7 General Discussion 147 Another limitation of this dissertation is the interpretability of the findings relating to the IeG. While we showed valuable pragmatic lessons learned and found that the target group accepted and adhered to the resulting intervention, attributing these findings solely to the IeG’s influence would overlook other contributing factors. My empathy for the target group developed through earlier community-based and participatory design work likely played an important role in the commencement of the approaches and design decisions. My intrinsic connection with the IeG’s development may have also introduced a bias that could influence my evaluation of its utility. Addressing this, less-biased, systematic approaches could be suggested, where the IeG’s efficacy is assessed by different designers in diverse contexts through multiple case studies. However, isolating the IeG’s efficacy as a singular contributing factor to successful interventions could be inherently challenging considering the complexity and heterogeneity imperative to design cases. One must question whether the objective should be to prove the IeG’s efficacy or to continue refining it through action cycles and case studies, thus enriching it with practical knowledge and sustaining its immediate impact on healthcare practice. My inclination is toward the latter, favoring an iterative approach that prioritizes direct contributions to the field over definitive studies about its efficacy. Finally, a notable limitation of this study is the challenge of conclusively assessing the effects of the developed eHealth intervention. The feasibility design of our study meant that there were several methodological constraints that could affect the validity and generalizability of the results (e.g., single center and small sample size). This means that the results should be considered as suggestive rather than conclusive. This limitation should also be taken into account when considering our claims about the value of the IeG. Nevertheless, we have gathered promising insights regarding the intervention’s acceptance and adherence and preliminary indications of its potential effects, which are invaluable for its further development. Notably, the enthusiasm shown by the CR center to proceed with the direct implementation and further refinement of the intervention marks a successful initial phase in its overall development and implementation process. For a designer, establishing such a proof-of-concept is crucial, as it lays the groundwork for more comprehensive and rigorous evaluations of the intervention’s (cost) effectiveness in future stages. 7.6 Future directions This section discusses the future directions to shape the trajectory of eHealth equity research. First, we will discuss the future evolution, implementation, and dissemination of the IeG. Second, we delve into reflections on academic research directions that hold promise for advancing our understanding of eHealth equity.
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