Patient Perspectives on a Nurse-Led Personalised Cardiovascular Risk Intervention in Type 2 Diabetes: A Qualitative Study Within the VOLTAIRE Trial

Aims: To explore patient perspectives on the acceptability of a nurse-led personalised cardiovascular risk intervention in Type 2 diabetes. Design: A qualitative study nested within a randomised controlled trial. Methods: Two online focus groups (n = 5 per group) were conducted with adults who received personalised cardiovascular risk information through computed tomography coronary angiography or polygenic risk scores within a nurse-led intervention. A co-designed discussion guide explored risk understanding, views of the nurse-led consultation, emotional responses, behaviour change and feasibility. Data were analysed using reflexive thematic analysis informed by the Theoretical Framework of Acceptability. Results: Five interrelated themes were identified: (1) making personalised risk tangible; (2) interpretation requires relationship; (3) channelling concern into action; (4) from insight to incremental agency; and (5) feasibility and system conditions for scale. Conclusion: Among focus group participants who completed the intervention, the model was highly acceptable, with nurse-led translation of complex risk information supporting engagement and behaviour change. Implications for the Profession and Patient Care: Cardiovascular nurse coaching may strengthen the clinical value of personalised risk tools by supporting understanding, emotional response and translation into achievable prevention goals. Impact: This study addressed the limited understanding of how adults with Type 2 diabetes perceive personalised cardiovascular risk communication. It found that acceptability was dynamic and improved when nurse-led explanation and goal setting supported behavioural engagement, with implications for cardiovascular nurses and services implementing personalised prevention. Reporting Method: This study adhered to the consolidated criteria for reporting qualitative research. Patient or Public Contribution: Participants contributed to study design through co-development of the focus group guide and informed interpretation of findings. Trial and Protocol Registration: ClinicalTrials.gov (NCT07091162).