Risk Visualization With Petal-X and Continuous Glucose Monitoring to Support Person-Centered Care and Lifestyle Change in Cardiovascular Prevention: Qualitative Descriptive Study.
Svenšek A, Rojo D, et al. • JMIR human factors • 2026
Interactive CVD risk visualization (Petal-X), especially when complemented by CGM, was perceived as a meaningful support for person-centered care and a driver of motivation and lifestyle change in primary prevention.
Key Findings
Results
The analysis produced 11 subcategories grouped into 4 categories with an overarching theme: visualization and digital tools as support for person-centered care to enhance motivation and lifestyle change in individuals at risk of CVD.
Data were collected through individual, face-to-face semistructured interviews with 6 patients at increased CVD risk and 6 registered nurses
Interviews were conducted between September and December 2024
Analysis used inductive qualitative content analysis within a qualitative descriptive design
Coding continued until code saturation and data adequacy were judged to have been reached
Total population (census) sampling was used within a closed, predefined trial cohort
Results
Patients and nurses reported that personalized visual displays (Petal-X) improved understanding of risk factors, facilitated dialogue and shared decision-making, and increased patients' sense of involvement, responsibility, and control.
Patients foregrounded personal meaning and self-regulation in their perceptions of the tool
Nurses foregrounded communication and fit with the consultation workflow
The two groups differed in emphasis despite sharing overall positive perceptions
Participants were drawn from a single community health center in central Slovenia
Results
Continuous glucose monitoring (CGM) was perceived as particularly motivating by linking behavior (food, activity, and stress) to real-time glucose changes.
CGM encouraged dietary and activity adjustments among participants
Some participants maintained behavioral changes after the intervention ended
CGM provided immediate feedback on the physiological effects of daily choices
The combination of Petal-X and CGM was perceived as complementary in supporting motivation
Results
Key barriers to implementation included variable digital literacy, fear or mistrust of technology, attentional burden of continuous monitoring, potential information overload, workflow integration needs, and affordability or accessibility of CGM.
Digital literacy concerns were especially noted among older users
Fear or mistrust of technology was identified as a distinct barrier category
Workflow integration was a concern raised particularly by nurse participants
Affordability and accessibility of CGM were identified as equity-related barriers
Methods
The study was the qualitative phase of a larger sequential mixed methods study, with the quantitative randomized controlled trial reported separately.
The qualitative phase used total population (census) sampling within the closed, predefined trial cohort from the parallel RCT
Only participants who had completed the intervention arm of the RCT were eligible as patients
Only registered nurses who had been familiarized with the intervention and Petal-X dashboard were eligible as nurse participants
The study was conducted at a single community health center in central Slovenia
6 patients and 6 nurses participated in total
What This Means
This research suggests that combining an interactive heart disease risk visualization tool called Petal-X with a continuous glucose monitor (a small device that tracks blood sugar levels in real time) can meaningfully support people at increased risk of cardiovascular disease in understanding their health and making lifestyle changes. In interviews with 6 patients and 6 nurses at a health center in Slovenia, both groups reported that seeing personalized, visual displays of risk factors made health information easier to understand and led to better conversations between patients and healthcare providers. Patients felt more involved and responsible for their own health, while nurses appreciated how the tools fit into preventive care consultations.
The real-time glucose monitoring component was seen as especially motivating because it showed people immediately how their food choices, physical activity, and stress levels affected their blood sugar. Some participants continued the healthy habits they developed during the study even after the monitoring period ended. However, the study also identified important challenges: older users sometimes struggled with the technology, some people were fearful or distrustful of digital health tools, and the constant stream of data could feel overwhelming. Nurses noted that integrating these tools into their regular workflows would require planning, and cost and access to CGM devices were flagged as potential equity concerns.
This research suggests that digital tools combining visual risk communication with physiological feedback could be a valuable addition to routine preventive care visits, but that successful implementation would require attention to user training, tool usability, workflow design, and ensuring equitable access across different patient populations. Because the study involved a small number of participants at a single health center, findings reflect the experiences and perceptions of this specific group rather than representing all patients or healthcare settings.
Svenšek A, Rojo D, Lorber M, Klemenc-Ketis Z, Gosak L, Verbert K, et al.. (2026). Risk Visualization With Petal-X and Continuous Glucose Monitoring to Support Person-Centered Care and Lifestyle Change in Cardiovascular Prevention: Qualitative Descriptive Study.. JMIR human factors. https://doi.org/10.2196/92101