A Scoping Review of the Mechanisms Influencing Socioeconomic Disparities in Outcomes of Digital Interventions for Weight-Related Behaviors.

Abstract

Digital behavioral change interventions (DBCIs) for weight-related behaviors may be less effective in disadvantaged populations, potentially widening health inequalities despite increased access. Limited research has explored the psychosocial mechanisms that may contribute to this divide. Following JBI guidelines for conducting scoping reviews, we conducted an electronic search on Embase, PubMed, APA PsycInfo, Web of Science, and SCOPUS on March 8, 2023, including studies published since 1990. The mechanisms of action ontology was used for deductive coding of the mechanisms discussed. The protocol was registered on the Open Science Framework (https://osf.io/ctua5). After initial screening of 17,503 papers, 21 studies met inclusion criteria, including RCTs, pre-post studies, systematic reviews, qualitative studies, cross-sectional, pilot, and feasibility studies. A second screen of 7840 articles in June 2025 identified three further studies that met the inclusion criteria. Socioeconomic inequalities and ethnicity were the predominant focus. Environment, motivation, and social influences were frequently cited mechanisms. However, mechanisms are inconsistently conceptualized and measured, highlighting a gap in explanatory research on the digital health divide.