Chapter 7 140 7.4.3 Implications for intervention design and design process Applying the IeG in the design process yielded results that brought forth several implications for designing equitable eHealth interventions for both the design of the intervention itself and the overall design process that need to be discussed. 7.4.3.1 Resources Regarding the design process, a central challenge in designing eHealth solutions for lowSEP groups, as posed by this dissertation, is the insufficient resource allocation dedicated to the involvement of these groups. This has several implications for the future of design for eHealth equity. One possible future pathway is for projects to allocate sufficient resources to work on inclusivity from the outset of a project. This can, for example, involve creating specific work packages dedicated to participatory design and research, emphasizing enduser and stakeholder input to tailor interventions to diverse user needs. Another pathway could be reconsidering the traditional resource distribution model, which often emphasizes assessing effectiveness using large-scale randomized controlled trials and overlooks the crucial initial phase of participatory, bottom-up research. Early user involvement in the development of digital interventions ensures the usability and real-world relevance of the intervention (van Gemert-Pijnen et al., 2011). Given their smaller scale, participatory approaches could concentrate resources on inclusivity and aligning interventions to meet diverse user needs. This then sets a solid foundation for future, more extensive trials, balancing scientific rigor and user-centric design. 7.4.3.2 Participatory design One of the main themes throughout this dissertation has been the role of participatory design in designing eHealth with and for people with a low SEP. Traditionally, the design of these interventions relied on methods that typically involve top-down approaches, with a focus on evidence development, standardized research procedures, and limited enduser engagement. These traditional methods have predominantly been oriented toward higher SEP groups, resulting in a misalignment with the needs of low-SEP populations. This misalignment stems from several limitations in conventional approaches. For example, these approaches often have limited flexibility to adjust research activities to the unique needs and constraints of participants with a low SEP, such as lower digital and health literacy levels. Additionally, traditional methods often face recruitment challenges, relying on passive strategies that attract a self-selecting group of motivated and available participants. Furthermore, traditional approaches prioritize effectiveness,
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