{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T15:38:52Z","timestamp":1792510732116,"version":"4.5.0"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":57,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"WHO Regional Office for Europe under an Agreement for Performance of Work","id":[{"id":"https:\/\/ror.org\/01rz37c55","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Digital health is increasingly promoted to address rural health and care workforce shortages. However, its workforce consequences are usually evaluated through implementation or service-delivery outcomes rather than the conditions that enable rural workers to remain, develop, and practice sustainably. We conducted a Joanna Briggs Institute-informed scoping review reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. The protocol was prospectively registered on the Open Science Framework. Five databases were searched for studies published between 2015 and 2025 in English, Spanish, and Portuguese. Two reviewers independently screened records and charted data using a prespecified framework. Synthesized entries were verified against full texts, with disagreements resolved by a third reviewer. Fifty-five sources were included. Telehealth or telemedicine was the most common intervention, followed by tele-education or distance education and multicomponent interventions. Direct retention or workforce-stability outcomes were uncommon, whereas most outcomes concerned proximal determinants of retention or implementation-related sustainability. Digital interventions most frequently influenced professional connection, supervision, continuing education, clinical confidence, and workflow support. Interpretive synthesis identified four workforce redistribution pathways (labor, authority, dependency, and infrastructure risk) through which interventions may strengthen or undermine rural workforce sustainability. Current evidence concerns retention pathways more than retention effects. Digital health should therefore be evaluated as a sociotechnical workforce intervention, extending beyond implementation success to examine how interventions redistribute labor, authority, dependency, and infrastructure risk across rural health systems.<\/jats:p>","DOI":"10.1093\/eurpub\/ckag177","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T19:34:24Z","timestamp":1789673664000},"source":"Crossref","is-referenced-by-count":0,"title":["Digital health and rural health workforce retention: mapping workforce retention pathways"],"prefix":"10.1093","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6015-3314","authenticated-orcid":false,"given":"Tiago","family":"Correia","sequence":"first","affiliation":[{"name":"Global Health and Tropical Medicine (GHTM), LA-REAL, Instituto de Higiene e Medicina Tropical (IHMT), Universidade NOVA de Lisboa , Lisboa,","place":["Portugal"]},{"name":"WHO Collaborating Centre on Health Workforce Policies and Planning, Instituto de Higiene e Medicina Tropical (IHMT), NOVA University Lisbon , Lisbon,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7807-3520","authenticated-orcid":false,"given":"Tomas","family":"Zapata","sequence":"additional","affiliation":[{"name":"WHO Regional Office for Europe , Copenhagen,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4366-4566","authenticated-orcid":false,"given":"Sulakshana","family":"Nandi","sequence":"additional","affiliation":[{"name":"WHO Regional Office for Europe , Copenhagen,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9756-0984","authenticated-orcid":false,"given":"David","family":"Novillo-Ortiz","sequence":"additional","affiliation":[{"name":"WHO Regional Office for Europe , Copenhagen,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3002-1075","authenticated-orcid":false,"given":"James","family":"Buchan","sequence":"additional","affiliation":[{"name":"WHO Collaborating Centre for Nursing, Midwifery and Health Development, University of Technology , Sydney,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3024-9726","authenticated-orcid":false,"given":"Shirin","family":"Kiani","sequence":"additional","affiliation":[{"name":"WHO Regional Office for Europe , Copenhagen,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1585-4452","authenticated-orcid":false,"given":"Cathal","family":"Morgan","sequence":"additional","affiliation":[{"name":"WHO Regional Office for Europe , Copenhagen,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1424-7309","authenticated-orcid":false,"given":"Margrieta","family":"Langins","sequence":"additional","affiliation":[{"name":"WHO Regional Office for Europe , Copenhagen,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9868-3855","authenticated-orcid":false,"given":"Anabela da Concei\u00e7\u00e3o","family":"Pereira","sequence":"additional","affiliation":[{"name":"Global Health and Tropical Medicine (GHTM), LA-REAL, Instituto de Higiene e Medicina Tropical (IHMT), Universidade NOVA de Lisboa , Lisboa,","place":["Portugal"]},{"name":"WHO Collaborating Centre on Health Workforce Policies and Planning, Instituto de Higiene e Medicina Tropical (IHMT), NOVA University Lisbon , Lisbon,","place":["Portugal"]},{"name":"Cies-Iscte, Instituto Universit\u00e1rio de Lisboa , Lisbon,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6135-0747","authenticated-orcid":false,"given":"Andr\u00e9","family":"Beja","sequence":"additional","affiliation":[{"name":"Global Health and Tropical Medicine (GHTM), LA-REAL, Instituto de Higiene e Medicina Tropical (IHMT), Universidade NOVA de Lisboa , Lisboa,","place":["Portugal"]},{"name":"WHO Collaborating Centre on Health Workforce Policies and Planning, Instituto de Higiene e Medicina Tropical (IHMT), NOVA University Lisbon , Lisbon,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9537-7895","authenticated-orcid":false,"given":"Roberto","family":"Esteves","sequence":"additional","affiliation":[{"name":"WHO Collaborating Centre on Health Workforce Policies and Planning, Instituto de Higiene e Medicina Tropical (IHMT), NOVA University Lisbon , Lisbon,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0043-8785","authenticated-orcid":false,"given":"Rita","family":"Morais","sequence":"additional","affiliation":[{"name":"Global Health and Tropical Medicine (GHTM), LA-REAL, Instituto de Higiene e Medicina Tropical (IHMT), Universidade NOVA de Lisboa , Lisboa,","place":["Portugal"]},{"name":"WHO Collaborating Centre on Health Workforce Policies and Planning, Instituto de Higiene e Medicina Tropical (IHMT), NOVA University Lisbon , Lisbon,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3695-0537","authenticated-orcid":false,"given":"M\u00e9lanie","family":"Maia","sequence":"additional","affiliation":[{"name":"Global Health and Tropical Medicine (GHTM), LA-REAL, Instituto de Higiene e Medicina Tropical (IHMT), Universidade NOVA de Lisboa , Lisboa,","place":["Portugal"]},{"name":"WHO Collaborating 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