Ethical approval was not required for this study, as no sensitive or personally identifiable data were collected, in accordance with institutional guidelines. Verbal informed consent was obtained from all participants. Interview data were anonymized during transcription, no compensation was provided, and all procedures complied with institutional and GDPR (General Data Protection Regulation) guidelines [10-12].

A qualitative study with semistructured interviews was performed between September and October 2023 with 17 HCPs (9 cardiologists, 2 rehabilitation physicians, 5 nurses, and 1 physiotherapist) who were involved in the care of patients with HF at the cardiology departments of Althaia, Xarxa Assistencial Universitària de Manresa (Manresa, Spain) and Hospital Universitari Germans Trias i Pujol (Barcelona, Spain).

For semistructured interviews on HCPs’ experiences with sex differences in exercise among patients with HF, HCPs were asked one additional question to explore HCPs’ expectations regarding mobile exergaming as an approach to decreasing sedentary time in patients with HF (Multimedia Appendix 1). The interviews were conducted by a medical student (supervised by 2 experienced researchers [TJ and LK]), recorded, transcribed verbatim, and analyzed via thematic analysis [13].

One of the most expressed expectations was that exergaming may motivate patients with HF to engage in regular PA. The interactive and gamified nature of exergaming was seen as appealing, as it can transform PA from a chore into a fun and engaging activity. HCPs also highlighted mobile exergaming’s potential to support regular PA through reminders and progress tracking. They believed that such features could help patients maintain a consistent PA routine, which would ultimately lead to reduced sedentary time.

HCPs viewed exergaming as a complementary intervention rather than as a replacement for traditional PA advice or cardiac rehabilitation, acknowledging that while exergaming could offer benefits, it should not be seen as a stand-alone solution. Instead, it should be integrated into a broader, multifaceted approach to managing HF, potentially enhancing the effects of standard rehabilitation.

HCPs expressed concerns about the technological challenges associated with exergaming, noting that some patients, particularly older adults, may lack the necessary skills or confidence to use exergaming technology effectively. This can be a barrier to exergaming’s successful implementation. HCPs emphasized the importance of familiarizing patients with exergaming technology to ensure its successful adoption. Furthermore, socialization (eg, involving family members in the exergaming process) was seen as an important facilitator of engagement. Opinions diverged with regard to the influence of patients’ sex on the ease of adopting exergaming. Some HCPs believed that men might find exergaming easier due to a perceived greater familiarity with video games or technology. Conversely, others suggested that women might have an advantage, particularly in using mobile phones and apps, which are often integral to mobile exergaming.