[Digital health and its impacts on the access of minority groups to primary care: a systematic reviewLa salud digital y su impacto en el acceso a la atención primaria de salud en grupos minoritarios: revisión sistemática].

Abstract

Objective: To identify digital interventions applied in the context of primary health care (PHC) and assess their impact on access to health care by minority population groups.

Methods: We performed a systematic review of randomized clinical trials evaluating digital interventions in PHC settings, with health care access as the primary outcome. Searches were carried out in the PubMed, Scopus, and LILACS databases up to January 2025, with no restrictions regarding language, country, or year. The interventions were further analyzed using the PROGRESS-Plus framework to identify the social vulnerability markers addressed in the studies.

Results: Six studies were included, all conducted in the United States, focusing on populations vulnerable due to race (Black and Hispanic/Latino individuals), gender (women), education level (individuals with low educational attainment), and socioeconomic status (low-income individuals). Most participants (adults aged 30 to 60 years) were overweight or obese and had chronic comorbidities. In all studies, digital solutions were integrated into interprofessional practices involving dietitians, nurses, pharmacists, physicians, and/or psychologists, and were successful in improving clinical outcomes and expanding access to care. However, barriers related to digital and health literacy were reported, as well as difficulties using digital tools, particularly among participants with lower educational levels.

Conclusion: Realizing the equity potential of digital interventions requires overcoming barriers such as limited literacy, low connectivity, and social inequality through participatory design approaches and public policies guided by principles of social justice.