Chapter 7 132 7.1 Part A – Knowledge inquiry: Attitudes and participatory design 7.1.1 Main findings In part A, we aimed to contribute to design knowledge for eHealth equity by addressing two knowledge gaps. First, in Chapter 2, we examined the attitudes of people with a low SEP toward adopting health-promoting behavior and using eHealth solutions for this purpose. Approximately half of the participants exhibited what we have termed an “Optimistically Engaged” attitude, suggesting that a considerable portion of the target group has a positive attitude toward engaging with eHealth to improve health. However, the study also uncovered a spectrum of attitudes toward health, healthcare, and eHealth, suggesting that designers must thoroughly grasp and carefully tailor eHealth interventions to varied perspectives within the low-SEP target group. Specifically, people with a “Doubtfully Disadvantaged” attitude are expected to gain the most from eHealth interventions that better align with their needs. This is because they are generally open to using eHealth for health improvement but face insecurities and barriers that could be addressed through thoughtful and inclusive eHealth design. In pursuit of the second knowledge gap, Chapter 3 delves into the potential of participatory design methods in actively engaging individuals with low health literacy – a common challenge among groups with a low SEP – in the design process of an eHealth intervention. We suggest that participatory design has the potential not only to facilitate reciprocal communication but also to help diminish stigma and empower participants to discuss future technologies. Co-constructing stories, experience prototype exhibition, and video prototype evaluation emerged as valuable methods. Nonetheless, there still is an urgent need for clear, practical guidelines to effectively apply participatory design techniques together with and for people with a low SEP. 7.1.2 Discussion In our initial hypothesis, we expected that individuals with a low SEP might exhibit less favorable attitudes toward health, healthcare, and eHealth, potentially limiting the effectiveness of eHealth interventions within these groups. It is commonly understood that health behavior strategies employed in eHealth interventions, like goal-setting and self-monitoring, require a certain willingness to change (Hardcastle et al., 2015). However, our findings introduce a more nuanced perspective. We discovered that around three-quarters of the individuals with a low SEP in our study, categorized as either “Optimistically Engaged” or “Doubtfully Disadvantaged,” showed a willingness to
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