JMIR Publications

ABSTRACT

Background:

Policymakers increasingly advocate for the adoption of eHealth in healthcare, partly based on beliefs regarding its potential for efficient care delivery. Although healthcare is becoming increasingly digitalized, its implementation can negatively impact accessibility for some (potential) healthcare users. Some users cannot independently engage with eHealth. These users potentially benefit from targeted support, such as digital or eHealth skills training, or personalized guidance in using specific eHealth applications.

Objective:

This scoping review mapped existing research on support for eHealth, focusing on strategies and interventions adopted in peer-reviewed studies. The aim was to explore whether and how these strategies and interventions enhance eHealth inclusion.

Methods:

We included 40 peer-reviewed studies, published from 2014 onwards, identified through searches in four databases: PubMed, Scopus, Web of Science, and Embase. Nineteen studies examined support strategies, and 21 evaluated support interventions to enhance eHealth inclusion. Strategies and interventions were categorized based on the support actors involved, operating at the micro (interpersonal), meso (organizational), and macro (political) levels. Intervention studies reported primary outcomes related to adoption, use, skills, and attitudes.

Results:

Interventions targeting adoption—particularly those led by healthcare organizations—showed limited effectiveness. Interventions aimed at improving use and attitudes yielded mixed results. Nearly all multi-actor, collaborative support interventions were effective in improving skills-related outcomes. For attitudes, results were mixed. The findings suggest that collaboration between support actors across the micro, meso and macro levels might enhance skill development.

Conclusions:

While interventions yielded mixed results, multi-actor support interventions mostly result in improvement of skills-related outcomes, such as eHealth literacy. These findings highlight the added value of collaborative approaches in addressing eHealth skills. More broadly, the insights from this review can guide policymakers, healthcare organizations, and other stakeholders in designing effective support structures for (potential) eHealth users. Future research should explore the factors that influence the long-term sustainability of such support, as this was not addressed in depth by the included studies.