Scale-IT-up 2026 Abstracts

Area 1 - Scale-IT-up
Full Papers Short Papers

Area 1 - Scale-IT-up

Full Papers
Paper Nr: 5
Title:

Scaling Gender-Responsive Digital Health in the European Union: A Policy Commentary
Authors:

Laura Wagon
Abstract: Persistent gender inequities in research, innovation, and care continue to shape women’s and gender-diverse populations’ health across Europe. Gender-responsive digital health (GRDH) seeks to address these gaps by integrating the needs and preferences of all genders into the design, implementation, and evaluation of digital health interventions, yet progress remains constrained by structural, regulatory, and institutional barriers. This commentary examines how current European Union (EU) policies, regulations, and strategies enable or constrain the scalability of GRDH. Ten cornerstone frameworks were reviewed for structural enablers and barriers across the three domains vision and strategy, infrastructure and regulation, and implementation levers. Findings reveal substantial strategic and regulatory coherence, yet persistent asymmetries between normative ambition and operational reality. While the EU has built a strong foundation for digital transformation, institutionalization of gender equity remains limited. Three cross-cutting dynamics are identified that shape Eu-rope’s capacity to embed gender equity into digital health governance: policy interdependence, institutional asymmetry, and implementation opportunity. As major frameworks such as the European Health Data Space and AI Act enter implementation, the EU faces a critical window of opportunity to translate its normative commitments into measurable equity outcomes and ensure that digital health is not only innovative, but truly inclusive.
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Paper Nr: 6
Title:

From Workaround to Centerpiece: Translating Lived Experience into Perimenopause-Focused Menstrual Health Technologies
Authors:

Marinja Principe, Stefanie Krohmann, Tobias Kowatsch and Marcia Nißen
Abstract: Perimenopause is a prolonged and heterogeneous transition that can substantially affect health, well-being, and daily functioning, yet remains underrepresented in the design of Menstrual Health Technologies (MHTs). Existing MHTs often centre on fertility and contraception, offering limited support for midlife users and their changing needs. We foreground lived experience as a primary source of design insight, asking how individuals’ experiences of perimenopause can be translated into design needs and guiding considerations for more supportive MHTs. Therefore, this work analysed an online questionnaire with N=100 participants aged 45–55, spanning premenopause, perimenopause, and postmenopause; the survey captured current use of MHTs, key challenges, and desired functionalities. We combined these data with a focused review of existing MHTs and the academic literature to derive design considerations, which were visualised in a prototype. Our results show that physical and mental health symptoms are among the most significant challenges and that participants need support to understand their bodies, make sense of fluctuations over time, and actively manage their experiences. We argue for designs that (i) destigmatize perimenopause, (ii) embrace heterogeneity rather than one-size-fits-all solutions, (iii) minimize effort in everyday use, and (iv) move beyond passive logging towards holistic, anticipatory support.
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Paper Nr: 10
Title:

From Menstrual Cycle Tracking to Menstrual Cycle Syncing: A Scoping Review of Cycle Phase Effects on Lifestyle Behaviors
Authors:

Marcia Nißen, Maren Mauerhofer, Davinny Sou and Tobias Kowatsch
Abstract: Introduction: The concept of menstrual cycle syncing (MCS), first popularized in 2014, proposes that individuals adapt lifestyle behaviors such as nutrition, exercise, and sleep according to cyclical hormonal fluctuations. Despite its widespread dissemination through social media, scientific evidence and a scientific definition of MCS remains lacking. Objective: This scoping review aims to conceptualize MCS by examining scientific evidence on the effects of menstrual cycle (MC) phases on lifestyle behaviors and outcomes in eumenorrheic, non-athletic menstruating individuals and by assessing how and to what extent digital health technologies (DHTs) are used to support MCS research. Methods: A structured search was conducted across nine databases following PRISMA-ScR guidelines. Eligible studies were analyzed for methodology, sample characteristics, reliability of menstrual phase determination, and use of DHTs. Results: Of the 52 included studies, 71.2% reported phase-related behavioral or physiological variations, though methodologies were inconsistent and samples small. Only 7.7% of studies integrated DHTs. Conclusion: Current evidence does not support a universal model of MCS. This review proposes a refined definition of MCS as an individualized process, discusses the essential yet underused role of DHTs in enabling such personalization, and distills future research directions for digitally supported approaches to MCS research.
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Paper Nr: 11
Title:

Enhancing Menstrual Health Research through User-Centred Digital Data Structures: Findings from a Researcher Needs Study
Authors:

Gian Senpinar, Larissa Shuyin Moser-Chee and Marcia Nißen
Abstract: Progress in diagnosis, treatment, and health equity has been hampered by persistent gaps in women’s health research, especially in the field of menstrual health. Digital menstrual cycle tracking apps (MCTAs) provide an opportunity to fill these gaps by offering extensive, user-generated data. This ongoing study aims to identify the needs of researchers and medical professionals regarding the collection and integration of menstrual health-related data in research and practice, to suggest a research-ready, ethical data structure for research MCTAs. A digital survey was distributed to over 500 experts, yielding 127 responses across clinical, behav-ioural science, and digital health domains. Respondents rated menstrual, sociodemographic, reproductive, stress, sleep, psychological, and nutrition data as highly relevant, and preferred self-report for subjective domains and passive tracking for physiological measures. Clinical data (such as endocrine biomarkers or gynecological examination results) were rated as highly burdensome to collect and integrate, indicating the need for layered consent, opt-in, and a privacy-protective design. Based on these findings, a three-tiered data structure: core, optional, and sensitive layers, was proposed to balance research utility with user autonomy and privacy. Preliminary results offer guidance for developing research-ready MCTAs.
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Paper Nr: 13
Title:

When the User Is Female but the Design Is not: A Systematic Review of Gender Alignment in Digital Eating Disorder Interventions
Authors:

Rebecca Scheel
Abstract: Digital health interventions have become an increasingly important component of prevention and treatment for eating disorders (EDs). Although EDs disproportionately affect women, it remains unclear to what extent digital interventions address gender-specific pathways of ED risk. This review synthesizes evidence from digital ED interventions targeting women and contextualizes these findings within the broader digital intervention literature. A systematic search (01/2015–10/2025) across PubMed, Scopus, and PsycINFO identified 247 records; 24 studies met criteria for the women-focused synthesis, and 81 additional studies, including six meta-analyses, were examined for context. Across prevention and treatment studies, digital interventions showed consistent short-term reductions in ED psychopathology, binge eating, and associated distress. However, explicit gender-tailoring was rare despite predominantly female samples. Interventions seldom incorporated women-specific risk mechanisms such as thin-ideal internalization, compulsive exercise, or appearance-related pressures, and few studies reported gender-specific outcomes. Taken together, the findings reveal a persistent gap between the gendered nature of ED risk and the largely gender-neutral design of current digital interventions. A women-centered digital health agenda is needed to strengthen gender-responsive content, design, delivery, and evaluation.
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Paper Nr: 14
Title:

Menstrual Cycle Tracking at Scale: Scientific Evidence behind the Top 15 Funded Digital Menstrual Tracking Companies
Authors:

Lavinia Moretti, Sophie Paci, Davinny Sou, Tobias Kowatsch and Marcia Nißen
Abstract: Digital health technologies (DHTs) are transforming healthcare by enabling data-driven, personalized, and scalable management. Within this domain, Femtech – technologies supporting women’s health – has expanded rapidly, yet menstrual health remains underrepresented in research and practice. Menstrual cycle tracking technologies (MCTs) are widely used for monitoring cycles, fertility, and symptoms, but most rely on manual entry and lack clinical validation. This study maps the top-funded digital MCT companies (n=15) and assesses supporting evidence. Companies were classified per the Digital Therapeutics Alliance framework: Digital Diagnostics (40%), Health & Wellness (27%), Patient Monitoring (20%), and Care Support (13%), with none providing Digital Therapeutics. Across 24 publications, evidence was weak predominately consisting of descriptive studies, expert opinions, or reports from expert panels. The literature largely focused on healthy users and emphasized ovulation detection or education. Findings reveal misalignment between disease-oriented DHT taxonomies and menstrual health, overemphasis on fertility/reproduction, and a gap between investment and validation. These results underscore the need for rigorous validation, inclusive design, and flexible classification to realize MCTs’ potential in self-management, clinical support, and broader women’s health outcomes.
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Nr: 45
Title:

MARI: Co-Produced Digital Alcohol Intervention Tailored for Women Who Are Trying to Conceive, Pregnant, or Parenting
Authors:

Abi Rose
Abstract: Alcohol consumption during preconception, pregnancy, and early parenting stages poses significant health risks for women and their children. Yet this is a hidden health issue, attached to significant stigma, and existing interventions often fail to meet the nuanced needs of women in these life stages. This gap underscores the need for digital health solutions that are not only evidence-based but also responsive to the unique experiences and challenges faced by women in these stages. The MARI (Maternal Alcohol Resources & Information) intervention aims to address this need by offering a co-produced, scalable digital alcohol intervention tailored for women who are trying to conceive (TTC), pregnant, or parenting. MARI combines established behavioural change techniques (BCTs) with engaging, user-centred wellbeing tools and personal stories from women. Our coproduction approach is grounded in the lived experiences of women from a variety of backgrounds, ensuring the intervention resonates with and is accessible to a wide range of users. By incorporating diverse therapeutic components, MARI aims to increase engagement, trust, and adherence. MARI integrates digital tools for self-monitoring and goal-setting, as well as promoting awareness and reflection, thus empowering women to make informed decisions about their health and alcohol consumption. This intervention employs an intersectional design framework to address the complexities of gender, health, and social factors that influence alcohol consumption patterns in these key stages of women’s lives. Through a focus on co-design, the intervention is able to ensure that the content is not only evidence-based but also relevant to the lived realities of women in varying contexts. The inclusion of personal narratives from women helps bridge the gap between scientific evidence and personal experience, fostering a sense of community and shared understanding among users. MARI’s coproduction process and user-centred design also align with best practices in the development of scalable digital health tools. By emphasizing flexibility in content delivery and accessibility, MARI can be adapted to different settings (e.g. online, healthcare, prison/probation) making it a potentially powerful tool for addressing alcohol-related harm among women across diverse populations. Furthermore, the inclusion of real-world data on user engagement and outcomes can inform ongoing improvements to the intervention, ensuring that it evolves to meet emerging needs. MARI's potential for scalability and impact is grounded in its combination of well-established BCTs, culturally relevant content, and a flexible digital delivery model. As digital health tools continue to grow in popularity, MARI represents an innovative step forward in integrating behavioural change, user experience, and health equity in the design of women’s health interventions. This abstract will highlight key lessons learned from MARI’s coproduction process, discuss its alignment with the principles of intersectional design, and explore how the intervention can be scaled to diverse populations. The presentation will provide insights into how digital interventions can be co-designed and scaled to meet the diverse needs of women, offering valuable takeaways for researchers, practitioners, and policymakers looking to advance digital women’s health. MARI is funded by the National Institute of Health Research (NIHR207252)
Short Papers
Paper Nr: 7
Title:

An Ethical Approach to Co-Designing Scalable Digital Health Interventions for Vulnerable Populations
Authors:

Rasita Vinay and Tobias Kowatsch
Abstract: Digital health interventions (DHIs) have expanded rapidly across prevention, care, and self-management, yet their development often excludes populations most affected by health inequities, including older adults, women (including people assigned female at birth), individuals with cognitive decline, and people with low socioeconomic status (SES). This paper proposes an Ethical Co-Design Framework that integrates principles from Ethics by Design, Value-Sensitive Design, and the Assessment List for Trustworthy AI. The framework outlines a continuous cycle of ethical framing, participatory engagement, evaluation and accountability, and iterative reflexivity, offering a practical method for embedding ethical reflection throughout the innovation lifecycle, to enhance DHI scalability. To illustrate its application, the paper presents two early-stage case studies: GRACE, a voice-based conversational agent for people with early dementia, and PreDiaTx, a GenAI-powered precision digital therapeutic for type-2 diabetes prevention among women, older adults and low-SES groups. Across both cases, ethics emerges not as a constraint but as an enabler of inclusive, context-sensitive and trustworthy design. The paper argues that ethical co-design provides a replicable pathway for aligning DHI development with the needs and values of vulnerable populations and calls for organisational and policy structures that embed ethical co-design as a standard component of scalable digital health innovation.
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Paper Nr: 12
Title:

Barriers to Implementing and Scaling Wearable Technologies in Women’s Health: Perspectives from a Gynaecologist in Switzerland
Authors:

Alina Liebich, Lucia Mauz and Tobias Kowatsch
Abstract: Women in the EU tend to live longer than men but often spend more years in poor health, mainly due to diagnostic delays and barriers to care, especially in sexual and reproductive health. These gaps are intensified by women’s underrepresentation in clinical research, which results in less accurate diagnostics and treatments. To achieve gender equality in health, in line with the United Nations Sustainable Development Goals, there is a need for innovation in medical technology and research. Wearable-based digital health applications can enhance access, enable monitoring, and support personalized treatment for conditions like endometriosis, polycystic ovary syndrome, menopause, and maternal health. However, challenges like limited healthcare professional engagement impede their widespread adoption. This paper explores the main barriers to integrating wearables into gynaecological practice, using data obtained from an in-depth, semi-structured interview with a gynaecologist. Results indicate that several barriers currently prevent scaling digital women’s health, including a lack of scientific evidence for the technology, concerns about device reliability and data security, limited reimbursement, and inadequate IT infrastructure.
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