Sociotechnical Interventions for Health Disparity Reduction: A Research Agenda
The burden of negative health outcomes is, unfortunately, differential in the United States (US) and other countries, a phenomenon known as health disparities. Health disparities are differences the incidence and prevalence of disease, as well as disease-related morbidity, mortality and survival rates in one group when compared to the general population. Health disparities may emerge on the basis of socially stratifying factors such as socioeconomic status, race, gender, disability, sexual orientation, and place of residence. Critically, although there have been significant, coordinated governmental investments of resources to eliminate health disparities over the past 25 years in the US and elsewhere, there remain substantial and troubling inequities.
Sociotechnical interventions hold promise for reducing disparities and improving the health of marginalized populations – but this potential is yet to be fully realized. At the same time, researchers must take care when developing any sociotechnical intervention in the health domain, since such interventions can generate unintended consequences that exacerbate disparities, as research concerning patient portal implementation shows.
In this cross-disciplinary workshop, we will bring together leading researchers in computing, health informatics, and behavioral medicine to develop an integrative research agenda regarding sociotechnical interventions to reduce health disparities and improve the health of socio-economically disadvantaged populations. As part of these discussions, approaches for guarding against unintended consequences of general interventions will also be explored. To do so, this workshop will focus on integrating insights and findings from each of these fields, identifying gaps in understanding between fields, and surfacing opportunities for future interdisciplinary research to address relevant challenges.
The workshop will be held before the Society for Behavioral Medicine’s 39th Annual Meeting on Monday, April 9 and Tuesday, April 10, 2018 in New Orleans, Louisiana. Participants will be drawn from academia, industry, and government. During the 1.5 day workshop, participants will consider how social science and technology can combine to create inclusive sociotechnical systems that can benefit everyone, including those groups that experience health disparities. General themes and questions for the workshop include:
Theory to Design and Implementation: Sociotechnical interventions that reduce health disparities require interdisciplinary knowledge because health disparities are rooted in social, behavioral, economic and healthcare-based factors. This workshop will strengthen collaborative research by exploring, “How do researchers appropriately identify and map theory to design, implementation, and evaluation?”
Sociotechnical System Blackboxes: As research in interactive systems in healthcare has matured, computing and health informatics researchers have increasingly drawn upon social and behavioral science theories  to design, develop, and analyze sociotechnical systems. We ask: “How researchers can understand when sociotechnical systems elicit positive, negative or neutral health outcomes for disparity populations, can we identify why? How do we identify the individual or combined impacts of theory and design?”
Sociotechnical Systems to Inform Theory: Behavioral medicine researchers have traditionally developed health behavior theories and models through participant self-report or by utilizing commodity systems to evaluate the theory at scale. Thus, this workshop provides mutually beneficial opportunities for researchers to discuss the design of personalized, contextual sociotechnical systems that can triangulate and verify data that informs models. In this line of thought, we examine, “How do the data that sociotechnical systems collect impact theory? How do we negotiate the dosing of sociotechnical systems from what is clinically needed to what people are willing to use? “
Multidimensional Evaluation to Reduce Health Disparities at the Population Level: Sociotechnical interventions hold promise for reducing disparities and improving the health of marginalized populations, however interventions can generate unintended consequences that exacerbate disparities. To prevent this, we will consider optimal methods for engaging health disparity populations at all stages of intervention design, implementation, and evaluation. We will also consider safeguards at each level and checking mechanisms as the intervention is deployed at scale.
The four themes provide ample space for cross-cutting challenges to emerge in human computer interaction, complex systems, security, privacy, smart cities, and sustainability.
All participants are asked to create a one page document that addresses:
- A promising sociotechnical intervention they deployed;
- The audience and context in which the intervention was deployed;
- How health disparities were considered and addressed (or why they were not addressed);
- Based on the intervention deployment and outcomes, open research challenges.