Exploring Gender-based Experiences in a Digitally Delivered Cardiac Rehabilitation Program: Qualitative Insights From...

Cardiac rehabilitation (CR) is a cornerstone of secondary prevention for individuals with cardiovascular disease, yet participation remains suboptimal, particularly among women. Digital CR programs offer flexible alternatives; however, little is known about how gender influences engagement and experience in these settings.

This qualitative descriptive study explored gendered experiences within the My Heart Coach (MHC) digital CR program. Thirty-two participants (20 women, 12 men), mean age 63.7 years, who had completed the 12-week program were purposively sampled to ensure diversity in education, employment, stress, ethnicity, and geographic region. Semi-structured interviews were conducted between November 2024 and May 2025, audio-recorded and transcribed verbatim. Thematic analysis was used to identify patterns in participant narratives. Data collection and analysis proceeded iteratively until thematic saturation was achieved.

Three major themes were identified. Theme one, "From Cardiac Event to Recovery - Characterizing the MHC Cohort," explores participants' gender-based experiences of having a cardiac event. Theme two, "Gender and Accessibility with Digital Program Elements," highlights gender-based differences in engagement with the CR program. Women and men encountered distinct barriers and facilitators, with women prioritizing flexibility and social connection, and men valuing privacy and autonomy. Theme three, "Rebuilding - Gendered Motivations and Identity in Digital Cardiac Rehabilitation," explores other program motivators, facilitators, and changes following completion of the digital program.

Gender shapes how participants experience and engage in digital CR programs. These findings underscore the need for a gender-responsive design in CR that can enhance participation and support diverse needs in a scalable manner.