A multi-stakeholder approach to eHealth development: Promoting sustained healthy living among cardiovascular patients
International Journal of Medical Informatics, vol. 147, pp. 104364
Abstract
BACKGROUND: Healthy living is key in the prevention and rehabilitation of cardiovascular disease (CVD). Yet, supporting and maintaining a healthy lifestyle is exceptionally difficult and people differ in their needs regarding optimal support for healthy lifestyle interventions. OBJECTIVE: The goals of this study were threefold: to uncover stakeholders' needs and preferences, to translate these to core values, and develop eHealth technology based on these core values. Our primary research question is: What type of eHealth application to support healthy living among people with (a high risk of) CVD would provide the greatest benefit for all stakeholders? METHODS: User-centered design principles from the CeHRes roadmap for eHealth development were followed to guide the uncovering of important stakeholder values. Data were synthesized from various qualitative studies (i.e., literature studies, interviews, think-aloud sessions, focus groups) and usability tests (i.e., heuristic evaluation, cognitive walkthrough, think aloud study). We also developed an innovative application evaluation tool to perform a competitor analysis on 33 eHealth applications. Finally, to make sure to take into account all end-users needs and preferences in eHealth technology development, we created personas and a customer journey. RESULTS: We uncovered 10 universal values to which eHealth-based initiatives to support healthy living in the context of CVD prevention and rehabilitation should adhere to (e.g., providing social support, stimulating intrinsic motivation, offering continuity of care). These values were translated to 14 desired core attributes and then prototype designs. Interestingly, we found that the primary attribute of good eHealth technology was not a single intervention principle, but rather that the technology should be in the form of a digital platform disseminating various interventions, i.e., a 'one-stop-shop'. CONCLUSION: Various stakeholders in the field of cardiovascular prevention and rehabilitation may benefit most from utilizing one personalized eHealth platform that integrates a variety of evidence-based interventions, rather than a new tool. Instead of a one-size-fits-all approach, this digital platform should aid the matchmaking between patients and specific interventions based on personal characteristics and preferences.
Authors 13
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Affiliation as printed
Health, Medical, and Neuropsychology Unit, Leiden University, The Netherlands. Electronic address: L.D.Breeman@fsw.leidenuniv.nl
Health, Medical, and Neuropsychology Unit, Leiden University, The Netherlands
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Affiliation as printed
Health, Medical, and Neuropsychology Unit, Leiden University, The Netherlands. Electronic address: M.Keesman@fsw.leidenuniv.nl
Health, Medical, and Neuropsychology Unit, Leiden University, The Netherlands
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Leiden University Medical Center
Affiliation as printed
Department of Cardiology, Leiden University Medical Center, The Netherlands. Electronic address: D.E.Atsma@lumc.nl
Department of Cardiology, Leiden University Medical Center, The Netherlands
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Leiden University Medical Center
Affiliation as printed
Department of Public Health and Primary Care, Leiden University Medical Center, The Netherlands. Electronic address: N.H.Chavannes@lumc.nl
Department of Public Health and Primary Care, Leiden University Medical Center, The Netherlands
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Veronica R. Janssen Aachen Department of Cardiology, Leiden University Medical Center Health Neuropsychology Unit
Leiden University · Leiden University Medical Center
Affiliation as printed
Health, Medical, and Neuropsychology Unit, Leiden University, The Netherlands; Department of Cardiology, Leiden University Medical Center, The Netherlands. Electronic address: V.R.Janssen@lumc.nl
Department of Cardiology, Leiden University Medical Center, The Netherlands
Health, Medical, and Neuropsychology Unit, Leiden University, The Netherlands
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Máxima Medisch Centrum · Eindhoven University of Technology
Affiliation as printed
Department of Cardiology, Máxima Medical Center Veldhoven, The Netherlands; Department of Industrial Design, Eindhoven University of Technology, The Netherlands. Electronic address: H.Kemps@mmc.nl
Department of Cardiology, Máxima Medical Center Veldhoven, The Netherlands
Department of Industrial Design, Eindhoven University of Technology, The Netherlands
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Affiliation as printed
Leiden Institute for Advanced Computer Science, Leiden University, The Netherlands. Electronic address: W.Kraaij@liacs.leidenuniv.nl
Leiden Institute for Advanced Computer Science, Leiden University, The Netherlands
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Affiliation as printed
Health, Medical, and Neuropsychology Unit, Leiden University, The Netherlands. Electronic address: F.Rauwers@BB.leidenuniv.nl
Health, Medical, and Neuropsychology Unit, Leiden University, The Netherlands
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Affiliation as printed
Health, Medical, and Neuropsychology Unit, Leiden University, The Netherlands. Electronic address: T.Reijnders@fsw.leidenuniv.nl
Health, Medical, and Neuropsychology Unit, Leiden University, The Netherlands
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Amsterdam UMC Location University of Amsterdam · Amsterdam University of Applied Sciences
Affiliation as printed
Department of Cardiology, Academic Medical Center, The Netherlands; Faculty of Health, Amsterdam University of Applied Sciences, The Netherlands. Electronic address: w.j.scholteopreimer@amsterdamumc.nl
Department of Cardiology, Academic Medical Center, The Netherlands
Faculty of Health, Amsterdam University of Applied Sciences, The Netherlands
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Affiliation as printed
Centre for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, the Netherlands. Electronic address: M.J.Wentzel@utwente.nl
Centre for eHealth and Wellbeing Research, Department of Psychology, Health and Technology, University of Twente, the Netherlands
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Affiliation as printed
Vital10, Amsterdam, The Netherlands; NDDO Institute for Prevention and Early Diagnostics (NIPED), Amsterdam, The Netherlands. Electronic address: Roderik.Kraaijenhagen@cardiovitaal.nl
NDDO Institute for Prevention and Early Diagnostics (NIPED), Amsterdam, The Netherlands
Vital10, Amsterdam, The Netherlands
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Leiden University · Delft University of Technology
Affiliation as printed
Health, Medical, and Neuropsychology Unit, Leiden University, The Netherlands; Healthy Society, Medial Delta, Leiden University, TU Delft, Erasmus University, The Netherlands. Electronic address: A.Evers@fsw.leidenuniv.nl
Health, Medical, and Neuropsychology Unit, Leiden University, The Netherlands
Healthy Society, Medial Delta, Leiden University, TU Delft, Erasmus University, The Netherlands
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