Designing on a level playing field: Innovative approaches to eHealth design with older adults

As the global population ages, the concept of “healthspan”—years lived in good health—has gained importance. This shift emphasizes preventive health practices like exercise, nutrition, and mental well-being. eHealth technologies play a key role in supporting these efforts, but older adults often face barriers in using them, including low digital literacy, poorly designed interfaces, and exclusion from the design process. This dissertation addresses these issues by exploring how older adults can be more meaningfully involved in the co-design of eHealth technologies.

The central question is how to create equal partnerships between designers, researchers, and older adults during the co-design process. While co-design is often promoted as a way to make technology more user-centered, many initiatives still treat older adults as passive participants. The research argues that older adults should be seen as experts of their own experiences and involved in every stage of design appropriately.

The dissertation includes a scoping review and several case studies. These studies highlight challenges like tokenism and ageism, and they explore methods to overcome them, including remote co-design, scenario-based design, and low-contact engagement via newspapers. One case study examines using AI-generated “synthetic users” to simulate older adults’ input early in the design phase, while acknowledging that real user input remains essential.

Together, these findings advocate for a flexible, inclusive approach to co-design. By centering the real needs and experiences of older adults, the dissertation outlines practical methods for creating more effective and widely adopted eHealth technologies. It ultimately calls for a paradigm shift: from viewing older adults as passive users to recognizing them as active co-creators of their own health solutions.