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Informatics 2018, 5(4), 41; https://doi.org/10.3390/informatics5040041

Theory and Practice in Digital Behaviour Change: A Matrix Framework for the Co-Production of Digital Services That Engage, Empower and Emancipate Marginalised People Living with Complex and Chronic Conditions

1
Health Informatics & Innovation, University of Copenhagen, DK-1353 Copenhagen, Denmark
2
Maersk Mc-Kinney Møller Institute, University of Southern Denmark, DK-5230 Odense, Denmark
3
Danish Centre for Health Informatics, Aalborg University, DK-9000 Aalborg, Denmark
4
eHealth Services Research Group (eHSRG), University of Tasmania, Tasmania TAS-7001, Australia
*
Author to whom correspondence should be addressed.
Received: 10 September 2018 / Revised: 31 October 2018 / Accepted: 5 November 2018 / Published: 9 November 2018
(This article belongs to the Section Digital Humanities)
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Abstract

Background: The WHO framework on integrated people-centred health services promotes a focus on the needs of people and their communities to empower them to have a more active role in their own health. It has advocated five strategies including: Engaging and empowering people and communities; co-ordinating services within and across sectors; and, creating an enabling environment. Any implementation of these strategies needs to occur at individual, community, and health service levels. Useful steps to reorganising health service provision are already being guided by existing models of care linked to increased adoption and use of digital technologies with examples including: Wagner’s Chronic Care Model (CCM); Valentijn’s Rainbow Model of Integrated Care (RMIC); and Phanareth’s et al.’s Epital Care Model (ECM). However, what about individuals and the communities they live in? How will strategies be implemented to address known inequities in: the social determinants of health; access to, and use of digital technologies, and individual textual, technical, and health literacies? Proposal of a matrix framework: This paper argues that people with complex and chronic conditions (PwCCC) living in communities that are at risk of being under-served or marginalised in health service provision require particular attention. It articulates a step-by-step process to identify these individuals and co-produce mechanisms to engage, empower and ultimately emancipate these individuals to become activated in living with their conditions and in their interactions with the health system and community. This step-by-step process focuses on key issues related to the design and role of digital services in mitigating the effects of the health service inequity and avoiding the creation of an e-health divide amongst users when advocating digital behaviour change initiatives. This paper presents a matrix framework providing a scaffold across three inter-related levels of the individual; the provider, and the health and care system. The matrix framework supports examination of and reflection on the design and role of digital technologies in conjunction with pre-existing motivational instruments. This matrix framework is illustrated with examples from practice. Conclusion: It is anticipated that the matrix framework will evolve and can be used to map and reflect on approaches and practices aiming to enrich and stimulate co-production activities supported by digital technology focused on enhancing people-centred health services for the marginalised. View Full-Text
Keywords: complex chronic conditions; health informatics; engaged; empowered; emancipated complex chronic conditions; health informatics; engaged; empowered; emancipated
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Kayser, L.; Nøhr, C.; Bertelsen, P.; Botin, L.; Villumsen, S.; Showell, C.; Turner, P. Theory and Practice in Digital Behaviour Change: A Matrix Framework for the Co-Production of Digital Services That Engage, Empower and Emancipate Marginalised People Living with Complex and Chronic Conditions. Informatics 2018, 5, 41.

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