Empowering cardiac patients with low SEP through eHealth: Preparing for rehabilitation during their waiting period

Health disparities between socio-economic classes are growing. While eHealth has been proposed as a potential solution, it often disproportionately benefits people with a higher socio-economic position (SEP) thereby exacerbating health disparities. We aimed to develop an eHealth intervention that supports specifically people with a low SEP during their waiting period between hospital referral and start of cardiac rehabilitation (CR). We followed a participatory design process in which we used a variety of participatory and inclusive design tools and techniques to identify needs of the target group and develop the intervention. 15 cardiac patients with a low SEP participated in the development (n = 8) and evaluation (n = 7) of the intervention. We found that patients with a low SEP require certainty and guidance during their waiting period. To address this, healthcare providers guide them through this transitional phase using multimedia resources in the eHealth intervention. This includes introductions of the healthcare providers and information about their roles, peer experiences, practical tips and daily updates on the remaining waiting time. The evaluation yielded high scores on usability (4.4 out of 5), experience (4.1 out of 5) and perceived effect on certainty and guidance (4.0 out of 5). This study explored how eHealth can bridge gaps between hospitals and CR and between high and low SEP. It emphasizes the significance of utilizing participatory and inclusive approaches to develop feasible and acceptable eHealth interventions for those with low SEP. Currently, follow-up evaluative research is conducted to determine the proof-of-principle of the intervention.