Patient-reported preferences in eHealth-based cardiac rehabilitation: A qualitative investigation of behavior change techniques, barriers and facilitators
Background: Cardiac rehabilitation (CR) reduces recurrent cardiac events and mortality in patients with cardiovascular diseases (CVD). Innovative eHealth methods can facilitate CR uptake and effectiveness by addressing barriers associated with clinic-based rehabilitation. Tailoring eHealth-based CR...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-03-01
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| Series: | Internet Interventions |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214782924000216 |
| _version_ | 1827329786743095296 |
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| author | Emma R. Douma Svenja Wirtz Manuela Sestayo Fernandez Hendrik Schäfer Jos W.M.G. Widdershoven Mirela Habibović Carlos Peña Gil Jos A. Bosch Boris Schmitz Willem J. Kop |
| author_facet | Emma R. Douma Svenja Wirtz Manuela Sestayo Fernandez Hendrik Schäfer Jos W.M.G. Widdershoven Mirela Habibović Carlos Peña Gil Jos A. Bosch Boris Schmitz Willem J. Kop |
| author_sort | Emma R. Douma |
| collection | DOAJ |
| description | Background: Cardiac rehabilitation (CR) reduces recurrent cardiac events and mortality in patients with cardiovascular diseases (CVD). Innovative eHealth methods can facilitate CR uptake and effectiveness by addressing barriers associated with clinic-based rehabilitation. Tailoring eHealth-based CR to patient preferences is needed to further enhance CR. Purpose: To identify preferred behavior change techniques (BCTs) as well as barriers and facilitators for the different health behaviors targeted in eHealth-based CR among patients who have been referred to CR. Methods: Thirty-nine patients were interviewed in nine focus groups in The Netherlands, Germany, and Spain. A thematic analysis, using a combined deductive and inductive approach to coding, was conducted to identify BCTs and barriers and facilitators to behavior change. Behaviors under investigation included physical activity, medication adherence, eating a cardiac healthy-diet, stress reduction and smoking cessation. Results: The perceived helpfulness of BCTs depended on the specific behavior targeted. Common barriers were negative emotional state and physical limitations. A desire to feel physically or mentally well and having experienced a cardiac life event were the most common facilitators across health behaviors. Specific BCTs, barriers and facilitators were found for each of the health behavior. Conclusions: Behavior change techniques that patients preferred for each health behavior targeted in eHealth-based CR were identified. A negative emotional state, experiencing a life event, and improving physical functioning are important barriers and facilitators in multiple behaviors targeted in eHealth-based CR programs. Additional tailoring of interventions to patient preferences for BCTs and patient-specific barriers and facilitators per health behavior could lead to further improvement of eHealth-based CR. |
| first_indexed | 2024-03-07T15:46:09Z |
| format | Article |
| id | doaj.art-1464241b3ce14c21ba46e57ccd21223f |
| institution | Directory Open Access Journal |
| issn | 2214-7829 |
| language | English |
| last_indexed | 2024-03-07T15:46:09Z |
| publishDate | 2024-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Internet Interventions |
| spelling | doaj.art-1464241b3ce14c21ba46e57ccd21223f2024-03-05T04:29:52ZengElsevierInternet Interventions2214-78292024-03-0135100728Patient-reported preferences in eHealth-based cardiac rehabilitation: A qualitative investigation of behavior change techniques, barriers and facilitatorsEmma R. Douma0Svenja Wirtz1Manuela Sestayo Fernandez2Hendrik Schäfer3Jos W.M.G. Widdershoven4Mirela Habibović5Carlos Peña Gil6Jos A. Bosch7Boris Schmitz8Willem J. Kop9Tilburg University, Department of Medical and Clinical Psychology, Center of Research on Psychological Disorders and Somatic Diseases (CoRPS), Tilburg, the Netherlands; Corresponding author at: Department of Medical and Clinical Psychology, P.O. Box 90153, 5000 LE Tilburg, the Netherlands.DRV Clinic Königsfeld, Center for Medical Rehabilitation, Ennepetal, Germany; Department of Rehabilitation Sciences, Faculty of Health, University of Witten/Herdecke, Witten, GermanyHospital Universitario de Santiago de Compostela, Servizo Galego De Saude, Santiago de Compostela, SpainDRV Clinic Königsfeld, Center for Medical Rehabilitation, Ennepetal, Germany; Department of Rehabilitation Sciences, Faculty of Health, University of Witten/Herdecke, Witten, GermanyTilburg University, Department of Medical and Clinical Psychology, Center of Research on Psychological Disorders and Somatic Diseases (CoRPS), Tilburg, the Netherlands; Elisabeth-TweeSteden Hospital, Department of Cardiology, Tilburg, the NetherlandsTilburg University, Department of Medical and Clinical Psychology, Center of Research on Psychological Disorders and Somatic Diseases (CoRPS), Tilburg, the NetherlandsHospital Universitario de Santiago de Compostela, Servizo Galego De Saude, Santiago de Compostela, SpainUniversity of Amsterdam, Faculty of Social and Behavioral Sciences, Amsterdam, the NetherlandsDRV Clinic Königsfeld, Center for Medical Rehabilitation, Ennepetal, Germany; Department of Rehabilitation Sciences, Faculty of Health, University of Witten/Herdecke, Witten, GermanyTilburg University, Department of Medical and Clinical Psychology, Center of Research on Psychological Disorders and Somatic Diseases (CoRPS), Tilburg, the NetherlandsBackground: Cardiac rehabilitation (CR) reduces recurrent cardiac events and mortality in patients with cardiovascular diseases (CVD). Innovative eHealth methods can facilitate CR uptake and effectiveness by addressing barriers associated with clinic-based rehabilitation. Tailoring eHealth-based CR to patient preferences is needed to further enhance CR. Purpose: To identify preferred behavior change techniques (BCTs) as well as barriers and facilitators for the different health behaviors targeted in eHealth-based CR among patients who have been referred to CR. Methods: Thirty-nine patients were interviewed in nine focus groups in The Netherlands, Germany, and Spain. A thematic analysis, using a combined deductive and inductive approach to coding, was conducted to identify BCTs and barriers and facilitators to behavior change. Behaviors under investigation included physical activity, medication adherence, eating a cardiac healthy-diet, stress reduction and smoking cessation. Results: The perceived helpfulness of BCTs depended on the specific behavior targeted. Common barriers were negative emotional state and physical limitations. A desire to feel physically or mentally well and having experienced a cardiac life event were the most common facilitators across health behaviors. Specific BCTs, barriers and facilitators were found for each of the health behavior. Conclusions: Behavior change techniques that patients preferred for each health behavior targeted in eHealth-based CR were identified. A negative emotional state, experiencing a life event, and improving physical functioning are important barriers and facilitators in multiple behaviors targeted in eHealth-based CR programs. Additional tailoring of interventions to patient preferences for BCTs and patient-specific barriers and facilitators per health behavior could lead to further improvement of eHealth-based CR.http://www.sciencedirect.com/science/article/pii/S2214782924000216Cardiovascular diseaseCardiac rehabilitationHealth behavior changeBehavior change techniqueseHealth |
| spellingShingle | Emma R. Douma Svenja Wirtz Manuela Sestayo Fernandez Hendrik Schäfer Jos W.M.G. Widdershoven Mirela Habibović Carlos Peña Gil Jos A. Bosch Boris Schmitz Willem J. Kop Patient-reported preferences in eHealth-based cardiac rehabilitation: A qualitative investigation of behavior change techniques, barriers and facilitators Internet Interventions Cardiovascular disease Cardiac rehabilitation Health behavior change Behavior change techniques eHealth |
| title | Patient-reported preferences in eHealth-based cardiac rehabilitation: A qualitative investigation of behavior change techniques, barriers and facilitators |
| title_full | Patient-reported preferences in eHealth-based cardiac rehabilitation: A qualitative investigation of behavior change techniques, barriers and facilitators |
| title_fullStr | Patient-reported preferences in eHealth-based cardiac rehabilitation: A qualitative investigation of behavior change techniques, barriers and facilitators |
| title_full_unstemmed | Patient-reported preferences in eHealth-based cardiac rehabilitation: A qualitative investigation of behavior change techniques, barriers and facilitators |
| title_short | Patient-reported preferences in eHealth-based cardiac rehabilitation: A qualitative investigation of behavior change techniques, barriers and facilitators |
| title_sort | patient reported preferences in ehealth based cardiac rehabilitation a qualitative investigation of behavior change techniques barriers and facilitators |
| topic | Cardiovascular disease Cardiac rehabilitation Health behavior change Behavior change techniques eHealth |
| url | http://www.sciencedirect.com/science/article/pii/S2214782924000216 |
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