{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T17:42:37Z","timestamp":1787161357621,"version":"build-2736575974"},"reference-count":53,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Cardio"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec sec-type=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Advances in digital technology, such as health apps and telerehabilitation systems, offer promising treatment modalities in the secondary prevention of cardiovascular disease. However, the successful adoption of digital technology in clinical practice depends on a variety of factors. A comprehensive understanding of the influencing factors on digital technology usage in health care can support the complex implementation process of digital technology in clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"objective\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim of this study was to identify barriers and facilitators of digital technology usage in cardiovascular disease secondary prevention from the perspective of health care professionals, and to explore whether certain characteristics of health care professionals are related to the current usage of digital technology in clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted an exploratory online survey, inquiring about the perspectives and uses of digital technologies in cardiovascular disease secondary prevention. We developed an original questionnaire to address the study aim. The survey invitation was distributed among health care professionals from November 2021 to February 2022, via all cardiac rehabilitation centers, all community-based disease management services for patients with chronic heart failure, and all relevant national health care professional associations in Austria. Qualitative survey data were analyzed using thematic content analysis. Quantitative survey data were analyzed using descriptive statistics, group comparison tests, and association statistics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 125 health care professionals (mean age 41, SD 11 y; n=80, 64% females) across different professions and settings, including cardiac rehabilitation phases I through IV, were recruited. General readiness for using digital technologies in the care of cardiac patients was high, but only 65 (52%) respondents reported doing so. The top 3 rated barriers to digital technology use were poor user-experience of devices and apps, lack of cost coverage, and low digital competence of patients. The top 3 rated potential application areas for digital technology were organization and appointment planning, documenting treatments, and creating personalized treatment plans. The top 3 rated facilitators for digital technology use were assurance of patient safety, assurance of patients\u2019 privacy, and availability of technical support. Greater personal use of digital technology, younger age, and higher technology affinity of health care professionals was associated with higher readiness to use digital technology with cardiac patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>While there is interest in digital technology for the secondary prevention of cardiovascular disease in Austria, barriers to uptake need to be addressed. Our findings may inform the design and implementation of future digitalization projects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/71366","type":"journal-article","created":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T14:20:06Z","timestamp":1747232406000},"page":"e71366-e71366","source":"Crossref","is-referenced-by-count":6,"title":["Health Care Professionals\u2019 Use of Digital Technology in the Secondary Prevention of Cardiovascular Disease in Austria: Online Survey Study"],"prefix":"10.2196","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-3672-8091","authenticated-orcid":false,"given":"Luisa","family":"Lunz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6524-1724","authenticated-orcid":false,"given":"Sabine","family":"W\u00fcrth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5419-6713","authenticated-orcid":false,"given":"Stefan Tino","family":"Kulnik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,6,25]]},"reference":[{"issue":"25","key":"R1","doi-asserted-by":"publisher","first-page":"2980","DOI":"10.1016\/j.jacc.2020.11.021","article-title":"The global burden of cardiovascular diseases and risks: a compass for global action","volume":"76","author":"Roth","journal-title":"J Am Coll Cardiol"},{"issue":"10258","key":"R2","doi-asserted-by":"publisher","first-page":"1204","DOI":"10.1016\/S0140-6736(20)30925-9","article-title":"Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019","volume":"396","author":"Vos","journal-title":"Lancet"},{"issue":"34","key":"R3","doi-asserted-by":"publisher","first-page":"3227","DOI":"10.1093\/eurheartj\/ehab484","article-title":"2021 ESC Guidelines on cardiovascular disease prevention in clinical practice","volume":"42","author":"Visseren","journal-title":"Eur Heart J"},{"issue":"1","key":"R4","doi-asserted-by":"publisher","DOI":"10.5334\/gh.1278","article-title":"World Heart Federation roadmap for secondary prevention of cardiovascular disease: 2023 update","volume":"19","author":"Laranjo","journal-title":"Glob Heart"},{"issue":"8","key":"R5","doi-asserted-by":"publisher","first-page":"824","DOI":"10.1177\/2047487318825350","article-title":"Lifestyle and impact on cardiovascular risk factor control in coronary patients across 27 countries: results from the European Society of Cardiology ESC-EORP EUROASPIRE V registry","volume":"26","author":"Kotseva","journal-title":"Eur J Prev Cardiol"},{"issue":"11","key":"R6","doi-asserted-by":"publisher","first-page":"1166","DOI":"10.1177\/2047487319832394","article-title":"ESC e-cardiology working group position paper: overcoming challenges in digital health implementation in cardiovascular medicine","volume":"26","author":"Frederix","journal-title":"Eur J Prev Cardiol"},{"issue":"36","key":"R7","doi-asserted-by":"publisher","first-page":"3415","DOI":"10.1093\/eurheartj\/ehae177","article-title":"2024 ESC Guidelines for the management of chronic coronary syndromes","volume":"45","author":"Vrints","journal-title":"Eur Heart J"},{"issue":"2","key":"R8","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1016\/j.cjca.2016.08.017","article-title":"Effect of mobile health interventions on the secondary prevention of cardiovascular disease: systematic review and meta-analysis","volume":"33","author":"Gandhi","journal-title":"Can J Cardiol"},{"issue":"3","key":"R9","doi-asserted-by":"publisher","DOI":"10.2196\/21061","article-title":"Digital technology interventions for risk factor modification in patients with cardiovascular disease: systematic review and meta-analysis","volume":"9","author":"Akinosun","journal-title":"JMIR Mhealth Uhealth"},{"issue":"1","key":"R10","doi-asserted-by":"publisher","DOI":"10.1186\/s12966-020-00955-2","article-title":"Can consumer wearable activity tracker-based interventions improve physical activity and cardiometabolic health in patients with chronic diseases? A systematic review and meta-analysis of randomised controlled trials","volume":"17","author":"Franssen","journal-title":"Int J Behav Nutr Phys Act"},{"issue":"10","key":"R11","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0258460","article-title":"Smartphone applications for physical activity and sedentary behaviour change in people with cardiovascular disease: a systematic review and meta-analysis","volume":"16","author":"Patterson","journal-title":"PLOS ONE"},{"issue":"7","key":"R12","doi-asserted-by":"publisher","first-page":"1047","DOI":"10.1093\/eurjpc\/zwab146","article-title":"Impact of activity trackers on secondary prevention in patients with coronary artery disease: a systematic review and meta-analysis","volume":"29","author":"Kaihara","journal-title":"Eur J Prev Cardiol"},{"issue":"5","key":"R13","doi-asserted-by":"publisher","first-page":"460","DOI":"10.1177\/2047487320913379","article-title":"Secondary prevention through comprehensive cardiovascular rehabilitation: From knowledge to implementation. 2020 update. A position paper from the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology","volume":"28","author":"Ambrosetti","journal-title":"Eur J Prev Cardiol"},{"issue":"10","key":"R14","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD007130.pub5","article-title":"Home-based versus centre-based cardiac rehabilitation","volume":"10","author":"McDonagh","journal-title":"Cochrane Database Syst Rev"},{"issue":"7","key":"R15","doi-asserted-by":"publisher","first-page":"1017","DOI":"10.1093\/eurjpc\/zwab106","article-title":"Effectiveness of home-based cardiac telerehabilitation as an alternative to Phase 2 cardiac rehabilitation of coronary heart disease: a systematic review and meta-analysis","volume":"29","author":"Ramachandran","journal-title":"Eur J Prev Cardiol"},{"issue":"1","key":"R16","doi-asserted-by":"publisher","DOI":"10.5334\/gh.1141","article-title":"World Heart Federation roadmap for digital health in cardiology","volume":"17","author":"Tromp","journal-title":"Glob Heart"},{"issue":"11","key":"R17","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.8775","article-title":"Beyond adoption: a new framework for theorizing and evaluating nonadoption, abandonment, and challenges to the scale-up, spread, and sustainability of health and care technologies","volume":"19","author":"Greenhalgh","journal-title":"J Med Internet Res"},{"issue":"1","key":"R18","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1093\/ehjdh\/ztab005","article-title":"Barriers and facilitators of the uptake of digital health technology in cardiovascular care: a systematic scoping review","volume":"2","author":"Whitelaw","journal-title":"Eur Heart J Digit Health"},{"issue":"3","key":"R19","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.6.3.e34","article-title":"Improving the quality of web surveys: the Checklist for Reporting Results of Internet E-Surveys (CHERRIES)","volume":"6","author":"Eysenbach","journal-title":"J Med Internet Res"},{"issue":"1-2","key":"R20","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1007\/s10354-017-0607-x","article-title":"Cardiac rehabilitation in Austria","volume":"168","author":"Niebauer","journal-title":"Wien Med Wochenschr"},{"issue":"2","key":"R21","doi-asserted-by":"publisher","DOI":"10.2196\/15935","article-title":"Social, organizational, and technological factors impacting clinicians\u2019 adoption of mobile health tools: systematic literature review","volume":"8","author":"Jacob","journal-title":"JMIR Mhealth Uhealth"},{"issue":"4","key":"R22","doi-asserted-by":"publisher","first-page":"378","DOI":"10.1017\/S026646231300041X","article-title":"Telemedical versus conventional heart patient monitoring: a survey study with German physicians","volume":"29","author":"Klack","journal-title":"Int J Technol Assess Health Care"},{"key":"R23","doi-asserted-by":"crossref","unstructured":"Morris J Thompson N Wallace T Jones M DeRuyter F . Survey of rehabilitation clinicians in the United States: barriers and critical use-cases for mrehab adoption. In: Miesenberger K Manduchi R Covarrubias Rodriguez M Pe\u0148\u00e1z P , editors. Comput Help People Spec Needs. Springer International Publishing; 2020:250-258. [doi: 10.1007\/978-3-030-58805-2_30]","DOI":"10.1007\/978-3-030-58805-2_30"},{"key":"R24","doi-asserted-by":"crossref","unstructured":"Robinson J . Likert scale. In: Maggino F , editor. Encyclopedia of Quality of Life and Well-Being Research. Springer International Publishing; 2023:3917-3918. [doi: 10.1007\/978-3-031-17299-1_1654] ISBN: 978-3-031-17299-1","DOI":"10.1007\/978-3-031-17299-1_1654"},{"key":"R25","doi-asserted-by":"publisher","DOI":"10.17605\/OSF.IO\/N9JZ6","article-title":"Online survey of healthcare professionals on the use of digital technology in the secondary prevention of cardiovascular disease in Austria","author":"Kulnik","journal-title":"OSF"},{"issue":"24","key":"R26","doi-asserted-by":"publisher","first-page":"1451","DOI":"10.1136\/bjsports-2020-102955","article-title":"World Health Organization 2020 guidelines on physical activity and sedentary behaviour","volume":"54","author":"Bull","journal-title":"Br J Sports Med"},{"key":"R27","unstructured":"Karrer K Glaser C Clemens C Bruder C . Technikaffinit\u00e4t erfassen - der Fragebogen TA-EG [Book in German]. In: Lichtenstein A St\u00f6\u00dfel C Clemens C , editors. Der Mensch Im Mittelpunkt Technischer Systeme - 8 Berliner Werkstatt Mensch-Maschine-Systeme. VDI; 2009:196-201."},{"issue":"2","key":"R28","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"Braun","journal-title":"Qual Res Psychol"},{"issue":"21-22","key":"R29","doi-asserted-by":"publisher","first-page":"734","DOI":"10.1007\/s00508-014-0665-7","article-title":"HerzMobil Tirol network: rationale for and design of a collaborative heart failure disease management program in Austria","volume":"126","author":"Von der Heidt","journal-title":"Wien Klin Wochenschr"},{"key":"R30","unstructured":"Heartfish [Website in German]. URL: https:\/\/www.heartfish.io\/ [Accessed 31-01-2025]"},{"issue":"9","key":"R31","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/gnae078","article-title":"Ageism and (successful) digital engagement: a proposed theoretical model","volume":"64","author":"Mannheim","journal-title":"Gerontologist"},{"issue":"5-6","key":"R32","doi-asserted-by":"publisher","first-page":"745","DOI":"10.1111\/jocn.14710","article-title":"Healthcare professionals\u2019 competence in digitalisation: a systematic review","volume":"28","author":"Konttila","journal-title":"J Clin Nurs"},{"key":"R33","doi-asserted-by":"publisher","DOI":"10.1177\/2050312118773261","article-title":"Inside help: an integrative review of champions in healthcare-related implementation","volume":"6","author":"Miech","journal-title":"SAGE Open Med"},{"issue":"1","key":"R34","doi-asserted-by":"publisher","DOI":"10.1186\/s40798-018-0157-9","article-title":"The effect of physical activity interventions comprising wearables and smartphone applications on physical activity: a systematic review and meta-analysis","volume":"4","author":"Gal","journal-title":"Sports Med Open"},{"issue":"4","key":"R35","doi-asserted-by":"publisher","first-page":"1143","DOI":"10.31083\/j.rcm2204123","article-title":"Exercise-based cardiac rehabilitation programs in the era of COVID-19: a critical review","volume":"22","author":"Stefanakis","journal-title":"Rev Cardiovasc Med"},{"issue":"1","key":"R36","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-023-09287-w","article-title":"Evidence requirements of permanently listed digital health applications (DiGA) and their implementation in the German DiGA directory: an analysis","volume":"23","author":"M\u00e4der","journal-title":"BMC Health Serv Res"},{"issue":"3","key":"R37","doi-asserted-by":"publisher","first-page":"262","DOI":"10.21037\/cdt.2019.04.08","article-title":"Accuracy of wearable heart rate monitors in cardiac rehabilitation","volume":"9","author":"Etiwy","journal-title":"Cardiovasc Diagn Ther"},{"issue":"10","key":"R38","doi-asserted-by":"publisher","DOI":"10.2196\/25646","article-title":"Facilitators of and barriers to lifestyle support and ehealth solutions: interview study among health care professionals working in cardiac care","volume":"23","author":"Cohen Rodrigues","journal-title":"J Med Internet Res"},{"key":"R39","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijhcs.2018.04.007","article-title":"I track, therefore I walk \u2013 Exploring the motivational costs of wearing activity trackers in actual users","volume":"127","author":"Attig","journal-title":"Int J Hum Comput Stud"},{"key":"R40","doi-asserted-by":"publisher","DOI":"10.3389\/fspor.2024.1371652","article-title":"Patients\u2019 experiences and perspectives regarding the use of digital technology to support exercise-based cardiac rehabilitation: a qualitative interview study","volume":"6","author":"Zeller","journal-title":"Front Sports Act Living"},{"key":"R41","doi-asserted-by":"crossref","unstructured":"Gibson I Kerins C Foley L et al. Factors Influencing Implementation of Digital Cardiac Rehabilitation: A Qualitative Analysis of Health Workers Perspectives. HRB Open Research; 2024. [doi: 10.12688\/hrbopenres.13929.1]","DOI":"10.12688\/hrbopenres.13929.1"},{"issue":"1","key":"R42","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1111\/hex.13633","article-title":"Use of co-design methodology in the development of cardiovascular disease secondary prevention interventions: a scoping review","volume":"26","author":"Talevski","journal-title":"Health Expect"},{"issue":"2","key":"R43","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1177\/0733464815624151","article-title":"Older adults\u2019 acceptance of activity trackers","volume":"36","author":"Preusse","journal-title":"J Appl Gerontol"},{"issue":"7","key":"R44","doi-asserted-by":"publisher","first-page":"1623","DOI":"10.1038\/s41591-023-02391-8","article-title":"Digital health for aging populations","volume":"29","author":"Chen","journal-title":"Nat Med"},{"issue":"1","key":"R45","doi-asserted-by":"publisher","DOI":"10.2196\/26165","article-title":"Expanding telemonitoring in a virtual world: a case study of the expansion of a heart failure telemonitoring program during the COVID-19 pandemic","volume":"23","author":"Wali","journal-title":"J Med Internet Res"},{"key":"R46","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2018.02.001","article-title":"Effects of a 12-week mHealth program on peak VO2 and physical activity patterns after completing cardiac rehabilitation: a randomized controlled trial","volume":"199","author":"Duscha","journal-title":"Am Heart J"},{"issue":"16","key":"R47","doi-asserted-by":"publisher","first-page":"1782","DOI":"10.1177\/2047487320905717","article-title":"Long-term follow-up with a smartphone application improves exercise capacity post cardiac rehabilitation: a randomized controlled trial","volume":"27","author":"Lunde","journal-title":"Eur J Prev Cardiol"},{"key":"R48","unstructured":"Dorda W Duftschmid G Gerhold L Gall W Gambal J . Introducing the electronic health record in Austria. In: Connecting Medical Informatics and Bio-Informatics. IOS Press; 2005:119-124. URL: https:\/\/ebooks.iospress.nl\/publication\/10286 [Accessed 09-08-2024]"},{"key":"R49","unstructured":"eHealth-strategie \u00f6sterreich [Report in German]. Bundesministerium f\u00fcr Soziales, Gesundheit, Pflege und Konsumentenschutz; 2024."},{"issue":"3","key":"R50","doi-asserted-by":"publisher","DOI":"10.1016\/j.hlpt.2023.100780","article-title":"Digital health applications (DiHA): approaches to develop a reimbursement process for the statutory health insurance in Austria","volume":"12","author":"Goetz","journal-title":"Health Policy Technol"},{"issue":"3","key":"R51","doi-asserted-by":"publisher","DOI":"10.2196\/34144","article-title":"Inequities in health care services caused by the adoption of digital health technologies: scoping review","volume":"24","author":"Yao","journal-title":"J Med Internet Res"},{"issue":"1","key":"R52","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s12170-022-00711-0","article-title":"Health techequity: opportunities for digital health innovations to improve equity and diversity in cardiovascular care","volume":"17","author":"Hernandez","journal-title":"Curr Cardiovasc Risk Rep"},{"issue":"3","key":"R53","first-page":"1","volume":"20","author":"Bachner","journal-title":"Health Syst Transit"}],"container-title":["JMIR Cardio"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/cardio.jmir.org\/2025\/1\/e71366","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:00:40Z","timestamp":1782842440000},"score":1,"resource":{"primary":{"URL":"https:\/\/cardio.jmir.org\/2025\/1\/e71366"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,25]]},"references-count":53,"URL":"https:\/\/doi.org\/10.2196\/71366","relation":{},"ISSN":["2561-1011"],"issn-type":[{"value":"2561-1011","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,25]]},"article-number":"v9i25e71366"}}