title: A multisite examination of sex differences in cardiac rehabilitation barriers by participation status.
abstract: BACKGROUND
  Despite its proven benefits and need, women are significantly less likely than men to participate in and complete cardiac rehabilitation (CR). The purpose of this study was to quantitatively investigate sex differences in CR barriers by participation status.
  
  
  METHODS
  Cardiac outpatients (1496, 430 female, 28.7%) of 97 cardiologists completed a mailed survey to discern CR participation. Respondents were asked to rate 19 CR barriers on a 5-point Likert scale.
  
  
  RESULTS
  Five hundred twenty-nine (43%) respondents self-reported participating in CR, with men being more likely to participate (p < 0.05). There was no significant sex difference in total number of CR barriers, but differences in individual barriers were found. For CR participants, t tests revealed significant sex differences in the perception of exercise as tiring or painful (p = 0.042) and work responsibilities (p = 0.013). For CR nonparticipants, women rated the following barriers as greater than men: transportation (p = 0.025), family responsibilities (p = 0.039), lack of CR awareness (p = 0.036), experiencing exercise as tiring or painful (p = 0.002), and comorbidities (p = 0.009).
  
  
  CONCLUSIONS
  Overall, women do not perceive greater barriers to CR participation than men, but the nature of their barriers differs, particularly among nonparticipants. Beliefs about the value of CR, awareness, and exercise parameters are all modifiable barriers that should be addressed among women.
authors.affiliation: York University, Ontario, Canada., University Health Network Women's Health Program, Ontario, Canada., University of Toronto, Ontario, Canada. sgrace@yorku.ca
authors.forename: Sherry L
authors.initials: SL
authors.lastname: Grace
authors.forename: Shannon
authors.initials: S
authors.lastname: Gravely-Witte
authors.forename: Sheena
authors.initials: S
authors.lastname: Kayaniyil
authors.forename: Janette
authors.initials: J
authors.lastname: Brual
authors.forename: Neville
authors.initials: N
authors.lastname: Suskin
authors.forename: Donna E
authors.initials: DE
authors.lastname: Stewart
mesh_terms: D000704:Analysis of Variance; D000072038:Cardiac Rehabilitation; D002318:Cardiovascular Diseases / Q000523:psychology*; D015444:Exercise / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009864:Ontario; D010465:Perception; D017678:Sex Distribution