Table 4.

Summary of the focus group themes and subthemes

PRECEDE-PROCEED	Themes	Subthemes	Supporting quotations
Predisposing factors	Theme 1: unified as a group pre-COVID-19		“I loved the program, it was amazing. I was feeling better and making great progress”
			“Just the support from the other cancer survivors being there unified as a group was helping push me forward”
			“I can’t say enough great things about all of the staff that were there. They were so knowledgeable and motivating and it was a thrill to see them all”
Predisposing factors	Theme 2: the transition in CR experience due to COVID-19	Subtheme 2a: tough and disappointing end of in-person CR	“It was a huge, huge disappointment and I felt overwhelmed because I thought I’m going to do this, I’m going to get better”
			“There was a little bit of dialogue with me in the beginning but then I just kind of felt like I fell off the face of the earth with everybody and the group”
		Subtheme 2b: COVID-19 caused stress on top of health issues	“My health concerns were that I was still doing treatment and I had to go to the hospital every few weeks for blood tests. The first time doing that with all the new protocols, that was very nerve-wracking and everything”
		Subtheme 2c: I’ve got to get it [cardiac rehabilitation] done	“We had done so much of the program. You kind of want to finish it”
			“I was really happy that there was something that I could do. It offered some hope to try and deal with everything”
Enabling factors	Theme 3: CR participation during COVID-19	Subtheme 3a: virtual participation levels	“Once it went virtual you lost me there. I just couldn’t do the virtual… It was an emotional thing for me as well. I think that once we went virtual, I just lost all of that. I didn’t do much inside the house at all. I would walk but there’s only so much walking you can do”
			“I tried to do some exercise at home but wasn’t great at it when there was nothing structured… I was happy to have the online choice. I did participate in [it] a lot”
		Subtheme 3b: environmental factors	Positive: “Very compassionate, very supportive. I was really, really happy with the results of the support I was getting. It made me feel better in a lot of ways and helped keep me motivated even when I was losing the motivation”
			“My husband would just say let’s go for a walk and if I was up to it, we’d go walk”
			“I thought the videos they put on worked great”
			Negative: “I got a phone call saying thank you very much for your participation in our program and if you have any other questions give the healthcare network a call and basically, we are done with you. That was actually really discouraging”
			“It’s nicer to be doing those exercises with other people. We always have so many laughs it didn’t seem like it was exercise or work, it seemed like a fun morning. Doing it on my own comes like a grind”
			“I was just walking but it got to the point where the outdoors were so crowded, we were walking across the street trying to maneuver. It was a little bit trying at times even to walk”
			“I had an issue that my personal facilities shutdown as well, so I lost access to the gym and pool”
		Subtheme 3c: personal factors	“I feel better when I exercise so that was a motivation”
			“Motivation was another big barrier. Just the motivation wasn’t there, there was so much happening in the world that exercise wasn’t top of mind”
		Subtheme 3d: behavioural factors	“A big chunk of it is me being really busy and overwhelmed with so many different stuff”
			“It was overwhelming for me because I couldn’t keep track of all these different sessions that were happening, I just shut down completely”
Reinforcing factors	Theme 4: recommendations: stay connected and continue on		“I think that utilising it [CR] online to invite a lot of people and when we are all participating at the same time we can be motivated”
			“The option for an app is a great, great idea. We can load it up whenever we’re ready”
			“If we had a weekly session, every Friday, at the same time we would still continue doing something and that could help”