Introduction: Why Peer Support Matters in Cardiovascular Disease
Cardiovascular disease (CVD) remains the world’s leading cause of death, with secondary prevention and cardiac rehabilitation playing pivotal roles in reducing readmissions and improving quality of life. While traditional in-person rehabilitation provides social and educational benefits, attendance can be inconsistent. Digital peer support—built on lived experiences of those with heart disease—offers a promising complement or alternative to enhance self-management, motivation, and social connectedness.
Study Overview: Two Components, One Goal
Researchers conducted a qualitative, two-component study to identify the key elements that make peer support effective for people with CVD. Component 1 explored in-person peer support benefits via focus groups with attendees of Heart Support Australia groups in New South Wales and the Australian Capital Territory. Component 2 tested a digital peer support app prototype through consumer workshops and clinician interviews, gathering perspectives on usability, safety, and potential impact on self-management and social support.
Insights from In-Person Peer Support (Component 1)
Twenty-two participants across two groups revealed five core themes:
- Coping through shared experience: storytelling and humor helped participants address emotional challenges and realize they were not alone.
- Learning from peers: practical insights about recovery, medications, and lifestyle changes filled gaps left by hospital stay.
- Mutual understanding: a nonjudgmental space allowed questions and discussions often avoided with family or clinicians.
- Mood uplift and confidence: the group fostered optimism, camaraderie, and social accountability among members.
- Engagement factors: awareness, flexible scheduling, and involvement of health professionals enhanced attendance and relevance.
Overall, participants highlighted that in-person peer support supports coping, learning, social belonging, and ongoing motivation—critical components of secondary prevention.
Digital Peer Support: Opportunities and Boundaries (Component 2)
Feedback from five participants in consumer workshops and eight clinicians identified three overarching themes for a digital approach:
- Autonomy drives engagement: users should control how they appear (name, avatar) and decide when to comment, with options for passive participation still delivering value.
- Safeguarding matters: clear moderation rules, escalation pathways, and credentials of moderators are essential to maintain safety and trust.
- Simple, intuitive interfaces: easy setup, concise content, and visually clear design support sustained use, ideally in a group-oriented, nonhierarchical format rather than one-to-one matching.
Consumers and clinicians agreed that a successful digital peer support tool should complement routine care, offer flexible use alongside in-person rehabilitation, and be tailored to individual needs while preserving a sense of community.
A Framework for Future Digital Peer Support in CVD
Integrating findings from both components, researchers proposed a six-domain framework to guide development and delivery of digital peer support programs for CVD:
- Uptake: raise awareness and create a critical mass of participants to sustain engagement.
- Flexibility: allow delivery alongside various care models, including family involvement and hybrid formats.
- Resources: incorporate clinician input and educational materials to support self-management.
- Autonomy: empower users with privacy controls, nonhierarchical language, and choice about participation levels.
- Safeguarding: establish clear rules, moderation by credentialed clinicians, and safety disclosures.
- Interface: design simple, personalized, group-oriented experiences that encourage interaction and ease of use.
The framework emphasizes co-design and iterative testing with end users to ensure relevance, feasibility, and acceptability in real-world settings.
Implications for Practice and Research
Digital peer support is not a universal remedy; some patients may still prefer in-person interactions or require additional digital literacy support. Nevertheless, when thoughtfully designed—prioritizing autonomy, safeguarding, and accessible interfaces—digital peer support can extend the reach of cardiac rehabilitation, improve self-management, and reduce readmissions. Future work should test the framework in diverse populations, evaluate cost and integration with health systems, and explore moderation models that balance safety with authentic peer relationships.
