Addressing barriers to digital health technology adoption for cardiovascular disease prevention: preliminary findings from the ACHIEVE-Digital global qualitative survey
J Leroux, H Issa, H Mcgowan, S Joshi, I Gibson, M F Sonyuy, N Magero, S Oulousian, A Kraselnik, I A Amiali, N S Shah, S T Kulnik, A SharmaAbstract
Background
Digital health technologies (DHTs) for cardiovascular disease (CVD) prevention and heart failure (HF) management have experienced considerable growth, yet significant barriers remain to widespread adoption in clinical settings. Lack of trust in the quality of wearable-generated data is a frequently reported barrier among healthcare providers (HCPs).
Purpose
To identify and explore global expert-derived strategies supporting the adoption of DHTs in CVD (including HF) prevention and management.
Methods
This study is part of the ACHIEVE-Digital initiative, a collaborative, multi-phase research effort. Based on a systematic review identifying barriers and facilitators to DHT adoption (Phase 1), we developed a mixed-method survey. The survey included 9 demographic questions, 15 open-ended questions to identify expert-derived strategies to address the barriers to DHT adoption, and 9 prioritization questions to determine the urgency of addressing each barrier. Qualitative data are analysed using NVivo software following Braun and Clarke’s six-step thematic analysis framework. The survey was disseminated to over 6500 experts through diverse global cardiovascular and digital health networks via email and social media platforms. Data collection is ongoing and will conclude on 15 January 2026.
Results
At the time of this analysis, 80 experts had responded (response rate of 1.2%), representing Africa (n=31), Europe (n=19), North America (n=13), Asia (n=11), Oceania (n=4), and South America (n=2). Respondents were well balanced by gender (48% female), predominantly aged 31-45 years (56%), and most were currently working with patients (59%). Preliminary analyses focused on trust in wearable-generated data identified nine key themes (Fig. 1): 1) Validation and Real-World Evidence, reflecting concerns regarding accuracy, consistency, and clinical relevance; 2) Standardization and Compliance; 3) Training and Education; 4) Transparency and Communication; 5) Integration and Interoperability; 6) HCP Involvement and Co-Design; 7) Continuous Quality Monitoring; 8) Patient Partnership; and 9) Data Security and Safety.
Conclusion
Findings from this sample of global experts suggest that improving trust in DHT among HCPs will require validation and real-world evidence, with additional strategies spanning standardization, training, transparency, interoperability, and stakeholder engagement. These themes highlight the need for coordinated efforts among researchers, clinicians, industry, and regulators prior to broader adoption for CVD and HF management.Figure 1:Theme distributionFor image description, please refer to the figure legend and surrounding text.