Hovingh Jan Wessel, Elderson-van Duin Cynthia, Kuipers Derek A, van Rood Yanda, Ludden Geke D S, Hanssen Denise J C, Rosmalen Judith G M
Department of Psychiatry, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen, 9713 GZ, The Netherlands, 31 (0)50 361 61 61.
Department of Interaction Design, Department of Design, Production and Management, University of Twente, Enschede, The Netherlands.
JMIR Hum Factors. 2025 Sep 2;12:e76172. doi: 10.2196/76172.
Tailoring is an important strategy to improve uptake and efficacy of medical information and guidance provided through eHealth interventions. Given the rapid expansion of eHealth, understanding the design rationale of such tailored interventions is vital for further development of and research into eHealth interventions aimed at improving health and healthy behavior.
This systematic review examines the use of health literacy concepts through tailoring strategies in digital health interventions (eHealth) aimed at improving health and how these elements inform the overall design rationale.
A systematic search of PubMed, PsycINFO, Web of Science, and ACM databases yielded 31 eligible randomized trials that focused on adult health improvement through eHealth interventions. Eligible studies compared tailored versus nontailored eHealth interventions for adults, excluding non-English papers and those addressing solely readability or targeting populations with accessibility barriers. Data extraction focused on study characteristics, health literacy components, tailoring methods, and design rationales, with study quality evaluated using Quality Assessment for Diverse Studies (QuADS) by independent reviewers.
Most interventions applied both cognitive and social health literacy concepts and predominantly used content matching as a tailoring strategy. Of all studies using content matching, most used one or more supporting theories as well as end-user data to inform the content matching. While choices for individual intervention components were mostly explicated, detailed descriptions of the design process were scarce, with only a few studies articulating an underlying narrative that integrated the most important chosen components.
While tailored eHealth interventions demonstrate promise in enhancing health literacy and the trial design of the interventions overall was of good quality, inconsistent documentation of design rationales impedes replicability and broader application of the used eHealth concepts. This calls for more detailed reporting on the design choices of the intervention in efficacy studies, so that reported outcomes can be easier connected to choices made in the design of the eHealth intervention.
定制是提高通过电子健康干预提供的医学信息和指导的接受度及效果的重要策略。鉴于电子健康的迅速发展，了解此类定制干预措施的设计原理对于旨在改善健康和健康行为的电子健康干预措施的进一步发展和研究至关重要。
本系统评价考察了在旨在改善健康的数字健康干预（电子健康）中通过定制策略对健康素养概念的运用，以及这些要素如何为整体设计原理提供信息。
对PubMed、PsycINFO、科学网和美国计算机协会数据库进行系统检索，获得了31项符合条件的随机试验，这些试验聚焦于通过电子健康干预改善成人健康。符合条件的研究比较了针对成年人的定制电子健康干预与非定制电子健康干预，排除非英文论文以及那些仅涉及可读性或针对有可及性障碍人群的论文。数据提取集中在研究特征、健康素养成分、定制方法和设计原理上，由独立评审员使用多样研究质量评估（QuADS）对研究质量进行评估。
大多数干预措施同时应用了认知和社会健康素养概念，并且主要使用内容匹配作为定制策略。在所有使用内容匹配的研究中，大多数使用了一种或多种支持理论以及最终用户数据来为内容匹配提供信息。虽然对各个干预组成部分的选择大多有明确说明，但设计过程的详细描述却很少，只有少数研究阐述了一个整合了最重要选定组成部分的潜在叙述。
虽然定制电子健康干预措施在提高健康素养方面显示出前景，并且干预措施的整体试验设计质量良好，但设计原理的记录不一致阻碍了所使用的电子健康概念的可重复性和更广泛应用。这就要求在疗效研究中对干预措施的设计选择进行更详细的报告，以便报告的结果能够更容易地与电子健康干预措施设计中所做的选择联系起来。
