Towards a social practice of digital health: suggestions for engagement and implementation research in the context of digital health

Digital health is the use of technologies to support health, healthcare, and wellbeing. Although technology has potential, it still faces implementation, engagement, and abandonment issues. In this viewpoint, we use Social Practice Theory (SPT) to reflect on these challenges. Particularly, we examine three examples of digital health technologies: Electronic Health Records, Digital Self-Tracking Tools, and Digital Mental Health Interventions. Tensions concerning implementation of and engagement with digital health technologies are discussed through a SPT lens, and reflections for future research are proposed. We argue that concepts such as implementation and engagement should be more broadly interpreted and researched in the context of a social practice of digital health, and that the goal of digital health (implementation and engagement) research should shift from promoting ‘desired behaviors’, such as using a digital health intervention, to fostering a social practice of digital health. Moreover, the potential of bottom-up approaches to introduce digital health are highlighted. In light of these reflections, we suggest research in digital health should integrate perspectives from neighbouring fields (e.g. sociology and design) to broaden its views on choice, agency, health and responsibility.