Equity-by-design for socially assistive robots as digital health tools.

Abstract

To propose an equity-by-design agenda for socially assistive robots (SARs) as embodied digital health informatics interventions. We developed this Perspective via a purposive narrative synthesis of SARs healthcare studies, digital health equity, informatics governance, and human-robot interaction ethics/equity, integrating care- and technology-ethics to derive a 3-level equity framework. We outline equity requirements at product (user), institutional (meso), and policy/evaluation (macro) levels and operationalize them as a checklist covering co-design, accessibility, privacy, data governance, equitable access and financing, and equity-oriented evaluation. Applying equity-by-design to SARs highlights how embodied sensing, workflow fit and organizational readiness, and governance/reimbursement incentives determine who benefits, which risks are borne, and whether deployments narrow or widen digital divides. Treating SARs as embodied informatics interventions and operationalizing equity across micro (product), meso (institution), and macro (policy) levels can guide designers, informatics teams, providers, and payers toward deployments that are safe, acceptable, and just.