Chapter 7 136 7.3.2 Discussion The lessons learned emerging from applying the IeG should be discussed in relation to existing literature. The challenge of managing resources in eHealth for low-SEP projects is also confirmed by recent studies (Al-Dhahir et al., 2022). The significance of participatory design in involving populations with a low SEP still needs to be explored. A limited number of studies have documented this process, yielding promising outcomes in engagement (Gordon et al., 2016) and self-management (Salim et al., 2021). Therefore, it will be necessary to study the potential of this area further. Although there is a broad consensus in the literature regarding the importance of good usability for engaging low-SEP groups (Lee et al., 2022), simplicity receives less emphasis. Researchers frequently advocate incorporating more BCTs rather than fewer (Michie et al., 2013). While integrating multiple BCTs has the potential to enhance the effectiveness of an intervention, its success ultimately hinges on whether it is utilized as intended. Regarding personalization, while the body of literature highlighting its value in eHealth design is growing (Car et al., 2017; Conway et al., 2017), there appears to be a need for more research explicitly addressing its importance for low-SEP groups. Personalization in eHealth interventions may be particularly valuable for these groups, as it ensures that the content, delivery methods, and BCTs are tailored to their unique circumstances and needs. In our feasibility study described in Chapter 6, we hypothesized that, facilitated by the recommendations of the IeG, we would be able to develop an intervention that was both adhered to and accepted by the target group. The results indicate that our intervention met these expectations. The finding about favorable adherence stands in contrast to the prevailing trends, which document generally low adherence rates to eHealth interventions among people with a low SEP (Arsenijevic et al., 2020; Reiners et al., 2019). This contrast could be attributed to applying the recommendations in the IeG. Our findings on acceptance do align with existing literature, which indicates that acceptance rates might be similar for individuals with low and high SEP (Beuningen, 2019; Patel et al., 2011). Regardless of SEP, it is important to acknowledge the inherent risk that any eHealth intervention may not be accepted by its target audience (Barello et al., 2015). However, by engaging in a participatory design process and following the recommendations in the IeG, we developed an intervention that was well-accepted by our target group. 7.4 Implications In this section, we transition from theoretical discussions to practical implications based on the findings presented in this dissertation. We discuss the implications based on the three parts of this dissertation: addressing diversity in needs (Chapter 2), reconsidering
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