LGBTQ+ Participants’ Compliance and Acceptability of Cardiovascular and Physical Activity Research: A Feasibility Study

Introduction: Lesbian, Gay, Bisexual, Transgender, and Queer/Questioning (LGBTQ+) individuals experience greater cardiovascular disease risk and reduced physical activity participation compared with cisgender, heterosexual individuals. This feasibility study examined LGBTQ+ individuals’ experiences with data collection efforts to acquire cardiovascular- and physical activity-related data. Specifically, this study focused on compliance with and the acceptability of cardiac function measures, wearable devices, and smartphone app surveys. Methods: A convenience sample of 10 individuals self-identifying as LGBTQ+ underwent a cardiovascular testing protocol including arterial stiffness and electrocardiography. A 10-d field protocol utilized wearable accelerometers (ActiGraph and activPAL) and twice-daily smartphone surveys via LifeData software to collect leisure-time physical activity data. Compliance was measured via the proportion of valid wear days (device worn ≥10 waking hours) and completed smartphone surveys. Acceptability was assessed using the Measuring User Acceptance of Wearable Symbiotic Devices survey on 5-point Likert scales. Semistructured qualitative interviews were analyzed using the consensual qualitative research approach to identify themes regarding participants’ research experiences. Results: Participants demonstrated high compliance, wearing devices for >23 h/d (ActiGraph: 96% valid days; activPAL: 88% valid days) and completing 91% of morning and 87% of evening smartphone surveys. Median (interquartile range) acceptability scores were 4.3 (3.7–4.7) for the electrocardiography measures and 3.9 (3.6–4.6) for the VICORDER measures. For wearable devices, ActiGraph received higher overall acceptability than activPAL (4.1 (3.7–4.4) vs 3.4 (3.0–3.8); Wilcoxon signed-rank test P = 0.02). Five dominant themes emerged from the qualitative analysis: participant safety and well-being, research methodology and technical process, researcher/participant communication, self-reflection, and LGBTQ+ community considerations. Conclusion: Findings suggest that standard exercise science data collection can be done successfully with LGBTQ+ individuals when protocols are designed thoughtfully. Successful research with LGBTQ+ populations requires proactive consideration of minority stress, privacy concerns, body autonomy, and community representation to create inclusive research environments that do not contribute to existing health disparities.