Cultural Identity-Based User Experience Design for Digital Cardiac Care Platforms: From Patient Engagement to Therapeutic Adherence

Abstract Background Cardiovascular disease continues to be the number basis of death in the world. Although there is rapid development of digital health technologies aimed at managing cardiovascular disease, patient engagement and treatment adherence remain low, especially among racialized populations. Most of the traditional digital cardiac care platforms make use of the one-size-fits-all approach. This does not account for how cultural identity impacts health behaviors and technology acceptance. Cultural misalignment leads to a reduction in engagement rate of 30 to 40 percent among minorities. The existing user experience design frameworks do not design for cultural identity; as a result, platforms fail to engage diverse cardiovascular patients. Aim and objectives The objective is to create a design framework for digital cardiac care platforms based on cultural identity and formulate design strategies for patient archetypes as per their Cultural Proximity and Innovative Acceptance levels to boost therapeutic adherence in cardiovascular disease management. Methods A mixed-methods study involving 324 participants across three cultural groups constructed a three-module framework: Cultural Symbol Translation Model (deconstructing cultural elements across material, behavioral, and spiritual layers), User Perception and Experience Pyramid (mapping patient engagement from cultural recognition to emotional resonance), and Design Process and Evaluation System (integrating quantitative metrics including adherence rates and engagement duration, alongside qualitative assessments). Framework validation included traditional Chinese medicine cardiac rehabilitation interfaces, culturally-adapted cardiovascular health education materials, and localized heart health monitoring systems. Cultural identity was assessed using validated four-dimensional scales. Result Cultural identity alignment enhanced cardiac platform adoption by 43% and 6-month cardiovascular medication adherence by 37% versus generic platforms (p<0.001). Four patient archetypes emerged: Cultural Guardians (28.4%) preferred authentic cultural representations in heart health interfaces; Cultural Explorers (31.2%) responded to innovative reinterpretations in cardiac monitoring systems; Fashion Followers (22.8%) valued aesthetic elements; Functional Pragmatists (17.6%) prioritized core cardiovascular features. All cultural identity dimensions showed significant improvements: symbol recognition F (3,320) =4.29, behavioral support F (3,320) =3.74, emotional resonance F (3,320) =3.06, value alignment F (3,320) =3.91 (all p<0.001). Culturally-congruent design served as "trust anchors," improving trust scores 2.3-fold, particularly among elderly cardiovascular patients with limited digital literacy. Conclusion A design founded on cultural identity is a scalable way to improve the effectiveness of a digital cardiac care platform. Cardiovascular health organizations can use this study to improve digital health equity and therapeutic adherence in patients from different backgrounds. When digital health tools incorporate culture and architecture as well as interaction logic, they can turn into therapeutic partners.