title: Barriers to physical activity maintenance after cardiac rehabilitation.
abstract: OBJECTIVE
  Little is known about the contextual determinants for the maintenance of physical activity after cardiac rehabilitation. This study aimed to examine perceived social, psychological, and health-related barriers to the maintenance of physical activity among phase 2 cardiac rehabilitation graduates.
  
  
  METHODS
  Researchers using an open-ended format asked 160 participants (121 men and 39 women) 6 months after rehabilitation to identify perceived barriers to physical activity maintenance. The content of the participant responses was analyzed through categorization and coding of data, with independent review used to assess accuracy and reliability of decision rules. A social ecologic perspective was used for secondary coding and categorization. A chi analysis of categories was conducted to explore differences by gender, ethnicity, education, and employment.
  
  
  RESULTS
  Four categories were developed from the coded responses: intrapersonal, interpersonal, environmental, and organizational. In their responses, 93% of the participants reported intrapersonal barriers, with 24% reporting interpersonal barriers, 18% reporting environmental barriers, and 11% reporting organizational barriers. Years of education contributed significantly to acceptance of an inactive lifestyle among those less educated (chi = 32.489; P = .028). Employment status showed significant differences for work as a barrier among those employed full-time (chi = 13.570, P = .004). Barriers to physical activity by gender showed significant differences for interpersonal barriers as a whole (chi = 6.804; P = .009).
  
  
  CONCLUSIONS
  The open-ended format provided rich narrative data regarding barriers to the maintenance of physical activity. The acknowledgment of barriers, particularly from a social ecologic perspective, is needed to guide innovative, multilevel interventions for promoting physical activity maintenance among those with diagnosed coronary heart disease.
authors.affiliation: Arizona State University, College of Nursing, Tempe, Arizona 85257-2602, USA. Julie.fleury@asu.edu
authors.forename: Julie
authors.initials: J
authors.lastname: Fleury
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Lee
authors.forename: Betty
authors.initials: B
authors.lastname: Matteson
authors.forename: Michael
authors.initials: M
authors.lastname: Belyea
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003327:Coronary Disease / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D010349:Patient Compliance; D010809:Physical Fitness; D010865:Pilot Projects; D012931:Social Environment; D011795:Surveys and Questionnaires