Older adults' ability to access and use electronic health information is generally low, requiring innovative approaches for improvement. An integrated e-tutorial overlays instructions onto Websites. The literature suggests integrated e-tutorials are more effective than paper or video-based tutorials for younger people, but little is known about their effectiveness for older adults. This study explores the applicability of an integrated e-health tutorial for older adults. An integrated e-tutorial, the Online Tutorial Overlay Presenter (OnTOP), added an instructional overlay to the NIHSeniorHealth.gov Website. Overlay features were examined in seven participatory design sessions with seven older adults. Participatory design techniques were used to elicit participants' preferences for tutorial features. Three themes emerged: 1) using contextual cues; 2) tailoring to the learner's literacy level; and 3) enhancing interfaces with multimedia cues. These findings improved the design features of OnTOP. They also generated empirical evidence about the effects of multimedia learning among older adults.