A qualitative assessment of patient perspectives on a cardiac rehabilitation program tailored to breast cancer survivors: the heart health after cancer treatment (HEART-ACT) study

Abstract Purpose To understand the experiences of breast cancer survivors participating in the Heart Health After Cancer Treatment (HEART-ACT) study, a tailored 12-week cardiac rehabilitation (CR) program, and to identify perceived benefits and barriers to participation. Methods We conducted semi-structured interviews with a purposive sample of participants who completed the HEART-ACT program at an urban safety-net hospital. Interviews explored participants’ experiences, program preferences, barriers and facilitators to participation, and experiences with program technology. Transcripts were analyzed using rapid template analysis, with themes organized according to the Theory of Planned Behavior. Results Of 50 HEART-ACT participants, 21 (42%) completed exit interviews. Participants described perceived physical, emotional, and psychosocial benefits, including improved exercise ability, confidence, health knowledge, and reduced anxiety. Camaraderie among participants and supportive relationships with program staff were prominent sources of motivation and engagement. Frequent check-ins and practical, home-based instruction facilitated participation. Work and caregiving responsibilities remained important barriers, while transportation assistance helped mitigate logistical challenges. Participants had mixed experiences with wearable and mobile technologies. Conclusion A tailored CR program was perceived as beneficial and engaging among breast cancer survivors in a safety-net setting. Social support and individualized assistance were important contributors to engagement, while flexible approaches are needed to address technological barriers.