Salsabela RazaqpersName, Saleema AllanapersName (2025date). “Understanding Digital Health Equity: A Conceptual Analysis..” Journal of Advanced Nursingtitle·j.
Object of study — the meaning of the concept of digital health equityterm·dom
Research question — what the attributes, antecedentsterm, consequences and empirical referents of digital health equityterm·dom are
Contribution — a concept analysisterm·key of digital health equityterm·dom that links it to intersectionalityterm·key for the first time
phenomenon · claim-type · cross-domain-transfer · mechanism · claim-relation · replication-status · limitation — grounded in the full text| phenomenon | digital health equity remaining unclear despite the spread of digital health technologies — “Despite the increased use of DHTs and the development of various DHE frameworks, the concept of DHE remains unclear” | |
| claim-type | existence — “The main attribute of digital health equity is digital health technology that benefits everyone fairly.” | |
| method — evidence | — “Their method involves eight steps to capture the full essence of the concept, which will be addressed in the analysis section of this paper.” | |
| object of study — evidence | — “Therefore, the purpose of this paper is to use Walker and Avant's ( 2011 ) method of concept analysis to clarify the meaning of DHE beyond a simplistic definition, obtaining a richer meaning that can guide the digital healthcare landscape.” | |
| research question — evidence | — “Walker and Avant's concept analysis method was used to outline attributes, antecedents, consequences, and empirical referents of the concept digital health equity.” | |
| contribution — evidence | — “This concept analysis links intersectionality to DHE, which has not been brought to light previously.” | |
| mechanism | infrastructure Without the needed infrastructure digital health technologies cannot be adopted, so digital health equity cannot occur. — “Infrastructure is mandatory for digital health technology to operate, and without the appropriate infrastructure the adoption of DHTs is impossible; hence DHE will not occur” | mechanisms[0] |
| mechanism | co-creation Technologies co-created with underserved communities are more acceptable to those groups. — “If DHTs are co‐created with underserved communities, then there is a higher likelihood that the technology will be more acceptable to the specific equity‐deserving groups” | mechanisms[1] |
| builds-on | Walker and Avant (2011), method of concept analysis — “method is the most suitable for this concept analysis due to its structured, step‐by‐step approach that facilitates exploration of multifaceted concepts, such as DHE.” | claim_relations[0] |
| sense | digital health equity (professional bodies) - technology use that gives everyone a fair, equal chance of better health — “Furthermore, professional organisations, including the Association of Health Care Journalists ( n.d. ) and Public Health Ontario ( 2023 ), similarly define DHE as the use of DHTs that fosters a fair and equal opportunity for improved health outcomes, while carefully considering the needs of every individual.” | senses[0] |
| sense | digital health equity (as prevention) - avoiding unintended harms of digital health, such as the digital divide — “Moreover, the literature refers to DHE as the prevention of unintended consequences from DHTs, such as inequities caused by the digital divide” | senses[1] |
| sense | digital health (theory versus practice) - meant to reduce inequities, able to widen them — “In theory, DH is meant to reduce health inequities; however, in practice, DH may increase inequities due to the absence of antecedents such as appropriate digital literacy skills” | senses[2] |
| relation | DHTs —same-as→ digital health technologies — Digital health technologies (DHTs) are advancing at unprecedented rates, and the concept of digital health equity (DHE) is fundamental to ensure all populations, including equity‐deserving groups, can benefit from these technologies — “Digital health technologies (DHTs) are advancing at unprecedented rates, and the concept of digital health equity (DHE) is fundamental to ensure all populations, including equity‐deserving groups, can benefit from these technologies” | concept_edges[0] |
| weight | DHTs —same-as→ digital health technologies — 0.9 — “Digital health technologies (DHTs) are advancing at unprecedented rates, and the concept of digital health equity (DHE) is fundamental to ensure all populations, including equity‐deserving groups, can benefit from these technologies” | concept_edges[0] |
| relation | DHE —same-as→ digital health equity — Digital health technologies (DHTs) are advancing at unprecedented rates, and the concept of digital health equity (DHE) is fundamental to ensure all populations, including equity‐deserving groups, can benefit from these technologies — “Digital health technologies (DHTs) are advancing at unprecedented rates, and the concept of digital health equity (DHE) is fundamental to ensure all populations, including equity‐deserving groups, can benefit from these technologies” | concept_edges[1] |
| weight | DHE —same-as→ digital health equity — 0.9 — “Digital health technologies (DHTs) are advancing at unprecedented rates, and the concept of digital health equity (DHE) is fundamental to ensure all populations, including equity‐deserving groups, can benefit from these technologies” | concept_edges[1] |
| relation | DDOH —same-as→ digital determinants of health — Digital health equity is shaped by the digital determinants of health (DDOH) and the social determinants of health (SDOH), which present a significant global challenge, disproportionately affecting equity — “Digital health equity is shaped by the digital determinants of health (DDOH) and the social determinants of health (SDOH), which present a significant global challenge, disproportionately affecting equity” | concept_edges[2] |
| weight | DDOH —same-as→ digital determinants of health — 0.9 — “Digital health equity is shaped by the digital determinants of health (DDOH) and the social determinants of health (SDOH), which present a significant global challenge, disproportionately affecting equity” | concept_edges[2] |
| relation | SDOH —same-as→ social determinants of health — Digital health equity is shaped by the digital determinants of health (DDOH) and the social determinants of health (SDOH), which present a significant global challenge, disproportionately affecting equity — “Digital health equity is shaped by the digital determinants of health (DDOH) and the social determinants of health (SDOH), which present a significant global challenge, disproportionately affecting equity” | concept_edges[3] |
| weight | SDOH —same-as→ social determinants of health — 0.9 — “Digital health equity is shaped by the digital determinants of health (DDOH) and the social determinants of health (SDOH), which present a significant global challenge, disproportionately affecting equity” | concept_edges[3] |
| relation | ENP —same-as→ Emancipatory nursing praxis — Emancipatory nursing praxis (ENP) offers a critical lens through which nurses can engage to promote equitable healthcare — “Emancipatory nursing praxis (ENP) offers a critical lens through which nurses can engage to promote equitable healthcare” | concept_edges[4] |
| weight | ENP —same-as→ Emancipatory nursing praxis — 0.9 — “Emancipatory nursing praxis (ENP) offers a critical lens through which nurses can engage to promote equitable healthcare” | concept_edges[4] |
| replication | not-applicable | |
| limitation | Only English-language literature was used. — “Using only English literature in this concept analysis assumes that only evidence written in English is worthy.” | limitations[0] |
| limitation | There is no universally accepted definition of digital health equity to start from. — “A limitation of this scoping review stems from the absence of a universally accepted definition of DHE” | limitations[1] |
| limitation | The literature relied on may underrepresent equity-deserving voices. — “This concept analysis is also limited by its reliance on existing literature, which may underrepresent equity‐deserving voices.” | limitations[2] |
finding · quantity · variable · definition · key-term — grounded in the full text| finding | Six antecedents are needed: infrastructure, cognitive abilities including digital literacy, intersecting vulnerabilities, core ethical principles, accessibility with the social determinants, and co-creation. — “The antecedents necessary for DHE are as follows: (1) appropriate infrastructure; (2) cognitive abilities including digital literacy; (3) intersectionality of multiple vulnerabilities; (4) presence of the core ethical principles in healthcare; (5) digital accessibility with careful consideration of the SDOH; and (6) co‐creation of DHTs.” | content_tags.findings[0] |
| finding | The main consequences are better patient health outcomes and elimination of the digital divide. — “The literature reveals that the main consequences of DHE are improved patient health outcomes and elimination of the digital divide” | content_tags.findings[1] |
| key-terms | digital health equity, digital health technologies, health equity, digital divide, digital literacy, social determinants of health, concept analysis, nursing, intersectionality |
| concept | digital health equity — digital health technology that benefits everyone fairly — “The main attribute of digital health equity is digital health technology that benefits everyone fairly.” | concepts[0] |
| concept | DHE — digital health equity — “Digital health technologies (DHTs) are advancing at unprecedented rates, and the concept of digital health equity (DHE) is fundamental to ensure all populations, including equity‐deserving groups, can benefit from these technologies” | concepts[1] |
| concept | Digital health — tools and services that promote health and manage illness through technology — “Digital health is defined as tools and services that promote health and manage illness through technology” | concepts[2] |
| concept | digital health technologies — tools, applications and platforms that leverage technology for healthcare purposes — “Digital health technologies are tools, applications and platforms that leverage technology for healthcare purposes” | concepts[3] |
| concept | DHTs — Digital health technologies — “Digital health technologies (DHTs) are advancing at unprecedented rates, and the concept of digital health equity (DHE) is fundamental to ensure all populations, including equity‐deserving groups, can benefit from these technologies” | concepts[4] |
| concept | Health equity — ‘the fair and just opportunity for all people to achieve their full health potential without variation from personal characteristics, historical oppression and societal influences’ — “Health equity is defined as ‘the fair and just opportunity for all people to achieve their full health potential without variation from personal characteristics, historical oppression and societal influences’” | concepts[5] |
| concept | digital divide — technology access, usage, and outcome disparities — “The digital divide is defined as technology access, usage, and outcome disparities” | concepts[6] |
| concept | Digital literacy — the cognitive and technical skills required to successfully navigate DHTs — “Digital literacy refers to the cognitive and technical skills required to successfully navigate DHTs” | concepts[7] |
| concept | Antecedents — ‘events or incidents that must occur or be in place prior to the occurrence of the concept’ — “Antecedents are ‘events or incidents that must occur or be in place prior to the occurrence of the concept’” | concepts[8] |
| concept | model case — an example of the concept that showcases all of the defining attributes — “The fifth step of Walker and Avant's ( 2011 ) concept analysis is the identification of a model case; a model case is an example of the concept that showcases all of the defining attributes.” | concepts[9] |
| concept | borderline case — an example of the concept that has most of the defining attributes but not all of them — “A borderline case is an example of the concept that has most of the defining attributes but not all of them” | concepts[10] |
| concept | digital determinants of health — not defined in this paper's own words; the conditions around technology use that shape a person's chances of good health — “Digital health equity is shaped by the digital determinants of health (DDOH) and the social determinants of health (SDOH), which present a significant global challenge, disproportionately affecting equity” | concepts[11] |
| concept | DDOH — digital determinants of health — “Digital health equity is shaped by the digital determinants of health (DDOH) and the social determinants of health (SDOH), which present a significant global challenge, disproportionately affecting equity” | concepts[12] |
| concept | social determinants of health — not defined in this paper's own words; the living and working conditions that shape health — “Digital health equity is shaped by the digital determinants of health (DDOH) and the social determinants of health (SDOH), which present a significant global challenge, disproportionately affecting equity” | concepts[13] |
| concept | SDOH — social determinants of health — “Digital health equity is shaped by the digital determinants of health (DDOH) and the social determinants of health (SDOH), which present a significant global challenge, disproportionately affecting equity” | concepts[14] |
| concept | Emancipatory nursing praxis — offers a critical lens through which nurses can engage to promote equitable healthcare — “Emancipatory nursing praxis (ENP) offers a critical lens through which nurses can engage to promote equitable healthcare” | concepts[15] |
| concept | ENP — Emancipatory nursing praxis — “Emancipatory nursing praxis (ENP) offers a critical lens through which nurses can engage to promote equitable healthcare” | concepts[16] |
Full text — tagged
Understanding Digital Health Equityterm·dom: A Conceptual Analysisterm·mth.
Abstract The purpose of this concept analysisterm·key is to clarify the meaning of digital health equityterm·dom beyond a simplistic definition, obtaining a richer meaning that can guide the digital healthcare landscape.
With the growing spread of digital healthterm·dom, digital health equityterm·dom should be at the center of healthcare. Health outcomes for equity‐deserving groups may be compromised without a clear understanding of digital health equityterm·dom. Although the concept of ‘health equityterm·dom’ has been analysed before; no concept analysisterm·key has been completed for the concept of ‘digital health equityterm·dom’.
Concept analysisterm·key using Walker and Avant's method.
Articles from PubMed, Scopus and Google Scholar with no limitation on the period of data collection.
Walker and Avant's concept analysisterm·key method was used to outline attributes, antecedentsterm, consequences, and empirical referents of the concept digital health equityterm·dom.
The main attribute of digital health equityterm·dom is digital healthterm·dom technology that benefits everyone fairly. The antecedentsterm include: (1) appropriate infrastructure; (2) cognitive abilities including digital literacyterm·dom; (3) intersectionalityterm·key of multiple vulnerabilities; (4) presence of the core ethical principles in healthcare; (5) digital accessibility with careful consideration of the social determinants of healthterm·dom; and (6) co‐creation of digital health technologiesterm·dom. The main consequences are improved patient health outcomes and elimination of the digital divideterm·dom.
This analysis explored the concept of digital health equityterm·dom as a means to promote positive health outcomes for equity‐deserving groups, highlighting the critical role of nursingterm·key practice and research in addressing digital healthterm·dom disparities.
This paper can have an impact on nursingterm·key practice, education and wider social and economic issues. First, various barriers encountered by patients when utilising digital health technologiesterm·dom can be understood. Second, clinicians can be encouraged to assess digital health equityterm·dom, improve interventions for equity‐deserving groups, and evaluate the effectiveness of digital healthterm·dom interventions to ensure they are equitable. In the context of educational implications, the understanding of digital health equityterm·dom can be used to facilitate the creation of appropriate education materials for clinicians. Finally, on a wider social and economic scale, understanding digital health equityterm·dom can aid in the creation of policies to enable equitable digital health technologiesterm·dom.
No patient or public contribution because this paper is a concept analysisterm·key.
Keywords: concept analysisterm·key, digital health equityterm·dom, digital healthterm·dom technology, nursingterm·key, Walker and Avant Introduction Digital health technologiesterm·dom (DHTsterm·dom) are advancing at unprecedented rates, and the concept of digital health equityterm·dom (DHEterm·dom) is fundamental to ensure all populations, including equity‐deserving groups, can benefit from these technologies (Jaworski et al. 2023 ; Richardson et al. 2022 ; Rowland et al. 2024 ). Without a great emphasis on DHEterm·dom, inequities such as those caused by limited access and poor digital literacyterm·dom skills will worsen, ultimately leading to poor patient health outcomes (Lawrence 2022 ; Lythreatis et al. 2022 ; Vassilakopoulou and Hustad 2023 ). It is imperative to first fully grasp the umbrella terms digital healthterm·dom and health equityterm·dom to understand the concept of DHEterm·dom (Jaworski et al. 2023 ; Rowland et al. 2024 ). Digital healthterm·dom is defined as tools and services that promote health and manage illness through technology (Canadian Association of Schools of Nursingterm·key 2022 ; Ronquillo et al. 2023 ). Digital health technologiesterm·dom are tools, applications and platforms that leverage technology for healthcare purposes (Yeung et al. 2023 ). Digital healthterm·dom technology (DHTterm·dom) broadly refers to the use of mobile health, virtual care, remote monitoring, tools for data exchange, artificial intelligence and more (WHO 2021 ). Health equityterm·dom is defined as ‘the fair and just opportunity for all people to achieve their full health potential without variation from personal characteristics, historical oppression and societal influences’ (Lewis et al. 2023 , 71). Digital health equityterm·dom accounts for the diverse needs of all populations with different socioeconomic statuses, ages, races, health conditions, digital literacyterm·dom levels, and geographic locations (Hadjiat 2023 ; Jaworski et al. 2023 ; Lawrence 2022 ; Vassilakopoulou and Hustad 2023 ).
International Relevance Digital health equityterm·dom is shaped by the digital determinants of healthterm·dom (DDOHterm·dom) and the social determinants of healthterm·dom (SDOHterm·dom), which present a significant global challenge, disproportionately affecting equity‐deserving groups (Chidambaram et al. 2024 ; Crawford and Serhal 2020 ; WHO 2025a ). Equity‐deserving groups, present worldwide, experience health disparities influenced by intersecting factors such as race, gender, disability, immigration, income and education (Burton et al. 2024 ). Digital health equityterm·dom is not confined to any specific region; rather, it holds global relevance. A scoping review conducted by Yao et al. ( 2022 ) outlined the existing literature documenting the presence of DH inequities across countries around the world. These countries included Australia, Bangladesh, Canada, Indonesia, Israel, Italy, Korea, the Netherlands, Norway, Switzerland, the United Kingdom and the United States (Yao et al. 2022 ). A study conducted by Yi et al. ( 2024 ) revealed DH inequities in South and Southeast Asia, further emphasising the global relevance of DHEterm·dom.
Situating Digital Health Equityterm·dom Within the Context of Nursingterm·key Knowledge Health equityterm·dom is a major concept in nursingterm·key practice, research and theory. At an individual nursingterm·key level, nurses can alleviate health inequities through effective communication, unbiased care, and supportive strategies that empower patients to manage their own health (Oruche and Zapolski 2020 ). Achieving health equityterm·dom also requires nurses to carefully consider the SDOHterm·dom (American Association of Colleges of Nursingterm·key n.d. ; Davis 2022 ). Nursingterm·key research plays a critical role in advancing health equityterm·dom by generating evidence to inform equitable care practices (Still et al. 2023 ).
Furthermore, health equityterm·dom is central to nursingterm·key theory. Walter's theory of emancipatory nursing praxisterm (ENPterm), for example, provides a framework for addressing health inequities, underscoring the theoretical foundations of nursingterm·key's commitment to health equityterm·dom (Velasco and Reed 2023 ). Walter's theory of ENPterm is particularly appropriate because it is centred around professional nursingterm·key obligations to address barriers beyond individual‐level determinants (Velasco and Reed 2023 ). Emancipatory nursing praxisterm (ENPterm) offers a critical lens through which nurses can engage to promote equitable healthcare (Velasco and Reed 2023 ). This concept analysisterm·key focuses on DHEterm·dom, an extension of the broader concept of health equityterm·dom; therefore, an ENPterm lens can look beyond individual‐level determinants causing inequities, allowing nurses to engage in equitable DH initiatives. As digital healthterm·dom becomes increasingly integral to healthcare delivery, it is essential to examine its relevance to nursingterm·key practice, research and theory.
Background Digital health equityterm·dom is a newly emerging concept that has evolved significantly over time, primarily due to its heavy reliance during and post the COVID‐19 pandemic (Crawford and Serhal 2020 ; Kaihlanen et al. 2022 ). Despite the increased use of DHTsterm·dom and the development of various DHEterm·dom frameworks, the concept of DHEterm·dom remains unclear (Crawford and Serhal 2020 ; Jahnel et al. 2022 ; Lawrence 2022 ; Richardson et al. 2022 ). To date, no comprehensive concept analysisterm·key has been conducted, which may hinder digital healthterm·dom outcomes for equity‐deserving groups. This underscores the significance of understanding the complexities of DHEterm·dom. Therefore, the purpose of this paper is to use Walker and Avant's ( 2011 ) method of concept analysisterm·key to clarify the meaning of DHEterm·dom beyond a simplistic definition, obtaining a richer meaning that can guide the digital healthcare landscape. Walker and Avant ( 2011 ) explain that concepts are mental constructs that are prerequisites for theory development. They outline a systematic framework for analysing a concept when it is undefined or when it has evolved over time. It is important to note that since knowledge is consistently evolving, the findings of a concept analysisterm·key are always considered tentative (Walker and Avant 2011 ). Walker and Avant's ( 2011 ) method of concept analysisterm·key will be employed to obtain a comprehensive understanding of DHEterm·dom at this current time. Although there are several approaches to conducting a concept analysisterm·key, Walker and Avant's ( 2011 ) method will guide this paper due to its clarity, which allows for ease of application. Their method involves eight steps to capture the full essence of the concept, which will be addressed in the analysis section of this paper. These steps include (1) select a concept; (2) determine the aims or purposes of analysis; (3) identify all uses of the concept that can be discovered; (4) determine the defining attributes; (5) identify a model caseterm; (6) identify borderline, related, contrary, invented and illegitimate cases; (7) identify antecedentsterm and consequences; and (8) define empirical referents (Walker and Avant 2011 ).
Data Sources A comprehensive search of the literature was conducted using the electronic databases PubMed, Scopus and Google Scholar. The search included ‘digital health equityterm·dom’ OR ‘digital healthterm·dom equit*’ OR ‘digital healthterm·dom AND equit*’. To understand how the concept of DHEterm·dom evolved over time across various disciplines, the date of publication and subject area were left unrestricted. Only articles written in English about DHEterm·dom were included in this concept analysisterm·key. Articles were initially screened for relevance by reviewing the titles and abstracts; if it was deemed suitable to the aims of this concept analysisterm·key, the article was read in its entirety. In addition, the reference lists of selected articles were reviewed to identify supplementary relevant research. Moreover, the search included the online Collins ( n.d. ) and Merriam‐Webster ( n.d. ) dictionaries. Additionally, the term ‘digital health equityterm·dom’ was searched via Google to find grey literature from various organisations and government websites. The search was concluded by searching for Dr. Alisson Crawford (who is at the forefront of promoting equity in digital healthterm·dom) in the Google Scholar database.
Overview of the Concept Select a Concept Walker and Avant ( 2011 ) outline that the first step in conducting a concept analysisterm·key is selecting a concept that is of significance. Conducting a concept analysisterm·key on DHEterm·dom is significant because it builds upon the foundational work done on broader health equityterm·dom (Lewis et al. 2023 ). Digital health equityterm·dom is emerging as a critical and distinct dimension of health equityterm·dom that warrants its own analysis. Understanding the concept of DHEterm·dom can support nursingterm·key practice, leadership, research, education and policy particularly to ensure that DH advancements do not widen disparities but instead contribute to equitable health outcomes for equity‐deserving groups. Walker and Avant's ( 2011 ) method is the most suitable for this concept analysisterm·key due to its structured, step‐by‐step approach that facilitates exploration of multifaceted concepts, such as DHEterm·dom.
Determine the Purposes of Analysis The second step of a concept analysisterm·key proposed by Walker and Avant ( 2011 ) is to explicitly state the purpose of the analysis. The purpose of this concept analysisterm·key is to clarify the meaning of DHEterm·dom beyond a simplistic definition, obtaining a richer meaning that can guide the digital healthcare landscape (Hellman 2024 ).
Identify All Uses of the Concept Walker and Avant's ( 2011 ) third step in the concept analysisterm·key involves identifying all uses of the concept. In doing so, this reduces bias and promotes an invaluable understanding of the concept (Walker and Avant 2011 ). There is no widely accepted definition of DHEterm·dom (Kim and Backonja 2025 ). As a result, the terms digital, health and equity were all searched separately.
Digital refers to technology, electronic signals or binary data (Collins n.d. ; Merriam‐Webster n.d. ). Within the information technology discipline, digital is derived from the Latin term ‘digit’ or ‘finger’ and this is the earliest tool used to count (IGI Global n.d. ). When information is either stored, transmitted or forwarded in a digital format it must be converted into a numerical system, known as digital (IGI Global n.d. ). The term ‘digital’ often refers to technology that requires the use of microprocessors such as computers or applications that depend on the internet (IGI Global n.d. ).
Health is defined as the body's ability to function and overall physical and mental well‐being (Collins n.d. ; Merriam‐Webster n.d. ). The term health can also be used to describe conditions of a community or system (Collins n.d. ; Merriam‐Webster n.d. ). The WHO defines health as the state of physical, mental and social well‐being and not just the mere absence of disease (World Health Organization 2025b ). The WHO definition of ‘health’ is widely used in medicine and many other disciplines (World Health Organization 2025b ). In the context of nursingterm·key science and social epidemiology, health is defined as the maintenance or restoration of psychological, cognitive, socioemotional and physical health for the purpose of adopting and managing changes in life (Joannès et al. 2024 ). Florence Nightingale's definition of health remains in today's nursingterm·key practice, defined as ‘not only to be well, but to use well every power we have’ (Beck 2021 , 2).
Equity is described as treatment that is fair regardless of individual differences. It also encompasses ownership rights in properties or companies and can appear in law when describing a just system (Collins n.d. ; Merriam‐Webster n.d. ). Equity can be defined in three ways: as a conceptual construct, benchmark or experience (Plamondon and Shahram 2024 ). As a conceptual construct, equity is a ‘manifestation of worldview, particularly the ways in which notions of justice and fairness function differentially in society’ (Plamondon and Shahram 2024 , 3). As an experience, equity is the feeling of navigating, interacting or socialising with others or with systems and settings (Plamondon and Shahram 2024 ). Equity as a benchmark means the standard that guides health and social sciences efforts to ensure everyone can live with dignity and their full potential without experiencing systemic disadvantages (Plamondon and Shahram 2024 ).
A scoping review conducted by Kim and Backonja ( 2025 ) presents five explicit definitions of DHEterm·dom as seen in Table 1 .
This table presents multiple definitions of DHEterm·dom.
The Covid‐19 pandemic accelerated the use of DHTsterm·dom, which subsequently highlighted the inequities within it, leading to the development of various DHEterm·dom frameworks (Crawford and Serhal 2020 ; Hatef et al. 2024 ; Kim and Backonja 2025 ; Richardson et al. 2022 ). The scope of these frameworks is commonly guided by the SDOHterm·dom and the DDOHterm·dom to promote equity when using DHTsterm·dom (Crawford and Serhal 2020 ; Hatef et al. 2024 ; Kim and Backonja 2025 ; Richardson et al. 2022 ). The DDOHterm·dom reflect ‘socio‐economic and socio‐cultural context of individuals and the intermediate health factors’ (Kaihlanen et al. 2022 , 2).
Furthermore, professional organisations, including the Association of Health Care Journalists ( n.d. ) and Public Health Ontario ( 2023 ), similarly define DHEterm·dom as the use of DHTsterm·dom that fosters a fair and equal opportunity for improved health outcomes, while carefully considering the needs of every individual. According to the Centre for Addiction and Mental Health ( n.d.‐a ) DHEterm·dom is described as quality healthcare that is delivered through technology for the purpose of improved health benefits without inflicting worse health outcomes for any individual or group.
Beyond the traditional healthcare sector, the American Health Law Association ( n.d. ) states that DHEterm·dom is a fair opportunity to attain positive health outcomes when engaging with DHTsterm·dom. Moreover, the literature refers to DHEterm·dom as the prevention of unintended consequences from DHTsterm·dom, such as inequities caused by the digital divideterm·dom (Crawford and Serhal 2020 ; Jaworski et al. 2023 ; Koehle et al. 2022 ). The digital divideterm·dom is defined as technology access, usage, and outcome disparities (Lythreatis et al. 2022 ).
DHEterm·dom advancements can be evident through numerous indications. For example, when DHEterm·dom initiatives ensure digital tools use equitable data sources to mitigate risk factors that can exacerbate inequities (Rowland et al. 2024 ; Yao et al. 2022 ). Another example is when the design of digital healthcare services incorporates the different needs of individuals (Ha et al. 2023 ). Additionally, co‐creation with the intended users ensures accessibility and effective utilisation of digital healthterm·dom tools (Koehle et al. 2022 ). Finally, when DHTsterm·dom are designed to be user‐friendly and culturally appropriate, it is more likely for equity‐deserving groups to utilise those tools effectively (Wilson et al. 2024 ).
Determine the Defining Attributes According to Walker and Avant ( 2011 ), the fourth step is to determine the concept's defining attributes. This is achieved by analysing numerous definitions of the concept to extract repetitive characteristics (Walker and Avant 2011 ). Across all the identified explicit definitions of DHEterm·dom presented in Table 1 , one common attribute is highlighted. The attribute of DHEterm·dom is DHTterm·dom that benefits everyone fairly. This attribute is also either explicitly stated or implied in the various DHEterm·dom frameworks and within the definitions of the related term ‘equity’.
Digital Healthterm·dom Technology That Benefits Everyone Fairly DHEterm·dom is a DHTterm·dom that benefits everyone fairly. This attribute aligns with various definitions of DHEterm·dom that emphasise fair benefits irrespective of any differences (Public Health Ontario 2023 ; Lewis et al. 2023 ; Richardson et al. 2022 ). These differences include factors, including, but not limited to, SDOHterm·dom, race, socioeconomic status and health conditions (Hadjiat 2023 ; Jaworski et al. 2023 ; Lawrence 2022 ; Vassilakopoulou and Hustad 2023 ). There is limited application of DHTsterm·dom within racialised and Indigenous communities (Public Health Ontario 2023 ; Saeed and Masters 2021 ; Yao et al. 2022 ). For example, an application created to assist physicians in diagnosing skin conditions did not work for those who had Black and Brown skin; therefore, these populations did not benefit fairly from this DHTterm·dom, when compared to others (Koehle et al. 2022 ). Furthermore, individuals of low socioeconomic status have been found to report reduced adoption of DHTsterm·dom due to financial constraints, leading to the unfair distribution of health benefits (Badr et al. 2024 ; Van de Vijver et al. 2023 ; Yao et al. 2022 ). Moreover, individuals with poor health conditions (such as chronic conditions, hearing impairments and arthritis) do not fairly benefit due to their limited physical ability when attempting to use DHTsterm·dom (Van de Vijver et al. 2023 ; Yao et al. 2022 ). Equity is at the forefront of DHTsterm·dom when there is a fair opportunity for health benefits, regardless of all these differences (Public Health Ontario 2023 ; Lewis et al. 2023 ; Richardson et al. 2022 ).
Furthermore, DDOHterm·dom are used as guiding principles in DHEterm·dom frameworks (Crawford and Serhal 2020 ; Lawrence 2022 ; Richardson et al. 2022 ). The DDOHterm·dom are outlined as (1) individuals' access to digital resources; (2) use of these resources for health seeking; (3) digital healthterm·dom literacy; (4) beliefs about the potential help or harm of digital healthterm·dom care; (5) values and cultural preferences regarding the use of digital resources; and (6) integration of digital resources into community and health infrastructure. (Kaihlanen et al. 2022 , 2) The DDOHterm·dom are tightly linked to this attribute as they outline further unique elements that need to be considered for everyone to fairly benefit from DHTsterm·dom (Lawrence 2022 ; Richardson et al. 2022 ).
Model Caseterm The fifth step of Walker and Avant's ( 2011 ) concept analysisterm·key is the identification of a model caseterm; a model caseterm is an example of the concept that showcases all of the defining attributes. Construction of a model caseterm is valuable because it is a practical application of the concept's attributes. Consider the following constructed model caseterm: Carlos is a 65‐year‐old male who lives in a rural region of Paris, Ontario. He has unmanaged type 2 diabetes because travelling to his family doctor is financially challenging. Upon his daily morning walk, he noticed a local community health staff member advertising a mobile health application program. This application assists patients in managing their chronic conditions by virtually connecting patients with physicians and providing them with online, tailored resources. When approached, Carlos was hesitant to participate because he was worried about the cost of the application, about using the technology, and his language barrier (he can speak English but prefers to read in his native language, Spanish). The staff member acknowledged these concerns and reassured Carlos that the mobile health application was free and that the program provides a workshop that teaches participants all the basic skills needed to use the application. The staff member also explained that the application offers a multilingual feature, allowing users to choose from various languages, including Spanish. Carlos was impressed with the features and agreed to use this mobile health application. Immediately afterwards, he was provided with the required training, the language settings were switched to Spanish, and he proceeded to use the application with ease. In using this application, Carlos connected with a physician and retrieved tailored resources about diabetes. In doing so, he was able to successfully manage his diabetes.
Digital healthterm·dom technology that benefits everyone fairly, is highlighted in this example. Carlos was able to fairly benefit from this DHTterm·dom as his diabetes was managed despite his income and language challenges. Carlos did not experience any inequities from this DHTterm·dom because the workshop taught Carlos how to utilise the technology, addressing his limited digital literacyterm·dom skills, thus increasing his accessibility.
Identifying Additional Cases Borderline Caseterm A borderline caseterm is an example of the concept that has most of the defining attributes but not all of them (Walker and Avant 2011 ). Consider the following constructed borderline caseterm: Jennifer is a 35‐year‐old woman diagnosed with severe anxiety and a hearing impairment. She works at Bell Canada for minimum wage. Her employer has a partnership with a digital mental health platform that offers free counselling sessions and mental health resources. Jennifer was happy with the platform because it had basic and advanced options, making it easy to navigate (even offered in offline mode when no internet was available). Jennifer also reported some improvement in her anxiety levels from using the platform, but her hearing impairment hindered communication during the counselling service. The technology accounted for various digital literacyterm·dom levels through basic and advanced user options, and it had an offline mode, which promoted accessibility. However, even though Jennifer had some benefits from using the platform, she was unable to fully benefit from the service as it did not accommodate for her hearing impairment.
Related Case Related cases are examples of the concept that are related, but do not include all of the defining attributes (Walker and Avant 2011 ). Consider the following constructed related case: Mariam, a 40‐year‐old physician, used an artificial intelligence (AI) diagnostic tool. This tool was designed to analyse electrocardiograms to identify abnormal cardiovascular rhythms with the aim of promoting better health outcomes for patients. Mariam noticed that they were the only hospital that introduced this tool because it was expensive, and the hospital was well‐funded compared to surrounding hospitals. She also noticed biases in the technology, as the tool predominantly used data from middle‐aged Caucasian men, resulting in reduced accuracy for diagnosing other populations. Mariam also had trouble using this tool because it was very challenging to navigate. This is a related case because although the AI diagnostic tool attempted to improve patient outcomes, it did not benefit all patients fairly. It had biases in the data that disproportionately benefited Caucasian men. This tool created inequities because the hospital did not provide adequate training for Mariam to appropriately use the tool. This case also did not consider various digital literacyterm·dom levels. Therefore, Mariam was unable to utilise it effectively.
Contrary Case A contrary case is an example that does not represent the concept (Walker and Avant 2011 ). Consider the following constructed contrary case: John rushed into a walk‐in clinic during his work lunch break because he could not financially afford to miss a day at work for a scheduled appointment. John experienced longer‐than‐usual wait times because the clinic operated entirely without DHTterm·dom. Since the wait times were long, John requested a virtual appointment instead; however, the clinic only offered in‐person visits. John left without any support regarding his symptoms because he needed to get back to work on time. Despite leaving in a hurry, he was still late for work, resulting in a pay deduction. This example does not include the defining attributes of DHEterm·dom. John did not benefit fairly from this service as he left without any guidance for his symptoms due to his financial constraints. John had an inequitable experience because the healthcare was inaccessible.
Antecedentsterm The seventh step in Walker and Avant's ( 2011 ) concept analysisterm·key is to identify antecedentsterm and consequences. Antecedentsterm are ‘events or incidents that must occur or be in place prior to the occurrence of the concept’ (Walker and Avant 2011 , 167). Any factors or events that must take place to ensure the occurrence of DHEterm·dom would be considered antecedentsterm of DHEterm·dom. However, there is a slight difference between the theory and practice of DH. In theory, DH is meant to reduce health inequities; however, in practice, DH may increase inequities due to the absence of antecedentsterm such as appropriate digital literacyterm·dom skills (Richardson et al. 2022 ). Therefore, it is important to discuss and understand the antecedentsterm of DHEterm·dom in depth.
The antecedentsterm necessary for DHEterm·dom are as follows: (1) appropriate infrastructure; (2) cognitive abilities including digital literacyterm·dom; (3) intersectionalityterm·key of multiple vulnerabilities; (4) presence of the core ethical principles in healthcare; (5) digital accessibility with careful consideration of the SDOHterm·dom; and (6) co‐creation of DHTsterm·dom. These antecedentsterm have been drawn from various sources used when identifying all uses of the concept. The two major sources are the DHEterm·dom frameworks and DHEterm·dom‐related research literature. Guiding frameworks used in the identification of the specific antecedentsterm include the framework for digital health equityterm·dom developed by Richardson et al. ( 2022 ), the digital health equityterm·dom framework developed by Crawford and Serhal ( 2020 ), and the digital healthcare equity framework created by Hatef et al. ( 2024 ). Studies undertaken by Ha et al. ( 2023 ), Kaihlanen et al. ( 2022 ), Kim and Backonja ( 2025 ), Koehle et al. ( 2022 ) and Wilson et al. ( 2024 ) are some of the DHEterm·dom‐related studies that have been used to identify the antecedentsterm.
As previously discussed, the term ‘digital’ refers to content within a digital format (IGI Global n.d. ), and digital healthterm·dom is a form of digitalised healthcare delivery; consequently, infrastructure is a foundational antecedentterm to this digitalisation (Labrique 2025 ). There must be appropriate infrastructure available in the community and healthcare settings for DHEterm·dom to exist. Infrastructure includes, but is not limited to, cellular wireless and broadband access (Richardson et al. 2022 ). Infrastructure is mandatory for digital healthterm·dom technology to operate, and without the appropriate infrastructure the adoption of DHTsterm·dom is impossible; hence DHEterm·dom will not occur (Yeung et al. 2023 ).
Across various DHEterm·dom frameworks, such as the commonly cited frameworks by Richardson et al. ( 2022 ) and Crawford and Serhal ( 2020 ), the presence of one's cognitive abilities greatly influences the use of DHTsterm·dom. Cognitive abilities are described as basic skills such as listening, communicating, reading and comprehension (Ban et al. 2024 ). This is a significant antecedentterm because DHEterm·dom will be impossible without the appropriate cognitive abilities to utilise the DHTsterm·dom. Digital literacyterm·dom is a specific cognitive ability, highlighted in various DHEterm·dom frameworks and is essential for digital healthterm·dom use (Crawford and Serhal 2020 ; Richardson et al. 2022 ). Digital literacyterm·dom refers to the cognitive and technical skills required to successfully navigate DHTsterm·dom (Richardson et al. 2022 ). Without digital literacyterm·dom, one is unable to make use of DH and thus DHEterm·dom will not take place. Digital healthterm·dom inequities are frequently documented among individuals of an older age (Badr et al. 2024 ; Jaworski et al. 2023 ; Rowland et al. 2024 ). Older adults (aged over 75) are less inclined to utilise DHTsterm·dom due to limited digital literacyterm·dom skills (Van de Vijver et al. 2023 ; Yao et al. 2022 ).
Intersectionalityterm·key of multiple vulnerabilities is another key antecedentterm for DHEterm·dom. Digital health equityterm·dom frameworks, such as that developed by Crawford and Serhal ( 2020 ), describe that multiple barriers can be experienced by the same individual. When overlapping vulnerabilities are ignored, the concept of DHEterm·dom will not take place, reinforcing digital healthterm·dom inequities (Crawford and Serhal 2020 ). For example, there can be biases in the design of DHTsterm·dom, making some tools less effective for people of colour, creating a DH inequity (Brewer et al. 2020 ). This same tool may also further cause biases for those who are female if they do not capture symptoms experienced by women and focus on male symptoms instead. During the development of this DHTterm·dom, there was limited consideration of the intersectionalityterm·key of multiple vulnerabilities for a black woman of colour, leading to DH inequities. Meaning intersectionalityterm·key of multiple vulnerabilities must exist before DHEterm·dom can occur.
The core ethical principles in healthcare are beneficence, nonmaleficence, autonomy and justice (Varkey 2021 ). These four core ethical principles are not directly linked to the definitions of DHEterm·dom within the literature, but are implied within DHEterm·dom frameworks (Crawford and Serhal 2020 ; Richardson et al. 2022 ). These four principles are ethical matters that contribute to and maintain health equityterm·dom and the elimination of the digital divideterm·dom gap and are thus foundational to the occurrence of DHEterm·dom. For example, beneficence is promoting benefit to the patient (Varkey 2021 ). When the principle of beneficence is applied within the healthcare field, equity is possible. Nonmaleficence is the avoidance of harm (Varkey 2021 ). Nonmaleficence is the obligation of a healthcare provider not to harm the patient (Varkey 2021 ). When there is active consideration to prevent harm, equity is possible (Varkey 2021 ). Autonomy entails acts that allow for a patient's self‐determination (Varkey 2021 ). Autonomy relates to DHEterm·dom as the patient should make the choices surrounding their digital healthcare while understanding all risks and benefits. Justice is the treatment of a person that is fair, equitable, and appropriate (Varkey 2021 ). The fair, equitable, and appropriate treatment of a patient is a prerequisite to DHEterm·dom.
Digital accessibility is commonly cited as a requirement for DHEterm·dom and is found within explicit definitions of the term by Foley et al. ( 2021 ), Ha et al. ( 2023 ) and Richardson et al. ( 2022 ). Accessibility refers to the ability of an individual and/or population to effectively obtain access to DHTsterm·dom (Lawrence 2022 ; de Lopez Coca et al. 2022 ; Lythreatis et al. 2022 ). Accessibility is a foundational requirement for the use of DH and therefore, must be in place prior to the occurrence of DHEterm·dom. DHEterm·dom is commonly described by the Association of Health Care Journalists ( n.d. ), Centre for Addiction and Mental Health ( n.d.‐b ), Ha et al. ( 2023 ) and Public Health Ontario ( 2023 ) as leaving no one behind, irrespective of any SDOHterm·dom. The SDOHterm·dom include employment, income, working conditions, housing, education, social inclusion, and the environment (Canadian Nurses Association 2025 ). Digital health equityterm·dom requires more than just access; it demands the careful consideration of the SDOHterm·dom. For instance, stable housing, a SDOHterm·dom, is a foundational component for DH access. DH inequities are frequently documented among individuals residing in rural communities (Badr et al. 2024 ; Jaworski et al. 2023 ; Rowland et al. 2024 ). Rural communities can experience an unequal distribution of DHTsterm·dom due to limited availability and accessibility (Badr et al. 2024 ; Jaworski et al. 2023 ; Rowland et al. 2024 ; Yao et al. 2022 ). On the other hand, individuals living in rural communities with limited access to healthcare services can receive healthcare via DHTsterm·dom, which is a pivotal factor for the concept of DHEterm·dom to occur (Jaworski et al. 2023 ; Lawrence 2022 ). Income, another SDOHterm·dom, directly influences an individual's ability to afford internet or devices to access DHTsterm·dom. When individuals are unable to afford this technology due to financial constraints, they are excluded from DH, which leads to disparities in access to DHTsterm·dom. Therefore, careful consideration of the SDOHterm·dom is essential to ensuring accessibility and achieving DHEterm·dom (Crawford and Serhal 2020 ).
There are also antecedentsterm of DHEterm·dom that take place at the healthcare provider level or healthcare organisational level. For example, how DHTterm·dom is developed, how the DHTterm·dom is disseminated and how much support healthcare providers receive in using these DHTsterm·dom with equity‐deserving groups (Ha et al. 2023 ; Koehle et al. 2022 ; Wilson et al. 2024 ). Each of these examples impacts whether DHEterm·dom occurs or not. If DHTsterm·dom are co‐created with underserved communities, then there is a higher likelihood that the technology will be more acceptable to the specific equity‐deserving groups (Blasimme et al. 2025 ). Similarly, if the DHTterm·dom is widely disseminated with equity‐deserving groups, there is a greater chance of achieving DHEterm·dom for everyone (Baumann et al. 2023 ). If optimum support to healthcare providers is provided, guiding the equitable utilisation of DHTsterm·dom among different populations, this can ensure the occurrence of DHEterm·dom widely (Borges do Nascimento et al. 2023 ).
All antecedentsterm must be present individually for the occurrence of DHEterm·dom to take place. However, given the nature of the antecedentsterm, they also intersect and can occur in combination for the occurrence of the concept. For example, income (a SDOHterm·dom) is a requirement to afford DH devices; however, income is also closely tied to accessibility. If one does not have the income to afford digital devices, they may not be able to access DHTsterm·dom. Another example is as follows: if an individual cannot afford to pay for a smartphone or device to run the technology or for the internet, then it will not be possible to use it despite the presence of the appropriate infrastructure, and all this comes before the concept of DHEterm·dom. These are just some of the many examples of intersecting antecedentsterm.
Consequences Walker and Avant ( 2011 ) define consequences as the result of a concept. The literature reveals that the main consequences of DHEterm·dom are improved patient health outcomes and elimination of the digital divideterm·dom (Crawford and Serhal 2020 ; The Lancet 2021 ; Lawrence 2022 ). The definitions of DHEterm·dom commonly describe the result of DHEterm·dom as the attainment of positive health outcomes, as seen in Table 1 . For example, DHEterm·dom promotes a personalised approach to care (Butcher and Hussain 2022 ), which leads to better patient self‐management of diseases (Abraham et al. 2023 ) to potentially improve patient health outcomes. Further supporting examples include better disease management, improved diagnosis accuracy, and fewer medical complications leading to reduced morbidity and mortality (Alotaibi and Federico 2017 ; Awad et al. 2021 ). Another consequence of DHEterm·dom is when DHTterm·dom do not cause or amplify the digital divideterm·dom (Koehle et al. 2022 ; Rowland et al. 2024 ). The digital divideterm·dom is often linked with DH inequities within the body of literature surrounding DHEterm·dom (Koehle et al. 2022 ; Public Health Ontario 2023 ; WHO 2021 ). When DHTsterm·dom account for the two central elements of the digital divideterm·dom, accessibility and digital literacyterm·dom levels, to avoid causing inequities or contributing to the existing inequities, this is a consequence of DHEterm·dom (Jaworski et al. 2023 ; Lawrence 2022 ; Vassilakopoulou and Hustad 2023 ; WHO 2021 ). The presence of the antecedentsterm brings forth the consequences. For example, the presence of the appropriate infrastructure, digital literacyterm·dom skills, and accessibility are part of the elimination of the digital divideterm·dom. The consideration of SDOHterm·dom and core ethical principles in healthcare helps improve health outcomes for all.
Define Empirical Referents The last step in Walker and Avant's ( 2011 ) concept analysisterm·key involves establishing empirical referents. Walker and Avant ( 2011 ) emphasise that empirical referents are not tools that measure the concept but rather a way to recognise the presence of the concept's defining attributes. The attribute of DHEterm·dom is DHTterm·dom that benefits everyone fairly. An empirical referent for this attribute is when DHTsterm·dom are designed to meet the needs of diverse patient populations, acknowledging individual differences (Hadjiat 2023 ; Jaworski et al. 2023 ; Lawrence 2022 ; Vassilakopoulou and Hustad 2023 ). Acknowledging differences can be evident in many ways. For example, if mobile health applications provide tailored health resources based on personal intake questionnaires to effectively accommodate individual patient differences (Badr et al. 2024 ). These accommodations can include how many interfaces are available within a DHTterm·dom (basic and advanced options) or different delivery formats such as audio or reading options (Agency for Healthcare Research and Quality 2024 ). Equity‐deserving groups come from many different cultural and socio‐economic backgrounds and have different preferences and needs, which is why different modes are helpful for underserved communities. Additionally, if the DHTterm·dom is available in multiple languages (Agency for Healthcare Research and Quality 2024 ), this is an empirical referent. Different languages within DHTsterm·dom are needed because not everyone is proficient in the common language of the country they reside in.
Discussion and Recommendations It is evident that grasping the concept of DHEterm·dom in its entirety is essential in the digital healthcare space, particularly in nursingterm·key (Badr et al. 2024 ; Jaworski et al. 2023 ; Lawrence 2022 ; Richardson et al. 2022 ; Rowland et al. 2024 ). Following this concept analysisterm·key, recommendations for practice, education, research, and policy can be identified.
Nursingterm·key practice should involve assessing, promoting, and evaluating DHEterm·dom among equity‐deserving groups; therefore it is necessary to create the infrastructure and framework to make these assessments. As frontline providers, nurses are positioned to influence health outcomes and address digital disparities directly (National Academies of Sciences, Engineering and Medicine 2021 ). Factors contributing to the digital divideterm·dom should be assessed by all nurses, as these can cause grave consequences of digital despair (Crawford and Serhal 2020 ; The Lancet 2021 ; Lawrence 2022 ). DHTsterm·dom must be co‐created with equity‐deserving groups so that their contextual cultural, and socio‐economic realities could inform the co‐creation of these tools and could make these more accessible for all (Baumann et al. 2023 ; Blasimme et al. 2025 ; Borges do Nascimento et al. 2023 ). DHTsterm·dom must be disseminated widely with equity‐deserving groups by healthcare professionals especially by nurses who work directly with these patients at the front line (Baumann et al. 2023 ; Blasimme et al. 2025 ; Borges do Nascimento et al. 2023 ). Healthcare professionals, including nurses, must be provided with adequate support by their organisations to be proficient in the use of DHTsterm·dom themselves and to be able to use these DHTsterm·dom with everyone effectively (Baumann et al. 2023 ; Blasimme et al. 2025 ; Borges do Nascimento et al. 2023 ).
This concept analysisterm·key identified various antecedentsterm required for the occurrence of DHEterm·dom. These findings should urge nurse educators to prepare nurses to assess all the antecedentsterm when they are caring for patients. The WHO ( 2021 ) proposed an action plan that advocates for the implementation of equitable DHTsterm·dom in the healthcare system. In the context of educational implications, the in‐depth understanding of DHEterm·dom obtained from this concept analysisterm·key can be used to facilitate the creation of appropriate education materials incorporated in this action plan and within nursingterm·key education. These educational materials can be in the form of training sessions, modules, pamphlets and so on. They can be provided to any healthcare provider that uses or develops DHTsterm·dom, and/or for healthcare providers who coach patients on how to use DHTsterm·dom (WHO 2021 ).
This concept analysisterm·key can be used to guide the direction of future research. Since DHEterm·dom is an emerging concept, its attributes require more attention in research (Jaworski et al. 2023 ; Koehle et al. 2022 ; Ronquillo et al. 2023 ). For example, studies can be undertaken to examine effective ways to promote each attribute within this concept analysisterm·key. Future nursingterm·key studies should aim to advance DHEterm·dom by focusing on the antecedentsterm identified in this analysis. Future DHEterm·dom research should also include the voices of marginalised and underserved communities. The theory of ENPterm offers a valuable framework to guide such research, as demonstrated by a grounded theory study that explored nursingterm·key's role in promoting social justice through the lens of ENPterm (Rooddehghan et al. 2019 ). Thus, the theory of ENPterm can be leveraged in future DHEterm·dom‐related research within the nursingterm·key discipline. Additionally, future research should focus on the co‐creation of DHTsterm·dom with equity‐deserving groups (Blasimme et al. 2025 ).
Moreover, the clear understanding of DHEterm·dom provided in this concept analysisterm·key can aid in the creation of policies to enable equitable DHTsterm·dom. For example, policies can be developed to ensure DHEterm·dom is achieved by enforcing the use of DHEterm·dom frameworks when creating DHTsterm·dom (Crawford and Serhal 2020 ; Kaihlanen et al. 2022 ; Lawrence 2022 ; Richardson et al. 2022 ). It is important to note that the concept of DHEterm·dom, along with its antecedentsterm and consequences, reflect a middle range explanatory theory, because there is a clear relationship between the outlined antecedentsterm and consequences, and the concept of DHEterm·dom. Since the consequences are linked to the antecedentsterm and the antecedentsterm can all intersect, policies should be developed to address the complexity of DHEterm·dom.
Novelty of This Concept Analysisterm·key This concept analysisterm·key expanded the understanding of the concept DHEterm·dom by not only addressing SDOHterm·dom, access and literacy, which are frequently discussed, but also bringing in the unique pieces of intersectionalityterm·key. This concept analysisterm·key identifies that each antecedentterm can impact the consequences of DHEterm·dom; however, all the antecedentsterm can also intersect with one another. This concept analysisterm·key links intersectionalityterm·key to DHEterm·dom, which has not been brought to light previously. Additionally, the linkage of the four healthcare ethical principles is not directly cited in DHEterm·dom literature; however, these four principles are core to DHEterm·dom and healthcare in general. There needs to be an explicit connection between these principles and DHEterm·dom.
Limitations A limitation of this scoping review stems from the absence of a universally accepted definition of DHEterm·dom (Kim and Backonja 2025 ). Consequently, the existing literature employs various DHEterm·dom frameworks, leading to inconsistencies in the understanding of DHEterm·dom. The existing body of knowledge is not unified, which prevents a straightforward understanding of the attributes of DHEterm·dom extending into practical limitations that can lead to digital healthcare inconsistencies. Due to resource, time, and other constraints it is not always possible to access and translate non‐English evidence. Using only English literature in this concept analysisterm·key assumes that only evidence written in English is worthy. However, in doing so, this may contribute to further inequities. Moreover, only those who know English or can afford translations will publish in English regarding this topic. This concept analysisterm·key is also limited by its reliance on existing literature, which may underrepresent equity‐deserving voices. Furthermore, given the rapidly evolving nature of digital healthterm·dom, emerging definitions and frameworks on DHEterm·dom may not yet be captured in the literature, potentially limiting the completeness of the concept attributes identified. Therefore, the authors plan to update this concept analysisterm·key as the literature in this area evolves further.
Conclusion In conclusion, a rigorous concept analysisterm·key was conducted to clarify the meaning of DHEterm·dom. Digital health equityterm·dom is a multifaceted concept. The findings highlighted that DHEterm·dom is a concept that benefits everyone fairly. Digital health equityterm·dom attributes were highlighted in various constructed cases. Various antecedentsterm were identified that work independently and intersect with one another. Improved patient health outcomes and elimination of the digital divideterm·dom are the consequences of DHEterm·dom. Digital health equityterm·dom has implications in practice, education, research and policy. Practice implications involve co‐creation and dissemination of DHTsterm·dom with equity‐deserving groups and provision of adequate support for healthcare professionals including nurses for the optimum utilisation of these DHTsterm·dom with equity‐deserving groups. Education implications entail preparing nurses to assess the antecedentsterm of DHEterm·dom. Future nursingterm·key research should aim to advance DHEterm·dom by focusing on the antecedentsterm of DHEterm·dom, and research should be inclusive of equity‐deserving groups through co‐creation. Finally, DHEterm·dom policies can be developed using a combination of various DHEterm·dom frameworks and based on the relevant research findings.
Funding The authors have nothing to report.
Conflicts of Interest The authors declare no conflicts of interest.
Data Availability Statement Data sharing not applicable to this article as no datasets were generated or analysed during the current study.
References Associated Data Data Availability Statement Data sharing not applicable to this article as no datasets were generated or analysed during the current study.