and digital health frameworks together with a consensus meeting with multidisciplinary experts. The outcome was a framework (DigiPHrame) that consists of 182 questions, structured by 12 domains: (1) Health Condition and Current Public Health Interventions, (2) Technical Aspects, (3) Usability, (4) Infrastructure and Organization, (5) Implementation, (6) Intended & Unintended Health-related Effects, (7) Social, Cultural, and Intersectional Aspects, (8) Ethics, (9) Legal and Regulatory, (10) Data Security and Data Protection, (11) Cost and Economics, and (12) Sustainability. Potential users can apply these questions to any digital public health intervention they want to develop and assess. The framework is a living framework that will be constantly revised.

This chapter explores the landscape of ethical frameworks and design concepts in digital public health. Our primary focus lies on the concept of autonomy in relation to users, with a particular focus on health data. We begin by discussing autonomy concepts from the domain of Human-Computer Interaction (HCI), which we carry over to the context of health data, including Big Data practices. We then consider the perspective of ethical autonomy frameworks relevant to (un)ethical design practices. As research in HCI has noticed malicious and deceptive practices, we follow up on the current discourse on dark patterns. Trying to find answers for practitioners to develop ethical systems, we offer an overview of user-empowering frameworks protecting their autonomy. Lastly, we discuss the ethical implications of user autonomy in health-related domains showing possible directions for future works pursuing empowering designs.