Latulippe Karine, Hamel Christine, Giroux Dominique
Laval University, Québec, QC, Canada.
Centre de recherche en santé durable VITAM, Quebec, QC, Canada.
JMIR Hum Factors. 2020 Aug 26;7(3):e18120. doi: 10.2196/18120.
eHealth can help reduce social health inequalities (SHIs); at the same time, it also has the potential to increase them. Several conversion factors can be integrated into the development of an eHealth tool to make it inclusive: (1) providing physical, technical, and financial access to eHealth; (2) enabling the integration of people at risk of SHIs into the research and development of digital projects targeting such populations (co-design or participatory research); (3) promoting consistency between the digital health literacy level of future users (FUs) and the eHealth tool; (4) developing an eHealth tool that is consistent with the technological skills of FUs; (5) ensuring that the eHealth tool is consistent with the help-seeking process of FUs; (6) respecting the learning capacities of FUs; and (7) being sensitive to FUs' cultural context. However, only little empirical evidence pointing out how these conversion factors can be integrated into an effective eHealth tool is available.
On the basis of Amartya Sen's theoretical framework of social justice, the objective of this study was to explore how these 7 conversion factors can be integrated into an eHealth tool for caregivers of functionally dependent older persons.
This study was based on a social justice design and participant observation as part of a large-scale research project funded by the Ministère de la Famille through the Quebec Ami des Aînés Program. Data were collected by recording the preparation sessions, the co-design and advisory committee sessions, as well as the debriefing sessions. The results were analyzed using Miles and Huberman's method.
A total of 78 co-designers participated in 11 co-design sessions, 24 preparation sessions, and 11 debriefing sessions. Of the 7 conversion factors, 5 could be explored in this experiment. The integration of conversion factors has been uneven. The participation of FUs in the development of the tool supports other conversion factors. Respecting the eHealth literacy level of FUs means that their learning abilities and technological skills are also respected because they are closely related to one another and are therefore practically difficult to be distinguished.
Conversion factors can be integrated into the development of eHealth tools that are intended to be inclusive and contribute to curbing SHIs by integrating FU participation into the tool design process.
电子健康可有助于减少社会健康不平等现象(SHIs);与此同时,它也有可能加剧这些不平等。若干转化因素可融入电子健康工具的开发过程,使其具有包容性:(1)提供使用电子健康的物理、技术和资金渠道;(2)让面临社会健康不平等风险的人群参与针对此类人群的数字项目的研发(共同设计或参与式研究);(3)促进未来用户(FUs)的数字健康素养水平与电子健康工具之间的一致性;(4)开发与未来用户的技术技能相一致的电子健康工具;(5)确保电子健康工具与未来用户的求助过程相一致;(6)尊重未来用户的学习能力;(7)对未来用户的文化背景保持敏感。然而,目前仅有很少的实证证据表明这些转化因素如何能够融入有效的电子健康工具。
基于阿玛蒂亚·森的社会正义理论框架,本研究的目的是探讨这7个转化因素如何能够融入针对功能依赖型老年人照料者的电子健康工具。
本研究基于社会正义设计和参与观察,是由家庭部通过魁北克老年人之友计划资助的一个大型研究项目的一部分。通过记录准备会议、共同设计和咨询委员会会议以及汇报会议来收集数据。使用迈尔斯和休伯曼的方法对结果进行分析。
共有78名共同设计者参加了11次共同设计会议、24次准备会议和11次汇报会议。在这7个转化因素中,有5个可在本实验中进行探讨。转化因素的整合并不均衡。未来用户参与工具开发有助于支持其他转化因素。尊重未来用户的电子健康素养水平意味着他们的学习能力和技术技能也得到了尊重,因为它们彼此密切相关,实际上很难区分。
通过将未来用户的参与纳入工具设计过程,转化因素可融入旨在具有包容性并有助于遏制社会健康不平等现象的电子健康工具的开发中。