Exploring COPD Participants' Experiences in a Comprehensive Telewellness Program within a Mixed-Disability Cohort: A...

Telehealth pulmonary rehabilitation (PR) has expanded access to rehabilitation services for individuals with Chronic Obstructive Pulmonary Disease (COPD); however, participation and adherence remain variable. COPD management emphasizes patient-centered approaches that address heterogeneity of this condition. Although telehealth PR has improved access to care, there is a need to better understand how broader telewellness programs can support patient-centered care and improve patient engagement.

This study aimed to explore how individuals with COPD perceive changes in their physical and psychological health after participation in a generic, group-based telewellness (MENTOR: mindfulness, exercise and nutrition to optimize resilience) program. It further examined how personal and contextual factors influence engagement by identifying barriers and facilitators across five domains (built environment and community context, service delivery, instructional strategies, equipment and technology use, and policy factors) as per Guidelines, Recommendations, and Adaptations Including Disability (GRAIDs) framework. Additionally, we explored the recommendations for enhancing telewellness models for individuals with COPD.

In-depth semi-structured interviews were conducted with participants (n=15) who completed the program. Transcripts were analyzed using Braun and Clarke's six-step thematic analysis.

Twelve primary themes were identified. Participants reported improvements in motivation, confidence in physical activity, emotional regulation, and nutrition awareness. The group-based format reduced isolation and fostered peer support. Program engagement was influenced by symptom burden, comorbidities, home environment, social support, and digital literacy. Participants valued supportive instructors, multimodal instructions (verbal, visual, written summaries, live demonstrations), adaptive exercise program, a user-friendly telehealth platform, and program's holistic nature. Participants emphasized the need for tailored nutrition guidance, technical training for telehealth platform and equipment use, and long-term access to program resources.

A generic, 8-week telewellness program designed for individuals with mobility limitations was acceptable and beneficial for individuals with COPD.