Willingness to participate in cardiac telerehabilitation: results from semi-structured interviews

Abstract

Introduction Cardiac rehabilitation (CR) is indicated in patients with cardiovascular disease but participation rates remain low. Telerehabilitation (TR) is often proposed as a solution. While many trials have investigated TR, few have studied participation rates in conventional CR non-participants. The aim of this study was to identify the percentage of patients that would be willing to participate in a TR programme to identify the main perceived barriers and facilitators for participating in TR. Methods Two groups of patients were recruited: CR non-participants and CR participants. Semi-structured interviews were conducted. Results Thirty non-participants and 30 participants were interviewed. Of CR non-participants, 33% would participate in TR and 10% would participate in a blended CR programme (combination of centre-based CR and TR). Of CR participants, 60% would participate in TR and 70% would be interested in a blended CR programme. Of those that would participate in TR, 44% would prefer centre-based CR, 33% would prefer a blended CR programme and 11% would prefer a full TR programme. In both groups, the main facilitating aspect about TR was not needing transport and the main barrier was digital literacy. Conclusion For CR non-participants TR will only partly solve the problem of low participation rates and blended programmes might not offer a solution. CR participants are more prepared to participate in TR and blended CR. Digital literacy was in both groups mentioned as an important barrier, emphasizing the challenges for healthcare and local governments to keep educating all types of patients in digital literacy.

The Effects of an Online–Offline Hybrid Exercise Program on the Lives of Children with Cerebral Palsy Using Wheelchairs during the COVID-19 Pandemic in Korea

“…In addition, although active parental involvement could play a significant role in intervention programs for health behaviors [ 49 ], the parents’ and caregivers’ lack of technical knowledge made it difficult to support the participants’ online participation, which possibly led to relatively high dropout rates. Many studies on digital health services for people with disabilities or chronic illness actually showed that digital literacy and related support were essential factors for the effectiveness of the program [ 50 ]. Therefore, the guidelines or support of online program usage for parents and caregivers should be given in more detail and easier formats in future studies than the ones that were applied in our study.…”

No transport? No worries! Cardiac telerehabilitation is a feasible and effective alternative to centre-based programs

“…One of the commonly reported barriers to accessing telerehabilitation is digital literacy [ 37 ]. It is important to upskill the participant in digital literacy where required.…”

“…A critical factor in the sustainability of alternative cardiac rehabilitation programs beyond the pandemic is a better understanding of an individual’s preferences. A recent Belgian study has shed some light on an individual’s willingness to participate in these alternative programs [ 37 ]. For example, a majority (60%) of participants in cardiac rehabilitation would participate in remote cardiac rehabilitation with an even larger proportion (70%) being interested in hybrid cardiac rehabilitation [ 37 ].…”

“…A recent Belgian study has shed some light on an individual’s willingness to participate in these alternative programs [ 37 ]. For example, a majority (60%) of participants in cardiac rehabilitation would participate in remote cardiac rehabilitation with an even larger proportion (70%) being interested in hybrid cardiac rehabilitation [ 37 ]. An equal proportion of these would prefer centre-based cardiac rehabilitation (44%) compared with either remote or hybrid cardiac rehabilitation (44%).…”

“…An equal proportion of these would prefer centre-based cardiac rehabilitation (44%) compared with either remote or hybrid cardiac rehabilitation (44%). Interestingly, the study showed that only 33% of non-participants in cardiac rehabilitation would be prepared to participate in remote cardiac rehabilitation, and an even smaller proportion (10%) would be prepared to participate in hybrid cardiac rehabilitation [ 37 ]. It appears that those already enrolled in cardiac rehabilitation are more prepared to trial alternative models and may reflect their status as having prepared to change their health behaviours [ 42 , 43 ].…”