[MA 2024 08] Exclusive Design of eHealth for People with Low Digital Health Literacy for Inclusive Digital Health care

eHealth Living & Learning Lab Amsterdam, Department of Medical Informatics, AMC
Proposed by: Dr. Marloes Derksen [m.e.derksen@amsterdamumc.nl]

Introduction

Healthcare is rapidly digitalizing. Digital healthcare requires new skills: digital health literacy (1). These skills include finding, understanding, evaluating, and applying online health information and digital applications related to healthcare (2). As with general health literacy, specific groups have low digital health literacy (e.g., people with low socioeconomic status, ethnic minorities, older populations) (3-6). A quarter of healthcare users lack sufficient knowledge and skills to utilize eHealth, despite the fact that they could greatly benefit from it (through features like text-to-speech, video use, less text, etc.) (7). Therefore, eHealth could become more inclusive by specifically designing for this target group. After all, if people with low (digital) health literacy can use eHealth, then everyone can. However, many (commercial) designers are hesitant and fear that their eHealth products will no longer be attractive to people with average or high (digital) health literacy (e.g., too childish, too simple, too boring).


The goal of this project is to gain initial insights into whether exclusively designing eHealth for people with low digital health literacy leads to more inclusive eHealth.



Description of the SRP Project/Problem

This study will take a user-centered design approach, ensuring that end-users are engaged in every phase of the design process (8):

- Understanding the context of use; and specifying user requirements through literature research on eHealth design principles for people with lower (digital) health literacy and qualitative interviews with end-users (n=10) (for recruitment the Digital Health Literacy Panel of the eHealth Living & Learning Lab Amsterdam will be contacted).

- Creating design solutions: two versions of a eHealth intervention (preferably in collaboration with one of my other SRP proposals):

a. one universal design principles and

b. one low digital health literacy (DHL) design principles.

- Evaluating the usability of the solution through means of a Think Aloud usability test combined with qualitative interviews with end-users (n=5) and a Heuristic Evaluation with UX-design experts (n=3). E.g.,

a. The completeness and accuracy with which the user achieve certain goals (effectiveness, ISO 9241-110).

b. How much effort (efficiency) it costs the user to achieve these goals (ISO 9241-110).

c. How free of disturbances, and how positive the user is towards the client portal (satisfaction, ISO 9241-11).

- Implementation of recommendations to improve user experience of the developed DHL serious game based on usability evaluation findings.


Research questions

- What are design principles for varying levels of digital health literacy?

- How can eHealth be designed taking a user-centred design and applying a) universal design principles and b) low digital health literacy (DHL) design principles?

- How do people with varying (digital) health literacy levels evaluate eHealth interventions that is specifically designed for people with low digital health literacy?

- What is the user experience of end-users with different digital health literacy levels, interacting with an existing eHealth intervention specifically designed for people with low digital health literacy vs. universal design principles?


Expected results

- New insights from the literature on achieving inclusive digital care by exclusively designing for people with low digital health literacy.

- Two versions of an eHealth intervention (preferably in collaboration with one of my other SRP proposals). Expected stage of maturity: prototype (9).

- Initial empirical evidence on whether exclusively designing for people with low digital health literacy leads to more inclusive eHealth.


Time period:

November – June

May – November

Both time periods are possible.


Allowance

Subject to the approval of a grant application, a modest internship allowance is available.


Contact

Dr. Marloes Derksen, eHealth Living & Learning Lab, Department of Medical Informatics, AMC

m.e.derksen@amsterdamumc.nl


References

1. Van Der Vaart, R., & Drossaert, C. (2017). Development of the digital health literacy instrument: measuring a broad spectrum of health 1.0 and health 2.0 skills.?Journal of medical Internet research,?19(1), e27.

2. TNS Political and Social. Flash Eurobarometer 404 European Citizens' Digital Health Literacy. Brussels, Belgium: European Union; 2014.

3. Neter, E., & Brainin, E. (2012). eHealth literacy: extending the digital divide to the realm of health information.?Journal of medical Internet research,?14(1), e19.

4. Kontos, E., Blake, K. D., Chou, W. Y. S., & Prestin, A. (2014). Predictors of eHealth usage: insights on the digital divide from the Health Information National Trends Survey 2012.?Journal of medical Internet research,?16(7), e172.

5. Gordon, N. P., & Hornbrook, M. C. (2016). Differences in access to and preferences for using patient portals and other eHealth technologies based on race, ethnicity, and age: a database and survey study of seniors in a large health plan.?Journal of medical Internet research,?18(3), e50.

6. Guo, Z., Zhao, S. Z., Guo, N., Wu, Y., Weng, X., Wong, J. Y. H., ... & Wang, M. P. (2021). Socioeconomic disparities in eHealth literacy and preventive behaviors during the COVID-19 pandemic in Hong Kong: cross-sectional study. Journal of medical Internet research, 23(4), e24577.

7. Rijksinstituut voor Volksgezondheid en Milieu. E-healthmonitor 2021: Stand van zaken digitale zorg. 2022. Ontleend op 20 oktober 2023 aan E-healthmonitor 2021: Stand van zaken digitale zorg | Rapport | Rijksoverheid.nl

8. Holtzblatt K, Wendell JB, & Wood S. (2004).?Rapid contextual design: a how-to guide to key techniques for user-centered design. Elsevier: San Francisco.

9. World Health Organization. (2016). Monitoring and evaluating digital health interventions: a practical guide to conducting research and assessment. Retrieved on July 19, 2024 from https://www.who.int/publications/i/item/9789241511766