Exclusion by Design: Lack of Information about Community Participation in COVID-19-related Mobile Apps and its Relationship to Digital Health Disparities (Preprint)

UNSTRUCTURED The rate and scale of transmission of COVID-19 overwhelmed healthcare systems worldwide, particularly in under-resourced communities of color that already faced a high prevalence of pre-existing health conditions. One way the health ecosystem has tried to address the pandemic is by creating mobile apps for telemedicine, dissemination of medical information, and disease tracking. As these new mobile health tools continue to be a primary format for healthcare, more attention needs to be given to their equitable distribution, usage, and accessibility. In this viewpoint collaboratively written by a community-based organization and a health app development research team, we present results of our systematic search and analysis of community engagement in mobile apps released between February and December 2020 to address the COVID-19 pandemic. We provide an overview of apps’ features and functionalities but could not find any publicly available information regarding whether these apps incorporated participation from communities of color disproportionately impacted by the pandemic. We argue that while mobile health technologies are a form of intellectual property, app developers should make public the steps taken to include community participation in app development. These steps could include community needs assessment, community feedback solicited and incorporated, and community participation in evaluation. These are factors that community-based organizations look for when assessing whether to promote digital health tools among the communities they serve. Transparency about the participation of community organizations in the process of app development would increase buy-in, trust, and usage of mobile health apps in communities where they are needed most.