The Dutch healthcare system is facing multiple challenges which have put a strain on the healthcare system in terms of finances and workforce shortages. eHealth offers innovative and promising ways... Show moreThe Dutch healthcare system is facing multiple challenges which have put a strain on the healthcare system in terms of finances and workforce shortages. eHealth offers innovative and promising ways of providing healthcare, including remote and digital care. However, despite the potential of eHealth to transform healthcare and improve patient outcomes, its wide-spread adoption and implementation have been limited. One major obstacle is limited usage, often due to the insufficient engagement of end-users, including patients, in the early design phase. The dissertation underscores the importance of participatory design to actively involve users. Another challenge is the short-term usage of eHealth applications, often a result of inadequate user engagement. The integration of "Persuasive games," incorporating game elements to promote behavioural change, is suggested to enhance engagement and encourage sustained use. The digital divide presents a third challenge, affecting specific user groups like those with limited (e)health literacy. Bridging this gap necessitates not only access to digital technologies but also promoting ehealth literacy and involving users in eHealth development. Moreover, a lack of evidence on the effectiveness of eHealth interventions impedes widespread acceptance. Traditional research designs, like randomized clinical studies, often overlook the complexity of intervention contexts. The dissertation seeks to address these challenges through practical research projects, emphasizing participatory design, evaluating effectiveness in real-world settings, translating and assessing the eHealth Literacy questionnaire, and creating tools for effective knowledge transfer. Advocating for early end-user engagement and a critical review of existing research paradigms, the dissertation offers valuable insights for overcoming challenges and advancing eHealth for improved patient and healthcare outcomes. Show less
Patients’ understanding of how to use their therapy is a key determinant of good medication adherence. Low-literate medication users, who have difficulty reading, are at higher risk to... Show morePatients’ understanding of how to use their therapy is a key determinant of good medication adherence. Low-literate medication users, who have difficulty reading, are at higher risk to misunderstand information about their therapy and to experience negative health outcomes compared to patients with higher reading levels.This thesis describes the development of visual aids, pictograms, to support written drug information for low-literate medication users, with repeated consultative/participative involvement of the target group.The pre-design phase showed that low-literate people experience drug leaflets as discouraging to use and that pictograms can make information look more appealing and easier to find, read and understand.This phase was followed by an iterative design, evaluation and redesign process using mixed-methods. Finally, the pictograms were tested in the context of easy-to-read drug leaflets with antihypertensive medication users.In addition to the resulting grammatical system of pharmaceutical pictograms, the thesis presents recommendations for the design of informative images for low-literate patients as well as an evaluation of end-user involvement in the design of pharmaceutical pictograms.The study shows that it is essential to provide low-literate medication users with suitable, printed drug information and that the use of pictograms can empower this target group. Show less
