Perception and satisfaction with a Tai Chi-based community cardiac rehabilitation program: a qualitative sub-study of a pilot randomised controlled trial

Introduction: Cardiac rehabilitation (CR) programs are increasingly incorporating innovative delivery models and interventions to improve implementation and enhance recovery following acute coronary events. This qualitative study aims to explore the perceptions and satisfaction of a novel CR program for Chinese migrants in Australia. Methods: This is a qualitative sub-study embedded in a 24-week pilot randomised controlled trial evaluating a community-based CR program among participants who were of Chinese migrant background and had undergone a recent stent placement or coronary bypass graft surgery. This program consists of a virtual shared medical appointment, virtual Tai Chi classes, and semi-personalised health education messages delivered via text messages. Upon completion of the program, participants were invited to participate in a semi-structured interview conducted in Chinese. Interviews were conducted online via Zoom meetings, transcribed verbatim, translated in English, and analysed using NVivo software (version 20). Results: Interviews with eleven participants (mean age 69 years, 82% male) found that the CR program integrating Tai Chi was well-received, with physical improvements cited as the most common benefit. Half of the participants reported notable psychological benefits from Tai Chi including reduced depressive symptoms, heightened body awareness, and improved mood. The program also fostered strong social connectedness between Chinese participants, with participants valuing the shared experience and mutual encouragement among peers with similar health conditions. Remote delivery of Tai Chi was widely accepted, noting its convenience and cultural relevance. However, the health education text messaging component received mixed feedback due to the generic messages and/or accessibility issues. Overall satisfaction with the program was high, driven by supportive interactions with the rehabilitation and research team, perceived benefits, and the sustainability of Tai Chi as a long-term exercise modality. Suggested areas for improvement included expansion of services and more frequent engagement with healthcare professionals to support their recovery. Conclusions: Participants described generally high satisfaction and positive experiences with the telehealth-delivered, Tai Chi-based CR program. Culturally tailored exercise components appeared to support social connection, and flexible delivery models were viewed as helpful for program participation and engagement. Findings of this study may inform future CR program designs for diverse populations in Australia.