eHealth - In or out of our daily lives? Measuring the (non-)use of eHealth in summative evaluations

While there are many different eHealth services (being) developed, its use among the target population is still low. The aim of this thesis was to increase our understanding about the (non-)use of eHealth services among the target population in a real-world setting. Within different studies, it was first explored which demographics and personality traits of older adults can predict dropping out of an eHealth service. Second, it was investigated which determinants of the Technology Acceptance Model explain older adults’ use and intention to continue use a gamified eHealth service. Next, a case study was presented within the thesis which shows how you can evaluate an eHealth service in a real-world setting with mixed methods. Furthermore, another study focused on qualitatively investigating barriers and facilitators adults with neck and/or low back pain perceive when using an mHealth app. Finally, in multiple chapters different aspects of eHealth (non-)use were discussed. However, to better understand why the target population does not use eHealth in daily live, the last study identified the reasons of potential end-users to participate in eHealth studies, the influence of these reasons on the use of eHealth, and their expectations about these studies. This thesis ends with a general discussion about the main findings. This discusses the use of eHealth and the intensity of use among different eHealth services, the different aspects which can be used to measure eHealth use, how eHealth use can be improved, recommendations on improving summative eHealth evaluations, and finally it discusses topics for future studies.