Faculty of Social and Behavioural Sciences, Leiden University, Leiden, the Netherlands.
Faculty of Industrial Design Engineering, Delft University of Technology, the Netherlands.
Int J Med Inform. 2023 Sep;177:105160. doi: 10.1016/j.ijmedinf.2023.105160. Epub 2023 Jul 22.
eHealth interventions can improve the health outcomes of people with a low socioeconomic position (SEP) by promoting healthy lifestyle behaviours. However, developing and implementing these interventions among the target group can be challenging for professionals. To facilitate the uptake of effective interventions, this study aimed to identify the barriers and facilitators anticipated or experienced by professionals in the development, reach, adherence, implementation and evaluation phases of eHealth interventions for people with a low SEP.
We used a Delphi method, consisting of two online questionnaires, to determine the consensus on barriers and facilitators anticipated or experienced during eHealth intervention phases and their importance. Participants provided open-ended responses in the first round and rated statements in the second round. The interquartile range was used to calculate consensus, and the (totally) agree ratings were used to assess importance.
Twenty-seven professionals participated in the first round, and 19 (70.4%) completed the second round. We found a consensus for 34.8% of the 46 items related to highly important rated barriers, such as the lack of involvement of low-SEP people in the development phase, lack of knowledge among professionals about reaching the target group, and lack of knowledge among lower-SEP groups about using eHealth interventions. Additionally, we identified a consensus for 80% of the 60 items related to highly important rated facilitators, such as rewarding people with a low SEP for their involvement in the development phase and connecting eHealth interventions to the everyday lives of lower-SEP groups to enhance reach.
Our study provides valuable insights into the barriers and facilitators of developing eHealth interventions for people with a low SEP by examining current practices and offering recommendations for future improvements. Strengthening facilitators can help overcome these barriers. To achieve this, we recommend defining the roles of professionals and lower-SEP groups in each phase of eHealth intervention and disseminating this study's findings to professionals to optimize the impact of eHealth interventions for this group.
电子健康干预措施可以通过促进健康的生活方式行为来改善社会经济地位较低人群的健康结果。然而,对于专业人员来说,在目标人群中开发和实施这些干预措施可能具有挑战性。为了促进有效干预措施的采用,本研究旨在确定专业人员在开发、覆盖范围、坚持、实施和评估社会经济地位较低人群的电子健康干预措施各阶段中预期或经历的障碍和促进因素。
我们使用德尔菲法,包括两轮在线问卷,以确定在电子健康干预阶段预期或经历的障碍和促进因素及其重要性的共识。参与者在第一轮中提供了开放式回答,在第二轮中对陈述进行了评分。四分位距用于计算共识,(完全)同意评分用于评估重要性。
27 名专业人员参加了第一轮,其中 19 名(70.4%)完成了第二轮。我们发现,在与高度重要的障碍相关的 46 个项目中,有 34.8%达成了共识,例如在开发阶段缺乏社会经济地位较低人群的参与、专业人员对覆盖目标人群的知识不足以及较低社会经济地位群体对使用电子健康干预措施的知识不足。此外,我们还确定了与高度重要的促进因素相关的 60 个项目中的 80%达成了共识,例如为参与开发阶段的社会经济地位较低人群提供奖励,以及将电子健康干预措施与较低社会经济地位群体的日常生活联系起来以提高覆盖面。
通过检查当前实践并为未来改进提供建议,我们的研究为开发针对社会经济地位较低人群的电子健康干预措施的障碍和促进因素提供了有价值的见解。加强促进因素可以帮助克服这些障碍。为此,我们建议在电子健康干预的每个阶段定义专业人员和社会经济地位较低人群的角色,并向专业人员传播本研究的结果,以优化电子健康干预措施对该人群的影响。