Health, Medical, and Neuropsychology Unit, Leiden University, The Netherlands.
Department of Cardiology, Leiden University Medical Center, The Netherlands.
Int J Med Inform. 2021 Mar;147:104364. doi: 10.1016/j.ijmedinf.2020.104364. Epub 2020 Dec 13.
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.
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?
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.
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'.
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.
健康生活是预防和康复心血管疾病（CVD）的关键。然而，支持和维持健康的生活方式极其困难，并且人们在健康生活方式干预的最佳支持方面存在需求差异。
本研究的目标有三：揭示利益相关者的需求和偏好，将这些需求和偏好转化为核心价值观，并基于这些核心价值观开发电子健康技术。我们的主要研究问题是：哪种类型的电子健康应用程序将为所有利益相关者提供最大的益处，以支持患有（高风险）心血管疾病的人群健康生活？
遵循 CeHRes 电子健康发展路线图中的用户为中心的设计原则，以指导揭示重要的利益相关者价值观。数据来自各种定性研究（即文献研究、访谈、出声思维会议、焦点小组）和可用性测试（即启发式评估、认知走查、出声思维研究）综合得出。我们还开发了一种创新的应用程序评估工具，对 33 种电子健康应用程序进行竞争分析。最后，为确保在电子健康技术开发中考虑到所有最终用户的需求和偏好，我们创建了角色和客户旅程。
我们发现了 10 项普遍的价值观，电子健康干预措施应遵循这些价值观，以支持 CVD 预防和康复背景下的健康生活（例如，提供社会支持、激发内在动机、提供连续性护理）。这些价值观被转化为 14 个理想的核心属性，然后是原型设计。有趣的是，我们发现，好的电子健康技术的主要属性不是单一的干预原则，而是技术应该以各种干预措施的数字平台形式呈现，即“一站式服务”。
心血管预防和康复领域的各种利益相关者可能最受益于利用一个集成各种基于证据的干预措施的个性化电子健康平台，而不是一种新工具。这种数字平台不应采用一刀切的方法，而应根据个人特征和偏好帮助患者与特定干预措施进行匹配。
