Background: Cardiac telerehabilitation (CTR) interventions can provide accessible and affordable remote rehabilitation services. However, as cardiac rehabilitation (CR) primarily targets inactive patients, little is known about the experiences with CR of highly active patients (ie, recreational athletes or, simply, athletes) with established coronary artery disease. Consequently, existing CTR interventions do not address the specific needs of the athletic subpopulation. Understanding the needs and values of athletes is crucial for designing meaningful CTR interventions that enhance user acceptance and engagement, thereby facilitating effective rehabilitation for this patient subgroup. Objective: This study aimed to inform the design of technologies that facilitate CTR for athletes. We intended to identify athletes' values related to CR, including health and sports tracking, as well as high-level requirements for technologies that can facilitate the CTR of athletes according to the identified values. Methods: We used value-sensitive design with a human-centric design approach to elicit design requirements for CTR that can serve athletes with established coronary artery disease. To identify athletes' values, we conducted 25 value-oriented semistructured interviews with 15 athletic patients and 10 health care professionals involved in CR programs. In a second phase, we conducted 6 card-sorting focus group sessions with 13 patients and 7 health care professionals to identify desired CTR features. Finally, we derived high-level CTR technology requirements connected to the athletes' needs and values. Results: We defined 12 athlete values divided into 3 categories: body centric, care centric, and data and technology centric. We clustered findings from the card-sorting activity into CTR technology requirements, such as remotely monitored sport-specific training and training data representations next to clinical limitations, and paired them with corresponding values. Conclusions: Athletes have distinct values and health goals in CR compared to general populations targeted by CTR interventions. Designing patient-centric CTR interventions that address these needs is crucial to support optimal recovery, safe return to sports, and adherence to CTR technologies in the home environment.

Nearly 20 years ago, Gaver et al. introduced ambiguity as a design resource, proposing tactics to reflect everyday uncertainty into interactive systems. This approach is especially relevant for self-tracking wearables, which often obscure the inherent ambiguity of system design and tracked phenomena with seemingly clear, prescriptive data and insights. Although scholars recognize the importance of ambiguity, its practical application in the design process remains underexplored. To address this, we conducted a two-week workshop with 60 designers, examining the application of Gaver et al.’s tactics into 11 design concepts, and performed interviews with 16 participants. Our findings reveal eight relevant ambiguity tactics for self-tracking and offer insights into participants’ experiences with designing using ambiguity. We discuss prescription and overlooked ambiguity as levers for the operationalization of ambiguity, the potential benefits and downsides of ambiguity tactics for users, future directions for HCI research and practice, and the study limitations.

Purpose: To define the user needs and preferences of the athletic population in cardiac (tele)rehabilitation (CTR).

Patients and Methods: In this qualitative study, we included athletes with established coronary artery disease (CAD) who participated in a cardiac rehabilitation (CR) program and health care professionals involved in CR. All athletes engaged in sports for at least four hours per week. Fourteen male and one female athlete (mean age 63 ± 10.6 years) participated in CR after an acute coronary syndrome, percutaneous coronary intervention and/or coronary bypass surgery. The twelve healthcare professionals invited included cardiac nurse practitioners, cardiologists, sports physicians, physiotherapists, and a clinical psychologist. This study consists of four phases: a stakeholder identification session, twenty-five semi-structured individual interviews, six card-sorting focus groups and a data analysis phase with thematic analysis.

Results: User needs for athletes in CR encompass personalized exercise plans featuring clear and quantifiable exercise recommendations and limitations. Additionally, there is a need for monitoring health and exercise data; measuring progression and performance longitudinally; easy-to-use, and reliable healthcare information systems with accurate sensors and data; as well as clinical supervision and validation of information and data. Social support from both peers and family is also identified as a crucial need. The preferred technological features for a CTR system tailored for athletes include periodic digital consultations with clinicians, home-based training specific to one’s sport, utilization of technology to monitor workouts, data sharing and remote feedback, personalized exercise recommendations and online educational materials.

Conclusion: This research explored the user needs and preferences of athlete patients in CR. The findings indicated that enhancing CR for athletes necessitates a personalized and sport-specific methodology. The integration of various technological features within a CTR program can play a pivotal role in assisting athletes with CAD to maintain an active lifestyle and regain their previous athletic performance levels.

Cardiac telerehabilitation (CTR) relies heavily on telemonitoring, predominantly gathering automated biophysical or survey data for clinical decision-making. However, lifestyle change during and after cardiac rehabilitation (CR) outside hospitals is impacted by many contextual factors, including mental well-being or social support. Failure to acknowledge these factors in remote cardiac care could result in healthcare professionals (HCPs) offering standardized recommendations that hinder health management. To gain insights into the utilization of contextual information in clinical decision-making in Dutch CR, we conducted semi-structured interviews with seven HCPs and CR experts. Our data analysis highlights the importance of routine, physical, and psychosocial information during holistic clinical decision-making. We argue for a transition towards a holistic approach to telemonitoring in CTR, discussing implications for more inclusive and contextual data-gathering practices.