Adapting digital tools for physical activity scheduling and monitoring in cardiac rehabilitation to low-resource settings: a qualitative study (Preprint)

BACKGROUND Digital tools for scheduling and monitoring physical activity offer a promising solution in cardiac rehabilitation, to support patients’ adherence to regular heart-healthy physical activity. However, most available tools have been developed for high-resource settings and developing new tools for low- and middle-income countries is costly and time-consuming. OBJECTIVE This study explored considerations for adapting existing digital tools to low-resource settings, based on the example of adapting a tool developed in Austria for use in Sri Lanka. METHODS A qualitative descriptive design was used. Eighteen participants, including medical doctors, nurses, physiotherapists and former cardiac rehabilitation patients, were recruited purposively from two teaching hospitals in Sri Lanka. Semi-structured interviews and focus group discussions were conducted online, demonstrating the Austrian aktivplan digital tool and gathering participants’ views on the suitability of the tool for their healthcare setting. Transcripts were analyzed using framework analysis, paying particular attention to transferable findings. RESULTS Three major themes were described: Acceptability and benefits of digital tools identified high acceptability for participants, especially patients. They perceived that such a tool could promote personalised care, improve remote care and self-management and provide structured guidance. Anticipated challenges included the digital divide, low patient motivation and clinical workflow constraints. Required adaptations identified translation to local languages, culturally appropriate exercises, workplace integration and visual guidance. CONCLUSIONS The study developed transferable considerations when adapting an existing digital tool for scheduling and monitoring physical activity to a low-resource setting. These finding can inform the adaptation and implementation of such tools in diverse healthcare settings. CLINICALTRIAL Not applicable