Background: Remote patient management (RPM) using smartphone-enabled health monitoring devices (SHMDs) can be an effective, value-added part of cardiovascular care. However, cardiac patients’ adherence to RPM is variable. Personas are fictional representations of users with common behaviors, needs, and motivation and can thereby help guide tailoring of interventions to be meaningful and possibly more effective. Personas can be used to understand the needs of the patient group and guide tailoring toward more personalized and effective eHealth intervention. Objective: The aim of this study was to develop data-driven personas for patients with myocardial infarction (MI) based on both quantitative and qualitative results. Methods: This study used a mixed methods design involving (1) database analysis of patients with MI (N=261) SHMD usage data (blood pressure [BP], weight, step count) over the course of a one-year care track and (2) semistructured interviews with patients with MI (N=16) currently using SHMDs. Overall, 12-month adherence rates were calculated based on the number of weeks patients performed the prescribed home measurements with the SHMDs. Results: A cluster analysis was conducted on the self-monitoring data resulting in four distinctive usage patterns labeled as stiff starting (low adherent in first 6 weeks: 13%, 34/261 of users), temporary persisting (decreasing adherence: 24%, 62/261), loyally persisting (continuously adherent: 26%, 68/261), and negligent quitting (nonadherent: 37%, 97/261). Health outcomes (BP, step count, and weight) were analyzed based on these patterns. More adherent usage patterns show better controlled BP when compared to less adherent usage patterns, suggesting that adherence is associated with health outcomes. Patient experiences regarding adherence or nonadherence to the RPM relating to the four distinctive usage patterns were uncovered by means of semistructured interviews, providing insight into adherence factors most relevant for each of the clusters. Thus, 4 distinct personas were developed by data collection (database analysis and semistructured interviews), persona segmentation, and persona creation, named Tamara, Sam, Peter, and Kim. Conclusions: This study identified 4 personas regarding adherence experiences and usage patterns of patients within an RPM care track. Adherent usage patterns were characterized by improved BP and step count. These personas can guide future tailoring of eHealth interventions to maximize patient adherence.

Background: Cardiovascular disease is one of the leading causes of disability worldwide. eHealth has the possibility to improve health outcomes and quality of life adjunct to regular care. “The Myocardial Infarction Box” (MI Box) is an at home monitoring system using smartphone-enabled health monitoring devices. However, like many eHealth interventions, the MI Box had variable adherence This variable adherence could be due to a misalignment with the needs of the users and the intervention. Through co-creation, this study aims to develop design strategies to enhance the effectiveness of the MI Box in the long term: to increase adherence in the first year and support MI patients in adopting a healthy lifestyle. Methods: Six iterative co-creation session were conducted with various stakeholders. One with designers and with healthcare professionals. Four sessions with users. In these sessions, the patient journey and patient personas were discussed to identify needs and opportunities for enhancements to the intervention. Furthermore, design strategies for enhancing the intervention, aiming both to optimize adherence and to stimulate a healthy lifestyle, were discussed. Findings: This resulted in themes such as personalized feedback, understanding the data, and regaining confidence in one’s own body to be key aspects to creating a more meaningful and personally relevant intervention. Discussion: Involving the stakeholders in co-creation sessions provides invaluable insights into the userexperiences and opportunities for personalization. Adapting the intervention to these needs is the next step to increase engagement with the intervention and thereby increase adherence.