2 Method

The questionnaire underwent a meticulous development process by NeRN researchers. The process included in-person meetings in Helsinki and subsequent online collaboration to address national differences, conceptual disagreements, and other essential aspects within the eHealth domain. This approach ensured expert validation of the questionnaire by researchers with country-specific experience and in-depth knowledge about the digital healthcare sector. A comprehensive validation based on citizens' perceptions is the next step in the validation process. Parties interested in using the questionnaire can contact the main author, Jeppe Eriksen, at je@plan.aau.dk.

The questionnaire consists of 25 questions, which examine the following themes:

After the development phase, the distribution of the questionnaire was initiated, which was handled by MEGAFON, who was hired due to their experience and methodological expertise in the area of survey studies. Before the survey commenced, five interviews were arranged by MEGAFON to test the face validity of the questionnaire. Hence, minor alterations and changes in the questionnaire were also implemented in this phase through inputs from MEGAFON and their partners.

The internet interviews, which constitute 90% of the data sample, were done with respondents who were members of the citizen panel managed by MEGAFON or collaborators, which in this case were Norstat and Gallup. The phone interviews, which make up 10% of the participants, were done with randomly selected citizens. The combination and use of these two approaches were deliberately chosen to secure representative, diverse, and inclusive samples.

The survey was conducted from February 2nd to March 4th, 2023, targeting citizens above 18 years of age in Denmark, Sweden, Norway, Finland, and Iceland. Respondents' identities remained anonymous. Internet interviews used email communication, and phone interviews were conducted between 16:00 and 21:30 on weekdays and 12:00 to 16:00 on Saturdays. Five extra attempts were made to contact respondents when no one answered the phone.

Across the five Nordic countries, 14.045 citizens were contacted via email, and 10.725 citizens were contacted via phone. The survey yielded 5.078 interviews, including 4.567 internet interviews and 511 phone interviews. Response rates were 33% and 5%, respectively, suggesting that certain population segments may be underrepresented in the sample. Consequently, it is plausible that the number of citizens requiring assistance when using digital healthcare services and those not using such services may in fact be higher.

Moreover, the study is based on a cross-sectional design, which involves collecting data at a single point in time. Consequently, the study's conclusions are time-limited, necessitating future research to monitor trends in citizens' access, use, and attitudes toward digital healthcare services. 

This report follows the structure of the questionnaire, which includes 25 questions. It begins with presenting data based on the five background variables and then proceeds to descriptive analyses of questions 6 to 25. The questionnaire's themes encompass Nordic citizens' access and understanding of digital health services, their usage of these services and devices, the collection and utilization of digital healthcare data, their attitudes toward sharing health data, and the potential effects and consequences of the digitalization of healthcare.

Whenever possible, responses from all five countries are presented in the same table or figure. However, for some questions, data is displayed in country-specific graphs due to substantial differences in healthcare systems among the countries. All responses are cross-referenced with background variables such as age, gender, and education. Additionally, answers from seven questions are correlated with the region of residence, and answers from 13 questions are linked to citizens' need for assistance when using digital health services. All numerical values are presented as integers, with percentages rounded accordingly.