5 Application of the Inclusive eHealth Guide during the development of an eHealth intervention for and with cardiac patients with a low socioeconomic position 97 5.2.2 Description of application of IeG in design process and intervention design 5.2.2.1 Process overview To illustrate how the IeG was practically applied and to elucidate the specific design decisions that emerged from this application, this section provides a detailed description of the design process. It refers to the guide’s recommendations as outlined in the recommendation table (Table 5.1). In line with the IeG, to successfully develop an eHealth intervention for lowSEP groups, we engaged in a participatory process with both patients and healthcare providers in every phase of the project (D.1, E.9) and worked with a multi-disciplinary team with expertise in rehabilitation science, cardiology, design, behavior change, eHealth, and vulnerable populations (D5, R.7). This process was conducted between June 2021 and December 2022, and followed the CeHRes Roadmap (van Gemert-Pijnen et al., 2011) as its methodological approach (See Figure 5.1). The CeHRes Roadmap is a structural framework for eHealth development grounded in participatory development, human-centered design, and persuasive design. Based on the roadmap, we engaged in the following phases with corresponding participatory activities: (1) Contextual inquiry and value specification - context mapping to develop a patient journey and discuss it with patients, care providers, and stakeholders (e.g., researchers, management) to define patient needs and the design opportunity; (2) Design - ideation cycles with design experts, focus groups with patients and care providers and the development of a prototype; and (3) Evaluation – a formative, preliminary, evaluation with cardiac patients with a low SEP to determine initial acceptance. 5.2.2.2 Recruitment We recruited different participants for each phase of the design process, which included: current CR patients with a low SEP who were within the first two weeks of their CR, former CR patients with a low SEP, and health professionals. See Figure 5.1 for an overview of participants in each project phase. We followed different procedures for recruiting current and former CR patients. We recruited current CR patients in phases one and two through care providers from various training locations of the CR center, following the IeG’s recommendation to engage participants via key persons (R.6). These locations were situated in areas generally associated with diverse socio-economic backgrounds. Before engaging with participants, we confirmed that their residential postal code corresponded to a neighborhood characterized by low SEP. We defined the SEP of neighborhoods
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