Advancing foundational models in digital health technology adoption: A systematic literature review of multidisciplinary factors
6 affiliations
- 1Centre for Postgraduate Studies for Research, Institute for Research, Development and Innovation, IMU University, Kuala Lumpur, Malaysia
- 2Department of Psychology and Counselling, School of Psychology and Social Sciences, IMU University, Kuala Lumpur, Malaysia
- 3School of Business and Technology, IMU University, Kuala Lumpur, Malaysia
- 4Division of Nutrition, Dietetics and Food Science, School of Health Sciences, IMU University, Kuala Lumpur, Malaysia
- 5Department of Social Sciences, School of Psychology and Social Sciences, IMU University, Kuala Lumpur, Malaysia
- 6Department of Digital Health and Health Informatics, School of Business and Technology, IMU University, Kuala Lumpur, Malaysia
Abstract
Digital health technologies (DHTs) such as patient portals, mobile applications, and electronic health records can improve access to healthcare, self-management and care coordination. However, their adoption remains inconsistent. This study systematically reviews the technological, psychological, social, cultural, health-related and environmental factors influencing DHT adoption. This protocol-registered review (PROSPERO: CRD420251056883) was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 guidelines. A search of multidisciplinary databases was conducted through the EBSCO Discovery Service (EDS) to identify peer-reviewed English primary studies published between 2015 and 18 June 2025. Although studies published from 2015 onward were searched, only studies published from 2020 onward were retained for synthesis. Two researchers independently applied the Sample, Phenomenon of Interest, Design, Evaluation, Research type (SPIDER) framework to screen articles and extract data. As Covidence operationalises screening using the Population, Intervention, Comparison, Outcome, Study type (PICOS) framework, SPIDER elements were mapped to PICOS to ensure consistency across screening and extraction. Methodological quality was appraised using the Mixed Methods Appraisal Tool (MMAT) to inform interpretation. Data were synthesised using a structured thematic analysis workflow informed by the Thematic Analysis Matrix proposed by Zairul, which operationalises the thematic analysis principles described by Braun and Clarke. Coding, category development and theme generation were managed using ATLAS.ti (Version 24). Eighty-two studies published between 2020 and 2025 met the inclusion criteria. Five themes were identified: (1) access, equity and affordability; (2) usability, engagement and user empowerment; (3) trust, privacy and governance; (4) integration, workforce and sustainability; and (5) clinical effectiveness and quality of care. The findings showed that adoption of DHTs is a multi-layered process shaped by multidisciplinary factors. This review provides researchers, policymakers and healthcare providers with theoretical and practical insights to support sustainable, effective and equitable DHT adoption and to guide the development of future strategies. Author summary: Digital health technologies such as mobile health apps, patient portals and online health records are becoming part of everyday healthcare tools. These tools improve access to healthcare and support self-management of health. However, many individuals encounter difficulties when adopting these tools. To explore this issue, we reviewed 82 studies to identify the technological, psychological, social, cultural, health-related and environmental factors influencing the adoption of digital health technologies. We grouped these factors into five themes: access, equity and affordability; usability, engagement and user empowerment; trust, privacy and governance; integration, workforce and sustainability; and clinical effectiveness and quality of care. Our findings highlight the need for an integrated framework that combines multidisciplinary factors to strengthen existing technology adoption models. This framework can guide researchers, healthcare providers, policymakers and developers in developing digital health technologies that are equitable, scalable and effective.
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BibTeX
@article{ng2026advancing,
title = {{Advancing foundational models in digital health technology adoption: A systematic literature review of multidisciplinary factors}},
author = {Huey Yu Ng and Shamala Ramasamy and Saravanan Muthaiyah and Asnina Anandan and Seong Ting Chen and Thulasi Munohsamy and Gunasekar Thangarasu},
journal = {PLOS Digital Health},
year = {2026},
month = sep,
doi = {10.1371/journal.pdig.0001690},
url = {https://journals.plos.org/digitalhealth/article?id=10.1371/journal.pdig.0001690},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Advancing foundational models in digital health technology adoption: A systematic literature review of multidisciplinary factors
AU - Huey Yu Ng
AU - Shamala Ramasamy
AU - Saravanan Muthaiyah
AU - Asnina Anandan
AU - Seong Ting Chen
AU - Thulasi Munohsamy
AU - Gunasekar Thangarasu
PY - 2026
DA - 2026/09/02
JO - PLOS Digital Health
DO - 10.1371/journal.pdig.0001690
UR - https://journals.plos.org/digitalhealth/article?id=10.1371/journal.pdig.0001690
AB - Digital health technologies (DHTs) such as patient portals, mobile applications, and electronic health records can improve access to healthcare, self-management and care coordination. However, their adoption remains inconsistent. This study systematically reviews the technological, psychological, social, cultural, health-related and environmental factors influencing DHT adoption. This protocol-registered review (PROSPERO: CRD420251056883) was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 guidelines. A search of multidisciplinary databases was conducted through the EBSCO Discovery Service (EDS) to identify peer-reviewed English primary studies published between 2015 and 18 June 2025. Although studies published from 2015 onward were searched, only studies published from 2020 onward were retained for synthesis. Two researchers independently applied the Sample, Phenomenon of Interest, Design, Evaluation, Research type (SPIDER) framework to screen articles and extract data. As Covidence operationalises screening using the Population, Intervention, Comparison, Outcome, Study type (PICOS) framework, SPIDER elements were mapped to PICOS to ensure consistency across screening and extraction. Methodological quality was appraised using the Mixed Methods Appraisal Tool (MMAT) to inform interpretation. Data were synthesised using a structured thematic analysis workflow informed by the Thematic Analysis Matrix proposed by Zairul, which operationalises the thematic analysis principles described by Braun and Clarke. Coding, category development and theme generation were managed using ATLAS.ti (Version 24). Eighty-two studies published between 2020 and 2025 met the inclusion criteria. Five themes were identified: (1) access, equity and affordability; (2) usability, engagement and user empowerment; (3) trust, privacy and governance; (4) integration, workforce and sustainability; and (5) clinical effectiveness and quality of care. The findings showed that adoption of DHTs is a multi-layered process shaped by multidisciplinary factors. This review provides researchers, policymakers and healthcare providers with theoretical and practical insights to support sustainable, effective and equitable DHT adoption and to guide the development of future strategies. Author summary: Digital health technologies such as mobile health apps, patient portals and online health records are becoming part of everyday healthcare tools. These tools improve access to healthcare and support self-management of health. However, many individuals encounter difficulties when adopting these tools. To explore this issue, we reviewed 82 studies to identify the technological, psychological, social, cultural, health-related and environmental factors influencing the adoption of digital health technologies. We grouped these factors into five themes: access, equity and affordability; usability, engagement and user empowerment; trust, privacy and governance; integration, workforce and sustainability; and clinical effectiveness and quality of care. Our findings highlight the need for an integrated framework that combines multidisciplinary factors to strengthen existing technology adoption models. This framework can guide researchers, healthcare providers, policymakers and developers in developing digital health technologies that are equitable, scalable and effective.
SN - 2767-3170
ER -