Guide Development for eHealth Interventions Targeting People With a Low Socioeconomic Position: Participatory Design Approach

Journal of Medical Internet Research, vol. 25, pp. e48461

Abstract

BACKGROUND: People with a low socioeconomic position (SEP) are less likely to benefit from eHealth interventions, exacerbating social health inequalities. Professionals developing eHealth interventions for this group face numerous challenges. A comprehensive guide to support these professionals in their work could mitigate these inequalities. OBJECTIVE: We aimed to develop a web-based guide to support professionals in the development, adaptation, evaluation, and implementation of eHealth interventions for people with a low SEP. METHODS: This study consisted of 2 phases. The first phase involved a secondary analysis of 2 previous qualitative and quantitative studies. In this phase, we synthesized insights from the previous studies to develop the guide's content and information structure. In the second phase, we used a participatory design process. This process included iterative development and evaluation of the guide's design with 11 professionals who had experience with both eHealth and the target group. We used test versions (prototypes) and think-aloud testing combined with semistructured interviews and a questionnaire to identify design requirements and develop and adapt the guide accordingly. RESULTS: The secondary analysis resulted in a framework of recommendations for developing the guide, which was categorized under 5 themes: development, reach, adherence, evaluation, and implementation. The participatory design process resulted in 16 requirements on system, content, and service aspects for the design of the guide. For the system category, the guide was required to have an open navigation strategy leading to more specific information and short pages with visual elements. Content requirements included providing comprehensible information, scientific evidence, a user perspective, information on practical applications, and a personal and informal tone of voice. Service requirements involved improving suitability for different professionals, ensuring long-term viability, and a focus on implementation. Based on these requirements, we developed the final version of "the inclusive eHealth guide." CONCLUSIONS: The inclusive eHealth guide provides a practical, user-centric tool for professionals aiming to develop, adapt, evaluate, and implement eHealth interventions for people with a low SEP, with the aim of reducing health disparities in this population. Future research should investigate its suitability for different end-user goals, its external validity, its applicability in specific contexts, and its real-world impact on social health inequality.

Authors 11

1. Jasper S Faber

   Delft University of Technology

   Affiliation as printed

   Department of Human-Centered Design, Delft University of Technology, Delft, Netherlands

2. Isra Al-Dhahir Aachen Faculty of Social and Behavioral Sciences

   Leiden University

   Affiliation as printed

   Faculty of Social and Behavioral Sciences, Leiden University, Leiden, Netherlands

3. Jos Johannes Kraal

   Delft University of Technology

   Affiliation as printed

   Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands

4. Linda D. Breeman Aachen Faculty of Social and Behavioral Sciences

   Leiden University

   Affiliation as printed

   Faculty of Social and Behavioral Sciences, Leiden University, Leiden, Netherlands

5. Rita J. G. van den Berg-Emons

   Erasmus MC · Capri Hartrevalidatie

   Affiliation as printed

   Capri Cardiac Rehabilitation, Rotterdam, Netherlands

   Department of Rehabilitation Medicine, Erasmus MC, Rotterdam, Netherlands

6. Thomas Reijnders Aachen Faculty of Social and Behavioral Sciences

   Leiden University

   Affiliation as printed

   Faculty of Social and Behavioral Sciences, Leiden University, Leiden, Netherlands

7. Veronica R. Janssen Aachen Department of Cardiology, Leiden University Medical Center Faculty of Social and Behavioral Sciences

   Leiden University · Leiden University Medical Center

   Affiliation as printed

   Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands

   Faculty of Social and Behavioral Sciences, Leiden University, Leiden, Netherlands

8. Roderik A. Kraaijenhagen
   Affiliation as printed

   NDDO Institute for Prevention and Early Diagnostics, Amsterdam, Netherlands

   Vital10, Amsterdam, Netherlands

9. Valentijn Visch

   Delft University of Technology

   Affiliation as printed

   Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands

10. Niels Henrik Chavannes Aachen Department of Public Health and Primary Care (PHEG)

    Leiden University · Leiden University Medical Center

    Affiliation as printed

    Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands

11. Andrea W.M. Evers Aachen Faculty of Social and Behavioral Sciences Medical Delta

    Leiden University · Medical Delta · Delft University of Technology

    Affiliation as printed

    Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands

    Faculty of Social and Behavioral Sciences, Leiden University, Leiden, Netherlands

    Medical Delta, Leiden University, Delft University of Technology, Erasmus University, Delft, Netherlands