Tailoring for Health Literacy in the Design and Development of eHealth Interventions: Systematic Review.

Area of Science:

• Digital Health
• Health Literacy
• Behavioral Science

Background:

• Tailoring medical information in eHealth interventions is crucial for improving user engagement and effectiveness.
• Understanding the design rationale behind tailored eHealth interventions is vital for future research and development.
• eHealth interventions are rapidly expanding, necessitating a clear understanding of design principles.

Purpose of the Study:

• To systematically review the integration of health literacy concepts and tailoring strategies in digital health interventions (eHealth).
• To examine how these elements inform the overall design rationale of eHealth interventions aimed at health improvement.
• To assess the quality and replicability of tailored eHealth intervention designs.

Main Methods:

• Systematic search of major databases (PubMed, PsycINFO, Web of Science, ACM) for randomized trials.
• Included studies focused on adult health improvement via tailored vs. non-tailored eHealth interventions.
• Data extraction covered study characteristics, health literacy, tailoring methods, and design rationales; quality assessed using QuADS.

Main Results:

• Most interventions incorporated cognitive and social health literacy, primarily using content matching for tailoring.
• Content matching often integrated supporting theories and end-user data.
• While intervention components were explained, detailed design process descriptions and overarching narratives were scarce.

Conclusions:

• Tailored eHealth interventions show potential for enhancing health literacy, with good overall trial design quality.
• Inconsistent documentation of design rationales limits replicability and broader adoption of eHealth concepts.
• More detailed reporting on design choices in efficacy studies is needed to link outcomes to specific intervention design elements.