Developing a framework for cardiovascular disease digital peer support interventions: a multi-component qualitative study

Abstract Background/Introduction Peer support (information/support sharing between people with the same condition) improves health outcomes among people with cardiovascular disease (CVD). However, current peer support interventions are diverse. Evidence is lacking on the perceived benefits and elements that are considered priorities, especially for digital interventions. Purpose The aims of this study were to 1) describe perceived benefits and recommendations for CVD peer support programs from people attending in-person peer support, 2) identify priorities for digital peer support from consumers and clinicians testing a peer support app prototype, and 3) develop a framework to inform future peer support interventions. Methods Study aims were addressed in two components using qualitative methodology. In Component 1, semi-structured focus groups were conducted with CVD in-person peer support groups attenders, exploring the perceived benefits of peer support and recommendations for future programs. In Component 2, semi-structured interactive workshops with consumers with CVD and semi-structured online interviews with CVD clinicians were undertaken, seeking feedback and recommendations for digital peer support using an exploratory CVD peer support application prototype. Data were recorded digitally, transcribed verbatim, and analysed thematically. Then, both components were iteratively synthesised to inform a digital peer support development framework. Results In Component 1, 22 participants (age range 29-84 years, male 45%) took part in focus groups. The overarching theme was that peer support provides benefits through sharing experiences. Five themes were identified; (i) peer support provides a way of coping, (ii) peers learn from each other, (iii) peers understand what each other are going through, (iv) the peer community uplifts mood and build confidence, and (v) awareness, flexibility and resources are important for engagement. In Component 2, five participants (age range 55-74 years, male 60%) attended two workshops and eight clinicians (age range 30-65 years, male 10%) were interviewed. Three themes were identified: (i) autonomy is essential to promote engagement, (ii) safeguarding is important to both users and clinicians, and (iii) interfaces that are simple, easy to use and visually attractive enable use. Priorities identified from both components included greater peer support awareness and uptake, flexibility with timing and family participation, healthcare professional involvement, provision of resources, autonomous features enabling choice, checklists and clinician moderation for safeguarding, and simple to use interfaces (Figure 1). Conclusion Peer support participants benefit from sharing their experience of living with CVD, which enables coping, learning, feeling understood and a sense of community. It is recommended that digital peer support developers prioritise six key areas: uptake, flexibility, resources, autonomy, safeguarding and interface.Figure 1.Key priorities of peer support