Research report: A systematic literature review to identify delivery strategies of digital health for low SEP populations

Location and point of contact were the most common components, but the evidence on whether particular approaches improve reach was insufficient and too scattered to support definitive conclusions. The review examined how e-health applications and supporting interventions are delivered to people with a low socio-economic position, assessed the reported effectiveness of these delivery strategies in reaching that population, and considered the scientific or experiential ideas used to design them. The authors identified some evidence of reach for delivery at locations already visited by target groups, delivery through authorities, and offline promotion.

Published in BMC Health Services Research , the review followed PRISMA 2020 guidelines and was registered with PROSPERO under the identifier CRD42024572294. The authors described inclusive implementation, tailored delivery of e-health applications, and support in using e-health as elements that could help address the digital divide between people with low and high socio-economic positions. For the systematic search, researchers used five databases: PsycINFO, Web of Science, Embase, PubMed and Sociological Abstracts.

Search terms were built around three core concepts: socio-economic position, e-health and delivery strategy. The search produced 5,127 papers after duplicates were removed, from which the researchers included 35 papers describing 33 studies. To compare the varied approaches, the review classified delivery strategies into five components: place, point of contact, promotion, facilitation and incentive.

The analysis showed that almost all identified strategies combined multiple components. Place and point-of-contact strategies were most frequently applied and often used together. These findings concern the delivery and reach of digital health rather than the clinical effectiveness of the e-health applications themselves.

The review therefore does not establish that any application improved health outcomes, nor does it demonstrate that one delivery strategy consistently outperformed another. The authors described the findings as insights into potentially effective approaches rather than conclusive proof of a preferred method. Reported design underpinnings were limited.

Stakeholder involvement was identified as an applied principle for implementation-strategy design, together with the identification and operationalization of specific delivery strategies. However, the studies rarely explained whether these strategies were based on established theory or accumulated experience. Overall, the review identifies a gap in evidence about effective e-health delivery for people with a low socio-economic position.

Its findings show that digital health delivery commonly depends on combinations of place, contact, promotion, facilitation and incentives, with place and point of contact appearing most often. The limited and dispersed evidence indicates potential approaches, but definitive conclusions require stronger evaluations of delivery strategies in real-world settings.

Subject of Research: Delivery strategies and reported reach of digital health for people with a low socio-economic position

Article Title: A systematic literature review to identify delivery strategies of digital health for low SEP populations

Article References: Bartha Standaar, L. M., van der Vaart, R., Leenaars, K., Friele, R. D., & van Tuyl, L. H. D. (2026). A systematic literature review to identify delivery strategies of digital health for low SEP populations. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15442-w

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15442-w

Keywords: digital health, e-health, health inequalities, socio-economic position, systematic review, digital divide, implementation, health services, stakeholder involvement, literature review, systematic, literature