5 Application of the Inclusive eHealth Guide during the development of an eHealth intervention for and with cardiac patients with a low socioeconomic position 93 5.1 Introduction Individuals with a low socio-economic position (SEP) tend to have higher rates of unhealthy behavior compared to those with a high SEP, which puts them at increased risk for chronic conditions such as cardiovascular disease, diabetes, and obesity (Mackenbach et al., 2008; Psaltopoulou et al., 2017; Rosengren et al., 2019; Schultz et al., 2018; Stringhini et al., 2010). While eHealth interventions like monitoring devices, online platforms, and serious games have shown to be effective in promoting healthy lifestyles in various populations, they are generally less successful in people with a low SEP, often due to low acceptance and adoption rates (Kontos et al., 2014; Reiners et al., 2019). A crucial factor in the success of eHealth interventions, especially for people with a low SEP, is aligning their design and design process (e.g., recruitment strategies, and design activities) with the needs, skills, and preferences of the target group (Kerkhoff et al., 2022; Lee et al., 2022). An intervention that requires extensive digital skills to be operated, will be abandoned by those inexperienced with digital devices (Sieck et al., 2021). Likewise, an intervention that provides complex and textual descriptions will disengage those with lower literacy levels (Estacio et al., 2019), and an intervention that requires active self-monitoring and goal-setting will not be adopted by those with lower motivation or other priorities (Coupe et al., 2018; Faber et al., 2021; Heutink et al., 2010). However, to develop understanding of and tailor interventions toward the needs, skills, and preferences of the target group also poses challenges. Designers and developers often come from different socio-economic, cultural, or professional backgrounds than the target group, which makes it difficult for them to fully understand the barriers, intentions and motivations of these individuals (Manstead, 2018). Despite the growing body of research about the design of eHealth with and for people with a low SEP (Al-Dhahir et al., 2023; Al-Dhahir et al., 2022), the process of translating this research into practical interventions remains challenging. Due to a lack of sufficient practical resources and the limited description of how design projects are carried out, existing information lacks applicability and concreteness to inform intervention design and design process. To bridge the gap between theory and practice, professionals (e.g., researchers, developers, healthcare providers) therefore need more applicable insights, how-to knowledge, and context-specific examples of design cases (Gagliardi et al., 2016; Greenhalgh et al., 2014; Hekler et al., 2013; Lavis et al., 2006). The recently developed Inclusive eHealth Guide (IeG) helps to bridge the gap between theory and practice to support professionals with the development, adaptation, evaluation, and implementation of eHealth interventions for low-SEP groups (Faber
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