Dataset Information

Sex differences in cardiac rehabilitation barriers among non-enrollees in the context of lower gender equality: a cross-sectional study.

ABSTRACT:

Background

Despite the benefits of cardiac rehabilitation (CR), it remains under-utilized, particularly by women. This study compared CR barriers between non-enrolling men and women in Iran, which has among the lowest gender equality globally.

Methods

In this cross-sectional study, CR barriers were assessed via phone interview in phase II non-attenders from March 2017 to February 2018 with the Persian version of the Cardiac Rehabilitation Barriers Scale (CRBS-P). T-tests were used to compare scores, with each of 18 barriers scored out of 5, between men and women.

Results

357 (33.9%) of the sample of 1053 were women, and they were older, less educated and less often employed than men. Total mean CRBS scores were significantly greater in women (2.37 ± 0.37) than men (2.29 ± 0.35; effect size[ES] = 0.08, confidence interval[CI]: 0.03-0.13; p < 0.001). The top CR barriers among women were cost (3.35; ES = 0.40, CI:0.23-0.56; P < 0.001), transportation problems (3.24; ES = 0.41, CI:0.25-0.58; P < 0.001), distance (3.21; ES = 0.31, CI:0.15-0.48; P < 0.001), comorbidities (2.97; ES = 0.49, CI:0.34-0.64; P < 0.001), low energy (2.41; ES = 0.29, CI:0.18-0.41; P < 0.001), finding exercise as tiring or painful (2.22; ES = 0.11, CI:0.02-0.21; P = 0.018), and older age (2.27; ES = 0.18, CI:0.07-0.28; P = 0.001). Men rated "already exercise at home or in community" (2.69; ES = 0.23, CI:0.1-0.36; P = 0.001), time constraints (2.18; ES = 0.15, CI:0.07-0.23; P < 0.001) and work responsibilities (2.24; ES = 0.16, CI:0.07-0.25; P = 0.001) as greater CR barriers than women.

Conclusion

Women had greater barriers to CR participation than men. CR programs should be modified to address women's needs. Home-based CR tailored to women's exercise needs and preferences should be considered.

SUBMITTER: Firoozabadi MG

PROVIDER: S-EPMC10311813 | biostudies-literature | 2023 Jun

REPOSITORIES: biostudies-literature

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Publications

Sex differences in cardiac rehabilitation barriers among non-enrollees in the context of lower gender equality: a cross-sectional study.

Firoozabadi Mahdieh Ghanbari MG Mirzaei Masoud M Grace Sherry L SL Vafaeinasab Mohammadreza M Dehghani-Tafti Maryam M Sadeghi Abbas A Asadi Zohre Z Basirinezhad Mohammad Hasan MH

BMC cardiovascular disorders 20230629 1

<h4>Background</h4>Despite the benefits of cardiac rehabilitation (CR), it remains under-utilized, particularly by women. This study compared CR barriers between non-enrolling men and women in Iran, which has among the lowest gender equality globally.<h4>Methods</h4>In this cross-sectional study, CR barriers were assessed via phone interview in phase II non-attenders from March 2017 to February 2018 with the Persian version of the Cardiac Rehabilitation Barriers Scale (CRBS-P). T-tests were used ...[more]

PMID: 37386414

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Project description:BackgroundHeart disease is one of the leading causes of death in Canada. Many heart disease patients are referred for cardiac rehabilitation, a multidisciplinary outpatient program often consisting of exercise training. Cardiac rehabilitation has been proven to be a successful secondary preventative measure in reducing mortality and improving overall health in heart disease patients, and its completion is important for both sexes as there is growing evidence that women benefit as much as men, if not more, with regard to mortality. It is important to note that previous studies have shown that healthy men and women respond differently to aerobic and resistance training, possibly due to hormones, body composition, autonomic and/or cardiovascular differences. However, evaluating sex differences in the efficacy of standard cardiac rehabilitation programs has not yet been fully explored with many studies investigating clinical or anthropometric data but not physiological outcomes. This systematic review aimed to investigate physiological differences in male and female heart disease patients after cardiac rehabilitation. The inclusion criteria were purposefully broad to encompass many cardiac rehabilitation scenarios, many cardiac disease states, and various program lengths and intensities with the intention of highlighting strengths and weaknesses of the current body of literature.MethodsTo conduct a synthesis without meta-analysis, a search strategy was generated to examine the relationships between heart disease patients, a supervised exercise program, physiological outcomes, and sex differences. The review was registered (Prospero: CRD42021251614) and the following databases were searched from inception to 19 December 2023: APA PsycInfo (Ovid), CINAHL Complete (EBSCOhost), Embase (Ovid), Emcare Nursing (Ovid), Medline All (Ovid; includes PubMed non-Medline), and Web of Science Core Collection. Eighty-eight studies pertaining to fitness, metabolism, body composition, respiratory function, cardiac function and C-reactive protein underwent data extraction.Results and conclusionsImportantly, this review suggests that men and women respond similarly to a wide-range of cardiac rehabilitation programs in most physiological variables. However, many studies discussing maximal oxygen consumption, functional capacity, six-minute walk distances, and grip strength suggest that men benefit more. Further research is required to address certain limitations, such as appropriate statistical methods and type/intensity of exercise interventions.

Project description:BackgroundBaseline physical activity in patients when they initiate cardiac rehabilitation is poorly understood. We used mobile health technology to understand baseline physical activity of patients initiating cardiac rehabilitation within a clinical trial to potentially inform personalized care.MethodsThe VALENTINE (Virtual Application-Supported Environment to Increase Exercise During Cardiac Rehabilitation Study) is a prospective, randomized-controlled, remotely administered trial designed to evaluate a mobile health intervention to supplement cardiac rehabilitation for low- and moderate-risk patients. All participants receive a smartwatch and usual care. Baseline physical activity was assessed remotely after enrollment and included (1) 6-minute walk distance, (2) daily step count, and (3) daily exercise minutes, both over 7 days and for compliant days, defined by >8 hours of watch wear time. Multivariable linear regression identified patient-level features associated with these 3 measures of baseline physical activity.ResultsFrom October 2020 to March 2022, 220 participants enrolled in the study. Participants are mostly White (184 [83.6%]); 67 (30.5%) are female and 84 (38.2%) are >65 years old. Most participants enrolled in cardiac rehabilitation after percutaneous coronary intervention (105 [47.7%]) or coronary artery bypass surgery (39 [17.7 %]). Clinical diagnoses include coronary artery disease (78.6%), heart failure (17.3%), and valve repair or replacement (26.4%). Baseline mean 6-minute walk distance was 489.6 (SD, 143.4) meters, daily step count was 6845 (SD, 3353), and exercise minutes was 37.5 (SD, 33.5). In a multivariable model, 6-minute walk distance was significantly associated with age and sex, but not cardiac rehabilitation indication. Sex but not age or cardiac rehabilitation indication was significantly associated with daily step count and exercise minutes.ConclusionsBaseline physical activity varies substantially in low- and moderate-risk patients enrolled in cardiac rehabilitation. Future studies are warranted to explore whether personalizing cardiac rehabilitation programs using mobile health technologies could optimize recovery.RegistrationURL: https://www.Clinicaltrialsgov; Unique identifier: NCT04587882.

Dataset Information

Sex differences in cardiac rehabilitation barriers among non-enrollees in the context of lower gender equality: a cross-sectional study.

Background

Methods

Results

Conclusion

Publications

Sex differences in cardiac rehabilitation barriers among non-enrollees in the context of lower gender equality: a cross-sectional study.

Similar Datasets

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