A multi-stakeholder approach to eHealth development: Promoting sustained healthy living among cardiovascular patients
Open accessAbstract
BACKGROUND: Healthy living is key in the prevention and rehabilitation of cardiovascular disease (CVD). Yet, supporting and maintaining a healthy lifestyle is exceptionally difficult and people differ in their needs regarding optimal support for healthy lifestyle interventions. OBJECTIVE: The goals of this study were threefold: to uncover stakeholders' needs and preferences, to translate these to core values, and develop eHealth technology based on these core values. Our primary research question is: What type of eHealth application to support healthy living among people with (a high risk of) CVD would provide the greatest benefit for all stakeholders? METHODS: User-centered design principles from the CeHRes roadmap for eHealth development were followed to guide the uncovering of important stakeholder values. Data were synthesized from various qualitative studies (i.e., literature studies, interviews, think-aloud sessions, focus groups) and usability tests (i.e., heuristic evaluation, cognitive walkthrough, think aloud study). We also developed an innovative application evaluation tool to perform a competitor analysis on 33 eHealth applications. Finally, to make sure to take into account all end-users needs and preferences in eHealth technology development, we created personas and a customer journey. RESULTS: We uncovered 10 universal values to which eHealth-based initiatives to support healthy living in the context of CVD prevention and rehabilitation should adhere to (e.g., providing social support, stimulating intrinsic motivation, offering continuity of care). These values were translated to 14 desired core attributes and then prototype designs. Interestingly, we found that the primary attribute of good eHealth technology was not a single intervention principle, but rather that the technology should be in the form of a digital platform disseminating various interventions, i.e., a 'one-stop-shop'. CONCLUSION: Various stakeholders in the field of cardiovascular prevention and rehabilitation may benefit most from utilizing one personalized eHealth platform that integrates a variety of evidence-based interventions, rather than a new tool. Instead of a one-size-fits-all approach, this digital platform should aid the matchmaking between patients and specific interventions based on personal characteristics and preferences.
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Values should capture the whole range of stakeholder needs and wishes, not merely those of end users of the eHealth technology.
“Second, values should capture the whole range of stakeholder needs and wishes, not merely those of end users of the eHealth technology”
From Methods for Human-Centered eHealth Development: Narrative Scoping Review (2022) · cites this paper as [81]
To structure the persona-building process, researchers need to identify characteristic categories that need to be included in the persona, in which attention should also be paid to skills and attitudes related to the to-be-developed eHealth technology.
“Second, to structure the persona-building process, researchers need to identify characteristic categories that need to be included in the persona, in which attention should also be paid to skills and attitudes related to the to-be-developed eHealth technology.”
From Methods for Human-Centered eHealth Development: Narrative Scoping Review (2022) · cites this paper as [81]
The use of behavior change theory was underrepresented in the included studies.
“a main point of improvement for eHealth development using the CeHRes Roadmap is related to the use of behavior change theory: this approach was underrepresented in the included studies [81].”
From Methods for Human-Centered eHealth Development: Narrative Scoping Review (2022) · cites this paper as [81]
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Research works printed but not linked: 1
- R.G.A. Groeneveld, Master Thesis: How Technology Can Be Supportive and Motivating for Patients With Chronic Heart Failure, Science and Technology, University of Twente, 2018. https://essay.utwente.nl/77885/.
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Methods for Human-Centered eHealth Development: Narrative Scoping Review
Kip, H., Keizer, J., da Silva, M. C., Beerlage-de Jong, N., Köhle, N., & Kelders, S. M. (2022) · Journal of Medical Internet Research · doi:10.2196/31858 · Cited by 67 · see citing works
Methods for Human-Centered eHealth Development: Narrative Scoping Review (Preprint)
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- Authors
- Breeman, L. D., Keesman, M., Atsma, D. E., Chavannes, N. H., Janssen, V., van Gemert-Pijnen, L., Kemps, H., Kraaij, W., Rauwers, F., Reijnders, T., Scholte op Reimer, W., Wentzel, J., Kraaijenhagen, R. A., & Evers, A. W. M.
- Affiliations
- Leiden University (NL)
- Leiden University Medical Center (NL)
- Máxima Medisch Centrum (NL)
- University of Twente (NL)
- Corresponding author
- Evers, Andrea W.M.
- ORCID
- Venue
- International Journal of Medical Informatics
- Publisher
- Elsevier BV
- Published
- 2021-03
- Volume
- 147
- Pages
- 104364
- ISSN
- 1386-5056 (ISSN-L)
- OpenAlex
- W3111144775
- Cited by
- 37
- References
- 46
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 8 · 2023: 7 · 2022: 12 · 2021: 4
- FWCI
- 6.00
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- International Journal of Medical Informatics (publishedVersion, cc-by)
- PubMed (publishedVersion)
- TU/e Research Portal (publishedVersion, other-oa)
- Leiden Repository (Leiden University) (submittedVersion, cc-by)
- University of Twente Research Information (submittedVersion, cc-by)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
- Pure Amsterdam UMC (submittedVersion, cc-by)
- Leiden Repository (Leiden University) (submittedVersion, cc-by-nc-nd)
- Research Repository (Delft University of Technology) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, cc-by)
- TU/e Research Portal (submittedVersion, other-oa)
- Funders
- ZonMw
- Netherlands Cardiovascular Research Initiative: An initiative with support of the Dutch Heart Foundation (CVON2016-12 BENEFIT)
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Physical Sciences › Computer Science › Human-Computer Interaction › Innovative Human-Technology Interaction
- Keywords
- cardiovascular disease prevention, cardiac rehabilitation, healthy lifestyle intervention, stakeholder needs, user-centered design, core values, digital health platforms, personalized interventions, social support, intrinsic motivation, continuity of care, personas, customer journey, competitor analysis
- MeSH terms
- Healthy Lifestyle, Humans, Motivation, Focus Groups, Telemedicine, Qualitative Research
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