“Is This Thing On?: Measuring Technology Self-Efficacy Influence on Cardiac Rehabilitation Patients’ Adoption of a Virtual Care Platform

Background: The COVID-19 pandemic accelerated the adoption of virtual cardiac rehabilitation (vCR) delivery models. Understanding patient-level factors, such as technology self-efficacy (SE), is crucial for enhancing vCR adoption and ensuring its long-term sustainability. However, no validated tool exists to assess technology SE specifically for vCR. This paper outlines the initial phase of a quality-improvement project focused on developing a survey to assess technology SE among patients with access to videoconferencing (VC) technology in a vCR program. Methods: A 30-item technology SE survey was developed by adapting items from validated instruments to prospectively assess technology SE in vCR and was tested for internal consistency. Results: Of the 413 eligible patients, 99 completed the technology SE survey (24% response rate); 86 attended vCR using VC, and 13 did not use VC. The VC attendees were significantly younger than the non-VC attendees (aged 64.1 vs 72.5 years, P = 0.009). Although no significant differences were found in overall self-reported technology skills, novel technology use SE, or healthcare technology-related attitudes, VC attendees scored significantly higher on a measure of healthcare technology SE and demonstrated greater confidence in tasks such as opening a Web browser, clicking hyperlinks, downloading apps, and using novel technologies. Conclusions: This quality-improvement initiative highlights disparities in technology SE that may impact participation in vCR programs. Addressing these gaps through targeted screening and interventions could enhance vCR accessibility and equity. Future research should focus on validating SE tools modified for vCR settings and exploring associated interventions to improve technology SE and patient vCR adoption.