Framework for the Development and Delivery of Digital Peer Support Programs: Qualitative Study on in-Person and Digital Delivery for People With Cardiovascular Disease

Background: Peer support (ie, sharing experiences and providing support with others with the same condition) improves health outcomes among people with cardiovascular disease (CVD), including self-management behaviors and self-efficacy. However, current peer support interventions are diverse, and evidence is lacking on the perceptions of benefits and the elements considered priorities by peer support attenders, especially regarding digital interventions.

Objective: The study aimed to (1) describe perceived benefits and recommendations for CVD peer support programs from people attending in-person peer support, (2) identify priorities for digital peer support from consumers and clinicians testing a peer support app prototype, and (3) develop a framework to inform future peer support intervention development. Methods: A qualitative study design was used across 2 components to address the objectives. In Component 1, semistructured focus groups were conducted with attenders of established in-person CVD peer support groups to explore the perceived benefits of peer support and recommendations for future programs. In Component 2, semistructured workshops with consumers with CVD and semistructured interviews with CVD clinicians/researchers were conducted to obtain feedback and recommendations for digital peer support using an exploratory digital CVD peer support application prototype. Data were digitally recorded, transcribed verbatim, and analyzed thematically. Findings from both components were iteratively synthesized to inform the development of a digital peer support framework.

Results: In Component 1, a total of 22 participants (age range 29‐84 years, 45% male) took part in focus groups. The overarching theme was that peer support provides benefits through the sharing of experiences. Five themes were refined and defined: (1) peer support provides a way of coping; (2) peers learn from each other; (3) peers understand what each other is going through; (4) the peer community uplifts mood and builds confidence; and (5) awareness, flexibility, and resources are important for engagement. In Component 2, five participants (age range 55‐74 years, 60% male) attended 2 workshops, and 8 clinicians-researchers (age range 30‐65 years, 10% male) were interviewed. Three themes were refined and defined: (1) autonomy is essential to promote engagement; (2) safeguarding is important to both users and clinicians; and (3) interfaces that are simple, easy to use, and visually attractive enable use. Priorities identified from both components included greater peer support awareness and uptake, flexibility with timing and family participation, health care professional involvement, provision of resources, autonomous features enabling choice, checklists and clinician moderation for safeguarding, and simple-to-use interfaces.

Conclusions: Participants in peer support programs derive benefit from sharing their experience of living with CVD, which enables coping, learning, feeling understood, and a sense of community. Priorities were synthesized to create a framework for digital peer support development, with recommendations to focus on 6 key areas: uptake, flexibility, resources, autonomy, safeguarding, and interface.