ArticleInternational journal for equity in health2013
Cardiac rehabilitation barriers by rurality and socioeconomic status: a cross-sectional study.
Article in International journal for equity in health, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers, 4 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
55 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Strategies to improve adherence to exercise-based phase II cardiac rehabilitation after percutaneous coronary intervention: a best evidence summary.Frontiers in cardiovascular medicine · 2026Pooled it
- Socioeconomic variation in the relationship between cardiac rehabilitation participation and clinical outcomes: a systematic review.Open heart · 2025Pooled it
- Does Connected Health Technology Improve Health-Related Outcomes in Rural Cardiac Populations? Systematic Review Narrative Synthesis.International journal of environmental research and public health · 2022Pooled it
- Disparities in Cardiac Rehabilitation Among Individuals from Racial and Ethnic Groups and Rural Communities-A Systematic Review.Journal of racial and ethnic health disparities · 2019Pooled it
- Trial
- Diet Versus Exercise in Cardiometabolic Disease: Are Two Always Better Than One?Current cardiology reports · 2026Review
- Social determinants of health and hospitalization risk in heart failure: A Retrospective analysis.American heart journal plus : cardiology research and practice · 2026Article
- Travel Distance, Urbanicity, and Cardiac Rehabilitation Participation in Medicare Beneficiaries.JACC. Advances · 2026Article
- Kinesiophobia and autonomous motivation for cardiac rehabilitation after cardiac surgery: sequential mediation by social support and psychological resilience.Frontiers in psychology · 2026Article
- Patient characteristics of non-participants and reasons for non-participation in cardiac (tele)rehabilitation-a prospective analysis.Frontiers in rehabilitation sciences · 2026Article
- Disparities in Geographic Access to Cardiac Rehabilitation Among Socially Vulnerable Communities.Journal of the American Heart Association · 2025Article
- Aerobic, resistance, and specialized exercise training in heart failure with preserved ejection fraction: A state-of-the-art review.Heart failure reviews · 2025Review
- The Effect of Family Support on Self-Management Behavior in Postoperative Cardiac Surgery Patients: A Cross-Sectional Study.Reviews in cardiovascular medicine · 2025Article
- Exploring Cardiac Rehabilitation Barriers Across Health Literacy Levels.Health literacy research and practice · 2025Article
- An eHealth intervention for patients with a low socioeconomic position during their waiting period preceding cardiac rehabilitation: a randomized feasibility study.European heart journal. Digital health · 2025Article
- Article
- The Accessibility and Effect of Cardiac Rehabilitation in COVID-19 Pandemic Era.Annals of rehabilitation medicine · 2024Article
- Article
- Unmet Needs for Cardiac Rehabilitation in Africa: A Perennial Gap in the Management of Individuals with Cardiac Diseases.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2023Review
- Online neuropilates classes in chronic stroke patients: Protocol for a randomised controlled feasibility study.Contemporary clinical trials communications · 2023Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
introductionDespite greater need, rural inhabitants and individuals of low socioeconomic status (SES) are less likely to undertake cardiac rehabilitation (CR). This study examined barriers to enrollment and participation in CR among these under-represented groups.
methodCardiac inpatients from 11 hospitals across Ontario were approached to participate in a larger study. Rurality was assessed by asking participants whether they lived within a 30-minute drive-time from the nearest hospital, with those >30 minutes considered "rural." Participants completed a sociodemographic survey, which included the MacArthur Scale of Subjective Social Status. One year later, they were mailed a survey which assessed CR utilization and included the Cardiac Rehabilitation Barriers Scale. In this cross-sectional study, CR utilization and barriers were compared by rurality and SES.
resultsOf the 1809 (80.4%) retained, there were 215 (11.9%) rural participants, and the mean subjective SES was 6.37 ± 1.76. The mean CRBS score was 2.03 ± 0.73. Rural inhabitants reported attending significantly fewer CR sessions (p < .05), and greater CR barriers overall compared to urban inhabitants (p < .01). Patients of lower subjective SES were significantly less likely to be referred, enroll, and participate in CR, and reported significantly greater barriers to CR compared to their high SES counterparts (p < .01). Prominent barriers for both groups included distance, cost, and transportation problems. These relationships sustained adjustment, and a significant relationship between having undergone coronary artery bypass graft surgery and lower barriers was also identified.
conclusionsThe results confirm that rural inhabitants and patients of low SES experience greater barriers to CR utilization when compared to their urban, high SES counterparts. It is time to implement known strategies to overcome these barriers, to achieve equitable and greater use of CR.
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