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Digital interventions for cardiometabolic disease in South Asians – a case study for opportunities, risks and inequalities in digital health
Start date: 1 July 2020
End date: 31 June 2023
Background and aims
This study aims to investigate whether there are inequalities in digital health interventions (DHIs) for diabetes mellitus (DM) and cardiovascular diseases (CVD), particularly in black and minority ethnic and low socioeconomic status groups.
Digital health interventions can be beneficial in treating and managing CVD and DM. Associations between ethnic and socioeconomic status, CVD and DM have been studied, however they have not been considered alongside digital health interventions.
There are number of reasons why black and minority ethnic and low socioeconomic groups may be disadvantaged including, health literacy, access to internet health resources, patient web portals or personal health records. Despite large-scale roll-out of digital health interventions in the NHS, there is evidence of a lack of BME inclusion in testing these technologies.
Our aims include:
- Identifying data on DHIs for CVD and DM in South Asians compared to other populations
- Identifying reasons at levels of individual, intervention, healthcare system and society for any observed differences for DHIs in CVD and DM in South Asians
- To make recommendations for monitoring, analysis, evaluation and policy regarding DHIs to reduce health inequalities by ethnicity and socioeconomic status.
Research
We are investigating the potential of digital interventions for DM and CVD in South Asian groups to improve or exacerbate inequalities.
Our research will focus on four areas:
- Review of literature and policies
- Individual- and intervention-level factors
- Healthcare system- and society-level factors
- Policy recommendations for digital health interventions in South Asians and BME groups.
Our methods will include:
- a scoping review to identify frameworks to study uptake of DHIs for CVD and DM prevention
- a realist review to assess evidence for differential uptake of DHIs for CVD and DM by ethnicity
- a policy content analysis of DHIs in CVD and DM, particularly regarding BME groups.
We will complete a qualitative analysis (focus group discussions and semi-structured interviews) of barriers and facilitators of uptake, use and effectiveness of DHIs for CVD and DM in South Asians.
In a mixed-methods study, we will synthesise evidence from four sources (focus group discussions, key informant interviews, routine data, online survey), we will investigate society- and system-level factors affecting DHIs in South Asians.
From our findings, we will develop a policy recommendation for DHIs in South Asians and BME groups to reduce the likelihood of health inequalities on the basis of ethnicity and socioeconomic status.
Our team
Dr Amitava Banerjee – UCL - lead
Professor Elizabeth Murray – UCL – Leading WP 1
Professor Fiona Stevenson – UCL – leading WP 2
Dr Henry Potts – UCL
Professor Ann Blandford – UCL
Collaborations
Professor Kamlesh Khunti – University of Leicester
Professor Paramjit Gill – University of Warwick
Professor M Wasim Hanif - University Hospitals Birmingham NHS Foundation Trust
Dr Neeraj Bhala - Queen Elizabeth Hospital, Birmingham
Professor Kiran Patel - University Hospitals Coventry and Warwickshire NHS Trust
Professor Mahendra Patel - University of Sheffield
Mr Ayath Ullah – PPI Representative
Mrs Shivali Modha - PPI Representative
Dr Partha Kar - Portsmouth Hospitals NHS Trust