Examining motivations and barriers for attending maintenance community-based cardiac rehabilitation using the health-belief model.
BACKGROUND
Reasons for low attendance at maintenance cardiac rehabilitation (CR) programs remain largely unknown. Using the Health Belief Model as a theoretical framework, this study compared the motivations and barriers for attending a community-based CR maintenance program in high attenders (HA), low attenders (LA) and non-attenders (NA) with coronary artery disease (CAD).


METHODS
Forty-four older adults with CAD (70.5% males; age: 72.7±6.9 years; 11 HA, 16 LA and 17 NA) completed questionnaires examining reasons for attending CR: perceived threat (symptoms of CAD; the Revised Illness Perception Questionnaire), perceived benefits (Multi-dimensional Outcomes Expectations for Exercise Scale), perceived barriers (Cardiac Rehabilitation Barriers Scale) and cues to action questionnaire.


RESULTS
Sociodemographic characteristics and perceived threat were not different between the groups. Compared to LA and NA, HA perceived greater social and physical (vs NA only) benefits of participation in maintenance CR and had fewer barriers to attending (all p<0.05). The CR program newsletter, personal health concerns and others having heart problems were stronger cues to action for HA versus NA (all p<0.05).


CONCLUSIONS
Participants perceived greater benefits from attending CR, had fewer barriers and perceived stronger cues to action compared to non-attenders. Promoting CR maintenance programs should emphasise physical and social benefits and provide encouragement.
Active Living Laboratory, School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand.
Hayley
H
Horwood
Dunedin School of Medicine, University of Otago, Dunedin, New Zealand; Dunedin Hospital, Dunedin, New Zealand.
Michael J A
MJ
Williams
Active Living Laboratory, School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, New Zealand. Electronic address: sandra.mandic@otago.ac.nz.
Sandra
S
Mandic
D000368:Aged; D003153:Community Health Services; D003324:Coronary Artery Disease / Q000534:rehabilitation*; D003430:Cross-Sectional Studies; D003463:Cues; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D009042:Motivation; D010349:Patient Compliance / Q000523:psychology*; D000066768:Rehabilitation Research; D011795:Surveys and Questionnaires
Attendance; Cardiac rehabilitation; Coronary artery disease; Elderly; Health-Belief Model