Planning locally relevant Internet programs for secondary prevention of cardiovascular disease

Background: Although the Internet has been shown to be an effective tool for supporting behavioural change in other chronic diseases, less in known about the efficacy of, or need for, Internet-based interventions in the prevention of coronary heart disease (CHD). Aims: We investigated computer literacy, consumer need and perceived usefulness of the Internet as a secondary prevention tool in people with CHD. Methods: A two-step mixed-method process was used that included a survey and two focus groups. The 12-item survey explored participants' access and confidence using the Internet. For the focus groups, we used standard methodology. Results: We recruited 66 (88% response rate) consecutive cardiac patients; age 36-73. years (mean 64 ± 13), mostly male (85%), whose primary language was predominantly English (67%). Seventy percent had a home computer with Internet access but only 20% reported researching their heart-health online. There was polarity between those with and without Internet access. Further, we found less women than men could complete online forms (p = 0.03) and that participants aged over 65. years were less likely to access the Internet (p < 0.01) and had lower confidence (p < 0.01) than younger counterparts. Focus groups revealed challenges of an online secondary prevention service, but participants valued relevant, practical advice and placed strong emphasis on simple web design. Conclusion: Using a mixed-methods process we collected locally sensitive information about Internet usage and recommendations for future online health-management strategies. Some patients have more confidence using the Internet, therefore a range of multi-technological secondary prevention interventions should be considered based on individual need.