Attitudes Toward Health, Healthcare, and eHealth of People With a Low Socioeconomic Status

Attitudes Toward Health, Healthcare, and eHealth of People With a Low Socioeconomic Status: A Community-Based Participatory Approach

Faber, J.S. (TU Delft Design Aesthetics)
Al-Dhahir, Isra (Universiteit Leiden)
Reijnders, T. (TU Delft Design Aesthetics; Universiteit Leiden)
Chavannes, N.H. (Leiden University Medical Center)
Evers, A.W.M. (TU Delft Applied Ergonomics and Design; Universiteit Leiden; Erasmus Universiteit Rotterdam)
Kraal, J.J. (TU Delft Applied Ergonomics and Design)
van den Berg-Emons, H. J. G. (Erasmus MC; Capri Cardiac Rehabilitation, Rotterdam)
Visch, V.T. (TU Delft Design Aesthetics)

2021

Low socioeconomic status (SES) is associated with a higher prevalence of unhealthy lifestyles compared to a high SES. Health interventions that promote a healthy lifestyle, like eHealth solutions, face limited adoption in low SES groups. To improve the adoption of eHealth interventions, their alignment with the target group's attitudes is crucial. This study investigated the attitudes of people with a low SES toward health, healthcare, and eHealth. We adopted a mixed-method community-based participatory research approach with 23 members of a community center in a low SES neighborhood in the city of Rotterdam, the Netherlands. We conducted a first set of interviews and analyzed these using a grounded theory approach resulting in a group of themes. These basic themes' representative value was validated and refined by an online questionnaire involving a different sample of 43 participants from multiple community centers in the same neighborhood. We executed three focus groups to validate and contextualize the results. We identified two general attitudes based on nine profiles toward health, healthcare, and eHealth. The first general attitude, optimistically engaged, embodied approximately half our sample and involved light-heartedness toward health, loyalty toward healthcare, and eagerness to adopt eHealth. The second general attitude, doubtfully disadvantaged, represented roughly a quarter of our sample and was related to feeling encumbered toward health, feeling disadvantaged within healthcare, and hesitance toward eHealth adoption. The resulting attitudes strengthen the knowledge of the motivation and behavior of people with low SES regarding their health. Our results indicate that negative health attitudes are not as evident as often claimed. Nevertheless, intervention developers should still be mindful of differentiating life situations, motivations, healthcare needs, and eHealth expectations. Based on our findings, we recommend eHealth should fit into the person's daily life, ensure personal communication, be perceived usable and useful, adapt its communication to literacy level and life situation, allow for meaningful self-monitoring and embody self-efficacy enhancing strategies.

low socioeconomic status
eHealth adoption
health attitudes
community-based participatory research
user profiles
health disparities
eHealth intervention design

http://resolver.tudelft.nl/uuid:d991245f-c898-4f5c-8507-0dffb735d91d

https://doi.org/10.3389/fdgth.2021.690182

2673-253X

Frontiers in Digital Health, 3, 1-15

Institutional Repository

journal article

© 2021 J.S. Faber, Isra Al-Dhahir, T. Reijnders, N.H. Chavannes, A.W.M. Evers, J.J. Kraal, H. J. G. van den Berg-Emons, V.T. Visch