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Challenges in the development of digital public health interventions and mapped solutions: Findings from a scoping review
Open accessAbstract
Background: “Digital public health” has emerged from an interest in integrating digital technologies into public health. However, significant challenges which limit the scale and extent of this digital integration in various public health domains have been described. We summarized the literature about these challenges and identified strategies to overcome them. Methods: We adopted Arksey and O’Malley's framework (2005) integrating adaptations by Levac et al. (2010). OVID Medline, Embase, Google Scholar, and 14 government and intergovernmental agency websites were searched using terms related to “digital” and “public health.” We included conceptual and explicit descriptions of digital technologies in public health published in English between 2000 and June 2020. We excluded primary research articles about digital health interventions. Data were extracted using a codebook created using the European Public Health Association's conceptual framework for digital public health. Results and analysis: Overall, 163 publications were included from 6953 retrieved articles with the majority (64%, n = 105) published between 2015 and June 2020. Nontechnical challenges to digital integration in public health concerned ethics, policy and governance, health equity, resource gaps, and quality of evidence. Technical challenges included fragmented and unsustainable systems, lack of clear standards, unreliability of available data, infrastructure gaps, and workforce capacity gaps. Identified strategies included securing political commitment, intersectoral collaboration, economic investments, standardized ethical, legal, and regulatory frameworks, adaptive research and evaluation, health workforce capacity building, and transparent communication and public engagement. Conclusion: Developing and implementing digital public health interventions requires efforts that leverage identified strategies to overcome diverse challenges encountered in integrating digital technologies in public health.
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“The sustainability of digital health interventions, particularly with limited public health funding, remains challenging [141,142].”
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Discursive framework for a multi-disease digital health passport in Africa: a perspective
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“Additionally, enforcement of existing frameworks may be inadequate, they may misalign with international standards, or they may be outdated, having been established before the emergence of advanced DHS technologies [62].”
BackgroundIyamu, I. O., Gorun, P., Chang, H.-J., Sierra-Rosales, R., Haag, D., Pedersen, H., Bartlett, S. R., Lachowsky, N. J., McKee, G. R., Worthington, C., et al. (2025) · Journal of Medical Internet Research · doi:10.2196/78008 · Cited by 2
“Within the context of societal digital transformation, there has been increasing recognition of the need for improved measures of DHL to guide public health advocacy, policy, and action at multiple levels [2,8,43,44].”
Self-citationBackman, C., Papp, S., Harley, A., Kolle, A. T., Visintini, S. M., Shah, S., Berdusco, R., Poitras, S., Beaulé, P. E., & French-Merkley, V. (2023) · JMIR Research Protocols · doi:10.2196/42056 · Cited by 2
“Although asynchronous digital platforms can sometimes be challenging, especially in relation to technological issues [6], successful use of these platforms has been described with patients living with diabetes [7,8], cardiovascular disease [9,10], chronic obstructive pulmonary disease [11], and patients recovering pos…”
BackgroundThe Future of Digital Healthcare: Integrating Rights, AI and Open StandardsPreprint
Clim, A. (2023) · SSRN Electronic Journal · doi:10.2139/ssrn.4576606 · Cited by 2
Guo, L., Tan, J., & Hughes, M. C. (2025) · Frontiers in Public Health · doi:10.3389/fpubh.2025.1472398 · Cited by 1
Role of AI in Revolutionizing Clinical Care
Ghosh, O., Kumar, B., & Roy, P. K. (2025) · Advances in computational intelligence and robotics book series · doi:10.4018/979-8-3373-4332-7.ch003 · Cited by 1
Assuring a Sufficient and Competent Public Health Workforce for Digital Public Health (EPHO 7)
Brînzac, M. G., Hrzic, R., Hachem, M., & Ogunlayi, F. (2025) · Springer series on epidemiology and public health · doi:10.1007/978-3-031-90154-6_22 · Cited by 1
Izadirad, H., Moein, H., Omara, E., Nakhaie, S., Masoudy, G., & Shahestan, M. K. (2025) · The Open Public Health Journal · doi:10.2174/0118749445407325250919071552 · Cited by 1
Kalawatia, M., Mehrunkar, A., & Lucke-Wold, B. P. (2025) · World Journal of Psychiatry · doi:10.5498/wjp.v15.i10.109462 · Cited by 3
Digital Health: Context and Challenges in Brazil with Focus on Public Health
Conrado, L. F., dos Reis, M. E. D. M., Couto, J. F., Viera, L. E. V., Lima, N., Zeferino, A. C. S., da Silva, E. S., & Calado, R. D. (2025) · IEEE International Conference on Industry Applications · doi:10.1109/induscon66435.2025.11241578 · Cited by 1
“The non-technical challenges can be considered as “key barriers with regard to the development and implementation of digital public health interventions” [17].”
Thew, H. Z., Yap, A. Q. R., Tan, T. Q., Goh, J. H., & Chen, T. C. (2025) · Springer eBooks · doi:10.1007/978-981-95-2175-3_4 · Cited by 1
Malungana, L., Motsi, L., & Chimbo, B. (2025) · Lecture notes in networks and systems · doi:10.1007/978-981-96-6935-6_46 · Cited by 1
Mannix, S., & Albury, K. (2026) · BMC Health Services Research · doi:10.1186/s12913-025-13970-5 · Cited by 1
Snowdon, A. W., Wright, A., Abdulkadir, H., Wymer, J., Howgate, J., & Storey, T. (2026) · Frontiers in Public Health · doi:10.3389/fpubh.2025.1680904 · Cited by 2
Lindberg, J. O., Lundgren, A. S., Eriksson, M., & Lindgren, H. (2026) · Frontiers in Digital Health · doi:10.3389/fdgth.2026.1748259 · Cited by 1
Hsiao, K. H., Quinn, E., Johnstone, T., Gomez, M., Ingleton, A., Parasuraman, A., Najjar, Z., & Gupta, L. (2024) · JMIR Public Health and Surveillance · doi:10.2196/37625 · Cited by 1
“However, the public health field is beleaguered by tools that are short-lived, duplicative, disconnected, of poor quality, or not suited to user needs [2,4,5].”
BackgroundRamachandran, S., Iyamu, I. O., Chang, H.-J., Kushniruk, A. W., Ibáñez-Carrasco, F., Worthington, C., Davies, H., McKee, G. R., Brown, A. D., & Gilbert, M. (2023) · doi:10.2196/preprints.52798 · Cited by 1
Self-citationHealth, Technology And Built Environment Nexus: A Systematic Literature ReviewPreprint
Ndimako, O. O., & Sholanke, A. B. (2024) · Preprints.org · doi:10.20944/preprints202404.0088.v1
Vetrivel, S. C., Sabareeshwari, V., Ambikapathi, R., Arun, V. P., & Sowmiya, K. C. (2025) · doi:10.1002/9781394275397.ch1 · Cited by 1
Foisey, L., Kothari, A. R., Donelle, L., Booth, R. G., & Quan‐Haase, A. (2023) · doi:10.2196/preprints.47571
Digital Health Intervention of Healthy Indonesia Program with Family Approach: Does it Work?
Prasiska, D. I., & Yaqin, M. J. A. (2023) · Jurnal PROMKES · doi:10.20473/jpk.v11.i1si.2023.1-8
Difficulties and Barriers in Accomplishment of HFA 2000
Yee, H. H. L., & Law, V. (2023) · Springer eBooks · doi:10.1007/978-981-99-4491-0_3
‘Alam, G. F., Wiyono, B. B., Burhanuddin, B., & Muslihati, M. (2023) · doi:10.1109/icet59790.2023.10435257
“Digital public health arises from an interest in being able to integrate digital technology into the wider scope of people's lives with the breadth of digital integration in various scientific fields [1].”
BackgroundBondaronek, P., Slee, A. E., & Hamilton, F. L. (2024) · doi:10.2196/preprints.57492
Digitale Transformation im chinesischen Gesundheitswesen: Eine Übersicht und Best Practice
Jiang‐Siebert, Q., Yang, M. J., & Yu, L. (2024) · Springer eBooks · doi:10.1007/978-3-658-43236-2_64
Djamaluddin, M., Akib, H., & Anshari, A. (2024) · Journal of Multidisciplinary Science MIKAILALSYS · doi:10.58578/mikailalsys.v3i1.4473
Iyamu, I. O., Haag, D., Carson, A., Wang, I., King, C., Roe, I., Kerr, K., McKee, G. R., & Gilbert, M. (2025) · doi:10.2196/preprints.72588
Self-citationIyamu, I. O., Ramachandran, S., Chang, H., Kushniruk, A. W., Ibáñez-Carrasco, F., Worthington, C., Davies, H., McKee, G. R., Brown, A. D., & Gilbert, M. (2025) · doi:10.2196/preprints.73088
Self-citationBondaronek, P., Slee, A. E., & Hamilton, F. L. (2025) · Qeios · doi:10.32388/pgu6li
Kindler, G. S., Kelly, N., & Watson, J. E. M. (2025) · Integrative Conservation · doi:10.1002/inc3.70031
Anforderungen und Möglichkeiten von Digitalisierung in der Verhaltens- und Verhältnisprävention
Zeeb, H., Muellmann, S., & Schüz, B. (2025) · Springer eBooks · doi:10.1007/978-3-662-71115-6_3
Digital Transformation for Improving Child Health in South Asia: Do We Need a Reboot?
Dwivedi, V., Dyson, M., Källander, K., & Boussery, G. (2025) · Journal of Medical Internet Research · doi:10.2196/73053
“Despite their potential, digital health interventions remain largely at the project or program level or in pilot phase due to various technical and nontechnical challenges (Textbox 1) in the development of the digital public health infrastructure required to optimize data for health outcomes [4].”
Finlay, S., Lamoureux, G., Moïse‐Richard, A., Ménard, L., & Verduyckt, I. A. (2025) · International Journal of Language & Communication Disorders · doi:10.1111/1460-6984.70115 · Cited by 1
“Overreliance on digital tools could create a reductionist perspective, suggesting that these tools alone are sufficient to address complex public health challenges (Iyamu et al. 2022).”
Participatory Approaches for Digital Public Health: Giving Voice to Values
Shrestha, R., Reinschluessel, A. V., & Niess, J. (2025) · Springer series on epidemiology and public health · doi:10.1007/978-3-031-90154-6_4
Evidence-Based Approaches in Digital Public Health
Albrecht, J., Tokgöz, P., & Dockweiler, C. (2025) · Springer series on epidemiology and public health · doi:10.1007/978-3-031-90154-6_6
Disease Prevention, Including Early Detection of Illnesses (EPHO5)
Iyamu, I. O., Haag, D., Pedersen, H., & Gilbert, M. (2025) · Springer series on epidemiology and public health · doi:10.1007/978-3-031-90154-6_20
Self-citation
Metadata
- Authors
- Iyamu, I., Gómez-Ramírez, O., Xu, A. X., Chang, H.-J., Watt, S., Mckee, G., & Gilbert, M.
- Affiliations
- University of British Columbia (CA)
- BC Centre for Disease Control (CA)
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
- Corresponding author
- Gilbert, Mark
- Venue
- DIGITAL HEALTH
- Publisher
- SAGE Publications
- Published
- 2022-01
- Volume
- 8
- Pages
- 205520762211022
- ISSN
- 2055-2076 (ISSN-L)
- PMC
- PMC9152201
- OpenAlex
- W4282924562
- Cited by
- 118
- References
- 147
- Citations by year
- 2026: 23 · 2025: 45 · 2024: 29 · 2023: 20 · 2022: 1
- FWCI
- 4.59
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Digital Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- Foundation for Population and Public Health at the British Columbia Center for Disease Control
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Public Health Policies and Education
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Healthcare Systems and Practices
- Keywords
- digital public health, digital health interventions, implementation barriers, health equity, health policy, data infrastructure, workforce capacity, intersectoral collaboration, political commitment, citizen participation, digital integration
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