Designing for Engagement in Digital Health for Chronic and Long-Term Care

In the rapidly advancing field of digital health, achieving meaningful engagement is pivotal to the success of innovations designed for chronic and long-term care. Digital innovations for health services, including telemedicine, mobile health applications, wearables, and artificial intelligence-driven decision support systems, enable patients to assume an active role in managing their health. They often require patients to actively engage in self-monitoring, take actions based on results, and assume leadership in tasks related to digital therapeutics, disease management, and drug delivery at home. When digital health solutions intersect with healthcare professionals, behavioral change and change management are also introduced into the clinical workflow. This paradigm shift thus necessitates careful attention to behavioral science to ensure effective adoption, sustained engagement, and equitable access.

Behavioral change science, a cornerstone in the design of digital products, plays a distinct role in digital health, presenting its own unique challenges. While most digital products aim for unlimited user engagement, digital health interventions must find a balance—delivering sufficient engagement to provide clinical value while minimizing user fatigue and anxiety, especially for long-term and chronic conditions. Simultaneously, behavioral science also underpins the successful integration of these tools into healthcare services, relying on fostering adequate adoption and sustained engagement. To overcome barriers such as resistance to change, unfamiliarity with technology, and privacy concerns, initiatives like education, training, and incentives are deployed, helping to enhance trust and user confidence in digital tools from both patient and provider perspectives.

This research topic seeks to bridge the gaps between behavioral design and engagement strategies in digital health solutions from patient, healthcare provider, and societal perspectives. We include telemedicine and artificial intelligence in our definition of digital health innovations. We invite submissions that explore theoretical, empirical, and practical perspectives on how to design, implement, and evaluate digital health toolsthat are accessible and effective for diverse populations in chronic and long-term care.

Specific themes we would like contributors to address are:

- Application of behavioral frameworks (e.g., COM-B, Fogg Behavior Model) to enhance patient engagement in digital health services or applications use.
- Assessing the mental and psychological impact of digital health innovations and how this relates to engagement.
- Strategies for improving engagement – considering quantity and quality of engagement - in digital health innovations for chronic disease care.
- Designing for and evaluating engagement across diverse patient population groups.
- Barriers and facilitators to engagement and uptake of digital health innovations - including financial barriers, digital literacy, and trust – and strategies to mitigate barriers
- The role of behavioral change strategies and change management for promoting equitable adoption within clinical workflows of digital health innovations.
- Digital health implementation or practical applications, with a focus on patient and professional engagement that have successfully navigated behavioral change challenges.
- The role of behavioral change and change management in embedding digital health into clinical workflows.
- Ethical considerations in engagement for chronic and long-term health conditions, for example autonomy and expectations.
- Innovations in digital therapeutics and tools that empower patients with chronic and long-term health conditions in disease management.

This topic welcomes all article types accepted by Frontiers in Digital Health. Narrative and systematic reviews are encouraged.

Keywords: behavioural design, engagement, digital health, retention, adherence

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.