The ABC of Digital Health: A Framework for Translating Digital Health Interventions into Real-World Applications

Jul 16, 2026

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Research-based digital health interventions are frequently promoted as ways to extend health care, but most do not progress beyond controlled studies. Existing frameworks guide development and testing yet provide limited, concrete support for turning evidenced mechanisms into durable, real-world use. The ABC framework is introduced: Accessibility, Buildability, and Continuity. It links design decisions to scalability, automation, and adherence. A shared language helps researchers, designers, and policymakers build and evaluate interventions viable in everyday life.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages21

Reading Time53 min

Abstract

Introduction

Existing Models

The ABC of digital health: A framework for translating digital health interventions into real-world applications David Grüning*1,2,3 Vincent Beermann4 Jan Enkmann4 Rose Hoch 1 Ralph Hertwig2 Paul Schmiedmayer1 1: Stanford University, Palo Alto, US 2: Center for Adaptive Rationality, Max-Planck Institute for Human Development, Berlin, Germany 3: University of Cambridge, Cambridge, UK 4: Hasso Plattner Institute, University of Potsdam, Potsdam, Germany *Corresponding author: [gruening@stanford.edu](gruening@stanford.edu), dgruening@mpib-berl[in.mpg.de](in.mpg.de), [david.gruning@mrc-cbu.cam.ac.uk](david.gruning@mrc-cbu.cam.ac.uk) Acknowledgements DG’s work is funded by Huo Family Foundation and Stanford’s Center for Digital Health. DG has ongoing research projects in collaboration with the one sec app. PS’s work is funded by Stanford’s Center for Digital Health. RH has been funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation)– HE 2768/11-1 . Contribution statement Framework conceptualization: DG, VB, JE. Theoretical formalization: DG. Literature synthesis: DG, VB, JE, RoH. Writing original draft: DG. Visualizations: DG. Revised the article: DG, VB, JE, RoH, RH, PS. Approved the submitted version for publication: DG, VB, JE, RoH, RH, PS. Grüning et al. 1 Abstract Research-based digital health interventions are often presented as potential solutions for extending health care in the real world. Yet the vast majority of these interventions fails to move beyond controlled studies. Existing frameworks offer valuable guidance for intervention development and testing, but provide less concrete support for translating these evidenced intervention mechanisms into sustained real-world applications. This paper introduces the ABC framework, referring to Accessibility, Buildability, and Continuity, as a practical model for a successful translation. Accessibility captures whether diverse users can find, understand, and begin using an application with minimal friction. Buildability refers to the development of an app that supports the iteration, integration, and personalization of features. Continuity describes both sustained user engagement and the operational capacity to maintain an application over time without disproportionate increases in cost, infrastructure, or human support. Different combinations ofthe ABC-dimensions make an application scalable (AB), automated (BC), and adherent (AC). By linking design decisions to these features, ABC offers a shared language for researchers, designers, and policymakers seeking to build or evaluate digital health interventions that work beyond trials and are viable applications in everyday life. Keywords: digital health interventions, mHealth, scalability, automation, adherence, real-world applications, implementation science Grüning et al. 2 Introduction Digital health interventions have grown from being considered interesting experiments to essential parts of people’s everyday life. Ranging from mental wellbeing to chronic disease management, health applications are increasingly suggested as scalable tools to extend care, reduce health disparities, and support long-term behavior change (Nahum-Shani et al., 2018) . Their promise lies not only in their reach but also in their potential to operate independently of constant human input (Mohr et al., 2017) . Yet while enthusiasm for these digital interventions is widespread in academic research, actual implementation in real life often falls short of expectations. Applications are predominantly built for intervention testing but rarely used beyond answering a research question. Features are developed but not implemented in actual digital environments for prolonged use. We argue that at the heart of this failure lies a design problem: the lack of practical frameworks that guide the translation of evidenced digital health interventions into real applications. Existing models T

FAQs

What problem does the ABC framework address in digital health interventions?

It targets the gap where evidence-based interventions often remain within controlled studies and do not translate into sustained real-world applications due to insufficient practical translation frameworks.

What do Accessibility, Buildability, and Continuity mean in the ABC framework?

Accessibility focuses on whether diverse users can find, understand, and start using an application with minimal friction. Buildability concerns developing apps that support iterative development, integration, and personalization. Continuity covers sustained engagement and the operational ability to maintain the app over time without disproportionate cost or support needs.

How can different combinations of the ABC dimensions affect an application?

Combining the dimensions determines whether an application becomes scalable (AB), automated (BC), and adherent (AC), connecting design choices to these practical outcomes for real-world viability.

Jul 16, 2026

Upload by Violet