Table 3.

Challenges to integrating digital technologies in public health and mapped solutions as identified in the literature.

Challenges	Mapped recommendations
Nontechnical challenges
Ethical, legal, and privacy issues	Establishment of ethical, legal, and regulatory frameworks a Transparent communication strategy to promote public trust a Open-source IT architecture with appropriate safeguards Research on additional privacy methods a Partnerships and collaboration including members from affected communities a Unique digital identifiers Widespread stakeholder engagement (going beyond consultation to ensure close collaboration) a
Paucity of high-quality evidence	Articulation of a clear research agenda by government agencies, public health researchers, and practitioners a Creation of new and adaptive research and evaluation methods a Digital interventions implemented based on proven behavior theories Integration of evaluation activities at all stages of implementation a Partnerships between researchers and digital public health practitioners a
Health equity	Health equity-focused design of digital public health interventions Deliberate action to foster digital literacy Equity-focused evaluation of digital health interventions a Establishing communities of practice addressing health disparities a Integrate digital interventions in universal health coverage strategies Health equity investments a Publicly available digital access points
Policy and governance challenges	Transdisciplinary partnerships a Coordinate frameworks to ensure adherence to standards and interoperability a Data governance and accountability frameworks a Advisory bodies at national, sub-national, and local levels Transparent public trust frameworks a
Resource barriers	Inter-sectorial approach that engages a wide range of stakeholders a Evidence of returns on investments in digital health interventions a Establishment of collective funding streams for digital health through public health agencies a Focus on long-term funding needs across project life cycles Shared financial risks through public–private partnerships a
Disinformation and misinformation	Proactive communication plans and policies to counter destructive posts a
Technological optimism	Needs-based services Robust research to support digital interventions a Balanced investment in innovation and ongoing investment in established methods a
Technical challenges
Unreliability of available data	Standardized reporting systems Inter-sectorial partnerships a Artificial intelligence assisted reporting Research on data quality assurance methods a
Fragmented, isolated, and unsustainable systems	Shared digital architecture and standards a Clear reporting standards and dissemination of such standards a Create interoperability requirements for digital health interventions Early sustainability and integration planning Establish health information exchange systems
Leadership and health workforce capacity-building gaps	Political commitment to integrate digital technologies Health workforce training a Health workforce redesign including updated job descriptions a Interdisciplinary communities of practice and knowledge exchange
Infrastructure gaps	Long-term resource planning and economic investments a Collaborative infrastructure building and resource pooling a Capacity building to complement infrastructure investments a
Lack of clear standards	Create normative standards/regulatory frameworks a Compile data dictionaries and repositories of digital public health tools
Suboptimal design and implementation of digital technologies	Needs-based digital health services Implementation based on proven behavioral theories

^a Indicates recurring recommendations to address multiple challenges identified.