Personas supporting the development of a digital cardiac rehabilitation programme: a methodological approach representing end-user needs

Introduction Cardiac rehabilitation (CR) is a Class 1A guideline recommended treatment and secondary preventive strategy for patients with coronary artery disease (CAD). Digital solutions for CR show promise to improve patient attrition and outcomes. However, development of digital solutions is time consuming, and more knowledge is needed on techniques to ensure that solutions meet the diverse needs of end-users and effectively motivate their engagement. Purpose To explore the use of personas as a design tool supporting the development of a digital CR programme. Methods Personas were developed in the early phase of the project, based on user-centred design as well as incorporating both qualitative and quantitative data from extensive studies on patient populations with CAD. This comprehensive data collection was strengthened through workshops involving a multidisciplinary group of stakeholders (N=30). These workshops facilitated collaborative discussions that allowed for the identification and synthesis of key user characteristics, preferences, and challenges faced by end-users in CR programmes. Results The development of two personas revealed significant differences in preferences and needs among patients. They represented both elderly and middle-aged women and men, with reduced mobility, multimorbidity, polypharmacy, and varying levels of digital health literacy (Figure 1). Older patients reported a lower capacity for physical activity, preference for simple log-in and digital interfaces, while younger users requested integration with existing health apps. Integrating insights from both empirical data and stakeholder experiences, the personas captured the diversity of needs across the target population. Conclusion The use of personas in the development of a digital CR programme provided a valuable way to incorporate the patient voice into the design process. This approach helped identify and address various healthcare needs for different end-users, potentially contributing to tailored content and functionality within the programme, and reduce inequalities in providing a digital CR programme. Still, the development and use of personas does not replace active end-user involvement in developing digital CR programmes.