{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T01:04:58Z","timestamp":1783040698039,"version":"3.54.6"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,1,4]],"date-time":"2024-01-04T00:00:00Z","timestamp":1704326400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Digit. Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Shared decision making (SDM) between healthcare professionals and persons with CVD can have a positive impact on motivation, adherence, or sustainability regarding long-term goals and integration of cardiovascular disease (CVD) rehabilitation in the everyday lives of persons with CVD. SDM can foster the transition between regular heart-healthy activity at rehabilitation facilities and more independent activity at home, but it is often challenging to implement SDM given limited time and resources, e.g., in the daily practice of rehabilitation. Digital tools can help but must be appropriately tailored for situated use and user needs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>We aimed to (1) describe in how far SDM is manifested in the situated context when using a digital tool developed by our group, and, based on that, (2) reflect on how digital health tools can be designed to facilitate and improve the SDM process.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In the context of a field study, we investigated how SDM is already naturally applied and manifested when using a digital tool for joint physical activity planning in cardiac rehabilitation in clinical practice. In a two-week qualitative study, we collected data on expectations, experiences and interactions during the use of a digital health tool by seven persons with CVD and five healthcare professionals. Data was collected by means of observations, interviews, questionnaires and a self-reported diary, and analysed with a particular focus on episodes related to SDM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We found that SDM was manifested in the situated context to limited extent. For example, we identified high improvement potential for more structured goal-setting and more explicit consideration of preferences and routines. Based on mapping our findings to temporal phases where SDM can be adopted, we highlight implications for design to further support SDM in clinical practice. We consider this as \u201cSDM supportive design in digital health apps,\u201d suggesting for example step-by-step guidance to be used during the actual consultation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study contributes to further understanding and integration of SDM in digital health tools with a focus on rehabilitation, to empower and support both persons with CVD and healthcare professionals.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fdgth.2023.1324488","type":"journal-article","created":{"date-parts":[[2024,1,4]],"date-time":"2024-01-04T04:53:52Z","timestamp":1704344032000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":15,"title":["Investigating shared decision-making during the use of a digital health tool for physical activity planning in cardiac rehabilitation"],"prefix":"10.3389","volume":"5","author":[{"given":"Daniela","family":"Wurhofer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Neunteufel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva-Maria","family":"Strumegger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"H\u00f6ppchen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Mayr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Egger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahdi","family":"Sareban","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard","family":"Reich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Neudorfer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josef","family":"Niebauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan David","family":"Smeddinck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan Tino","family":"Kulnik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,1,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e1077","DOI":"10.1016\/S2214-109X(18)30357-7","article-title":"Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population\u2013based surveys with 1.9 million participants","volume":"6","author":"Guthold","year":"2018","journal-title":"Lancet Global Health"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1451","DOI":"10.1136\/bjsports-2020-102955","article-title":"World health organization 2020 guidelines on physical activity, sedentary behaviour","volume":"54","author":"Bull","year":"2020","journal-title":"Br J Sports Med"},{"key":"B3","year":""},{"key":"B4","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1097\/HCO.0000000000000437","article-title":"Health benefits of physical activity: a systematic review of current systematic reviews","volume":"32","author":"Warburton","year":"2017","journal-title":"Curr Opin Cardiol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1270","DOI":"10.1249\/MSS.0000000000001939","article-title":"Physical activity, all-cause and cardiovascular mortality, and cardiovascular disease","volume":"51","author":"Kraus","year":"2019","journal-title":"Med Sci Sports Exerc"},{"key":"B6","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1007\/s13142-016-0453-1","article-title":"Conceptualising engagement with digital behaviour change interventions: a systematic review using principles from critical interpretive synthesis","volume":"7","author":"Perski","year":"2017","journal-title":"Transl Behav Med"},{"key":"B7","first-page":"32","article-title":"Designing engaging online behaviour change interventions: a proposed model of user engagement","volume-title":"Eur Psychol","author":"Short","year":"2015"},{"key":"B8","year":""},{"key":"B9","doi-asserted-by":"publisher","first-page":"e12053","DOI":"10.2196\/12053","article-title":"Can smartphone apps increase physical activity? 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