4 Guide development for eHealth interventions targeting people with a low socioeconomic position 69 4.1 Introduction Global progress in improving health has been challenging. For example, the burden of noncommunicable chronic diseases, such as cardiovascular disease, diabetes, and obesity, is higher among racial, ethnic, and lower socioeconomic (below-average occupational position, educational level, and income) groups (Adler & Stewart, 2010; Drewnowski et al., 2014; Latulipe et al., 2015; Mackenbach et al., 2008; Shishehbor et al., 2006). A low socioeconomic position (SEP) is associated with a higher prevalence of unhealthy lifestyles compared to a high SEP (Pampel et al., 2010; Schultz et al., 2018; Stringhini et al., 2010). A large segment of our society comprises people with a low SEP. For instance, in the Netherlands in 2019, there were 574,000 households with incomes below the low-income threshold, accounting for 7.7% of all households (CBS, 2021). Studies suggest that people with a low SEP face many challenges that impact their health (Pampel et al., 2010; Teuscher et al., 2015). For example, people with a low SEP may have low literacy or live in poverty under stressful conditions such as money-related stress, unfavorable work environments, or unemployment (Heutink et al., 2010). Various efforts have been made to reduce the incidence of noncommunicable chronic diseases in current societies through lifestyle change, including the use of eHealth interventions. eHealth interventions, such as monitoring devices, web-based communication platforms, and persuasive applications, have proven effective in changing behavior and promoting a healthy lifestyle when tailored appropriately toward the needs and preferences of the individual (Kelders et al., 2012; van Gemert-Pijnen et al., 2011). The use of smartphones and social media is not exclusive to people with a high SEP. These technologies have gained acceptance among people with a low SEP, particularly among less educated working young adults (Simons et al., 2018). Recognition of the benefits of eHealth for lower-SEP groups is growing (Brown et al., 2014; Latulippe et al., 2017; Lee et al., 2022; van Gemert-Pijnen et al., 2011). Many studies acknowledge that tailoring eHealth interventions to specific needs improves patient engagement and leads to more durable behavior changes (Kelders et al., 2012; van Gemert-Pijnen et al., 2011). People with a low SEP can particularly benefit from the asynchronous communication and multimedia patient education provided by eHealth (Evers et al., 2014), as they report lower satisfaction with patient-provider communication than those with a higher SEP (DeVoe et al., 2009). eHealth also has the potential to improve access to care (McMaughan et al., 2020) by reducing barriers such as the need for long-distance travel and its costs and allowing for personalized consideration of social, economic, and physical factors that may impact their lifestyle (Yardley et al., 2016). Finally, information individualized toward a person’s level of health literacy can improve knowledge and be
RkJQdWJsaXNoZXIy MTk4NDMw