Background: eHealth interventions have the potential to enhance health outcomes for people with a low socioeconomic position (SEP), but lack of knowledge on how to effectively meet the specific needs of this population can limit their effectiveness and widen the digital divide. Our study aimed to address this issue by developing an online guide for professionals (e.g., researchers and health professionals) to support the development and adaptation of eHealth interventions for people with low SEP. Methods: During the initial phase, we conducted two studies: (1) a Delphi study with professionals, identifying barriers to developing, evaluating, and implementing eHealth interventions (top-down), and (2) a communitybased study with people from low SEP, exploring their perspectives on health, healthcare, and eHealth (bottom-up). In the second phase, an iterative participatory process was used to develop the online guide, involving 11 professionals in think-aloud sessions and interviews to assess content and design acceptance. The presentation focuses on outcomes of this second phase. Findings: Professionals found the online guide to be user-friendly and helpful, particularly the recommendations on barriers, facilitators, and user scenarios. However, they requested more practical examples and engaging content. Discussion: This guide is an important contribution to addressing the knowledge gap in eHealth interventions for people with a low SEP and provides valuable information for professionals, whether they are new to the field or have experience. Future research should focus on enhancing the guide's usability and flexibility for its diverse audience, including healthcare practitioners, and other eHealth professionals working with this population. @en

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.@en