title: Exploring the barriers and enablers to attendance at rural cardiac rehabilitation programs.
abstract: OBJECTIVE
  The objectives of this study were to: (i) identify local barriers and enablers to the uptake of hospital-based cardiac rehabilitation (CR) programs, and (ii) identify preferred alternatives for the delivery of CR.
  
  
  METHODS
  A questionnaire administered by local CR coordinators and focus groups facilitated by the research team.
  
  
  METHODS
  Six regional hospitals in south-west Victoria offering hospital-based CR programs.
  
  
  METHODS
  Patients and their carers referred to and eligible for local CR programs; health professionals working within local CR programs.
  
  
  METHODS
  CR attendees and decliners demographics, patient and health professional perceived factors which contribute to enabling hospital-based CR attendance, patient and health professional perceived barriers to CR attendance, and receptiveness and preferences for alternative modes of CR delivery.
  
  
  RESULTS
  This study identified distance to travel to hospital-based CR programs the only statistically significant factor in determining uptake of CR. Easy access to transport (63%) and to a lesser extent family support (49%) and work flexibility (43%) were the primary enablers to attendance. Of the 97 study participants, 38% were receptive to alternative CR methods such as programs in outlying communities, evening facility-based programs, home and GP based programs, telephone support and a patient manual/workbook.
  
  
  CONCLUSIONS
  The results of this study provide valuable information for designing strategies to increase utilisation and improve patient acceptability of existing hospital-based CR programs. It provides a basis for pilot testing alternative modes of CR program delivery for cardiac patients in rural areas unable to access hospital-based CR.
authors.affiliation: Physiotherapy Department, Western District Health Services, Hamilton, Victoria, Australia.
authors.forename: Carla
authors.initials: C
authors.lastname: De Angelis
authors.forename: Steve
authors.initials: S
authors.lastname: Bunker
authors.forename: Adrian
authors.initials: A
authors.lastname: Schoo
mesh_terms: D000368:Aged; D005260:Female; D006297:Health Services Accessibility; D006331:Heart Diseases / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D012046:Rehabilitation / Q000458:organization & administration; D012423:Rural Health; D019035:Rural Health Services / Q000191:economics / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014186:Transportation / Q000191:economics; D014195:Travel; D014739:Victoria