Design for eHealth Equity

Abstract

The impact of socioeconomic position (SEP) on health in our society is evident. Chronic illnesses disproportionately affect individuals with low SEP, exacerbating the healthcare burden for both themselves and society at large. While a healthy lifestyle is crucial for disease prevention, engagement in this behavior is often limited within these groups. eHealth interventions, which could help these individuals adopt healthier lifestyles, typically follow a one-size-fits-all approach that favors higher SEP individuals, inadvertently widening the health gap. To address this issue, this dissertation presents the Inclusive eHealth Guide (IeG), a comprehensive tool developed through participatory methods to tailor eHealth interventions to the specific needs, skills, and preferences of low SEP individuals. The dissertation is organized into three parts.

Part A investigates the attitudes of low SEP individuals toward health, healthcare, and eHealth, revealing diverse needs that challenge the stereotype of unwillingness to engage in health-promoting activities and highlighting the potential of participatory design to meet these needs. Part B details the development of the IeG, synthesizing bottom-up insights from community engagement with top-down professional perspectives to create a practical resource for equitable eHealth design. Part C illustrates the application of the IeG in developing a tailored eHealth intervention for patients with low SEP in cardiac rehabilitation.

Ultimately, this work contributes to narrowing the health gap by identifying different SEP subgroups that require distinct approaches. Furthermore, the IeG serves as a practical tool to help eHealth professionals align their interventions with the needs of the target group. Finally, we outline key implications for the successful design of equitable eHealth solutions in the future.