190 Summary The impact of socioeconomic position (SEP) —encompassing income, education level, and occupation—on health is clear. Chronic illnesses such as heart disease, diabetes, and obesity disproportionately affect those in lower socioeconomic groups, leading to prolonged healthcare needs that burden both individuals and society. Although healthy lifestyle behaviors like regular physical activity and a balanced diet are crucial for disease prevention, research consistently shows that these behaviors are less prevalent among lower socioeconomic groups. As the costs of managing chronic illnesses rise, eHealth interventions have emerged as a potential solution. However, these interventions often require digital skills and proactive health attitudes that are not universally available across all socioeconomic levels. Too often, eHealth solutions are developed with a one-size-fits-all approach, catering primarily to the high health-literate and motivated, inadvertently widening the health gap instead of narrowing it. Bottom-up, participatory approaches offer a transformative outlook on tailoring eHealth interventions to the unique needs, skills, and preferences of individuals with a low SEP by involving them directly in the design process. Yet, professionals often encounter hurdles such as low health literacy and cultural disparities when engaging these groups. While the scientific community is gaining insights into these barriers, actionable guidance remains scarce. Thus, there is an urgent call for a comprehensive tool integrating known barriers and facilitators to steer the equitable design of eHealth interventions for individuals with a low SEP. This dissertation presents the development of such a tool for professionals. It unfolds across three key sections: Part A delves into knowledge inquiry, Part B focuses on tool development, and Part C illustrates its application in a real-world setting. Part A: Knowledge Inquiry In this part of the dissertation, we delve into the critical knowledge gaps: why eHealth interventions often fall short for individuals with a low SEP, and how participatory design could be leveraged to engage this group in the design process. In Chapter 2, we delve into the attitudes of individuals with a low SEP toward health, healthcare, and eHealth, to better understand their reasons for (not) engaging in healthpromoting activities and eHealth interventions. Rather than observing from a distance, we embraced a community-based participatory research approach, actively involving the target group in the process. Through this collaborative effort, we uncovered nine
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