Integrating the quantitative with the qualitative: findings from a mixed methods cardiac rehabilitation exercise trial

BACKGROUND Cardiac rehabilitation is a core component of cardiovascular disease management. Eastern Corridor Medical Engineering-Cardiac Rehabilitation is a digital health platform for online cardiac rehabilitation exercise. We conducted a mixed methods pilot trial to evaluate Eastern Corridor Medical Engineering-Cardiac Rehabilitation. OBJECTIVE The study sought to examine the difference between objectively measured outcomes and participant perceptions of benefits fi ts and improvements gained from participation in a cardiac rehabilitation exercise program. METHODS Seventeen participants (14 male, 3 female; 69.5 6 7.3 years of age) took part and were allocated to 1 of 2 groups; an online exercise group (n = 8), or an in-person exercise (n = 9) group. Due to the COVID-19 pandemic, a pragmatic approach to group allocation was adopted. Objective outcomes were assessed at baseline and repeated following the intervention period, with the primary outcome being 6-minute walk test distance. In addition to clinical outcome measurements, we undertook qualitative interviews with participants. RESULTS Only 5 participants demonstrated a clinically meaningful improvement in 6-minute walk test distance, following the 8-week exercise program. The main theme emerging from the qualitative interviews was the valued benefits fi ts of the cardiac rehabilitation exercise program. Despite the lack of measurable physical change, participants self-defined fi ned a range of benefits fi ts they valued and attributed directly to participation in the cardiac rehabilitation exercise program. CONCLUSION The fi ndings from this study may offer a useful starting point for further study of community-based cardiac rehabilitation exercise and also highlight the benefit fi t of adopting a mixed methods approach that considers both the objective outcomes measured as well as the subjective reports obtained from participants.