Jasper Faber

Chapter 5 94 & Al-Dhahir et al., 2023). The guide combines existing knowledge about barriers and facilitators during eHealth development for individuals with a low SEP (Al-Dhahir et al., 2023) and attitudes of the target group regarding health and eHealth (Faber et al., 2021). It is designed to be a modular tool by presenting the barriers, facilitators, and attitudes and providing recommendations, arranged according to different aims during designing eHealth interventions: development, reach, adherence, evaluation, and implementation. Professionals using the guide can adaptively combine the recommendations based on the unique needs and complexities of their specific design challenge. Given the modular nature of the guide, its utility extends beyond singular contexts or specific problems. Therefore, it is imperative that this guide will be applied across various contexts and refined through iterative cycles to strengthen its practical foundation. This brings us to the primary aim of the present study: to contribute to this ongoing refinement by exploring the application of the IeG in a particular setting – a case study. This case study, focusing on an eHealth intervention in cardiac rehabilitation (CR), will serve as a testing ground to uncover lessons learned through experienced challenges and applied solution strategies that would not become apparent in a theoretical setting. Through this, we seek to gain a better understanding of how the IeG can be used to address complex design questions in specific settings with use of different combinations of its recommendations. For our secondary aims, we describe the design process and resulting intervention design to provide professionals with concrete how-to information that can serve as inspiration for other design cases, and we evaluate the acceptance of the resulting eHealth intervention. For this specific case study, we chose to design an eHealth intervention targeting individuals with a low SEP in CR. CR is a multicomponent lifestyle intervention that includes information and advice on healthy behavior and supervised exercise. It plays a crucial role in cardiac patients to prevent progression of the disease, complications and mortality and has been shown to improve patient outcomes like physical fitness and health-related quality of life (Eijsvogels et al., 2020; Goel et al., 2011). CR provides a useful setting for this study because of its focus on lifestyle changes and involvement of a range of lifestyle interventions that could be delivered effectively through eHealth. In addition, its outcomes are impacted by socio-economic disparities, with patients with a low SEP dropping out earlier, attending fewer sessions, and experiencing more barriers to participation (Apfelbaum, 2016; Shanmugasegaram et al., 2013).

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