ArticleOpen heart
Identifying barriers to participation in cardiac prevention and rehabilitation programmes via decision tree analysis: establishing targets for remedial interventions.
Article in Open heart. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Barriers and Facilitators to Adherence to Exercise-Based Cardiac Rehabilitation Among Coronary Artery Disease Patients: A Scoping Review.Journal of multidisciplinary healthcare · 2025Review
- Barriers to Cardiac Rehabilitation in Ethnic Minority Groups: A Scoping Review.Journal of immigrant and minority health · 2021Article
- Motorcycle-related head and neck injuries: increased risk among ethnic minorities.Israel journal of health policy research · 2020Article
- Article
- Anxiety and Depression After a Cardiac Event: Prevalence and Predictors.Frontiers in psychology · 2019Article
- Healthcare disparities amongst vulnerable populations of Arabs and Jews in Israel.Israel journal of health policy research · 2018Article
- Gender differences in the factors predicting initial engagement at cardiac rehabilitation.Open heartArticle
- Depression, anxiety, and quality of life after percuataneous coronary interventions.Industrial psychiatry journalReview
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundParticipation rates of patients with acute coronary syndrome (ACS) in efficacious cardiac prevention and rehabilitation programmes (CPRPs) are low, particularly in ethnic minorities. Few studies have evaluated the full array of potential barriers to participation in a multiethnic cohort with identical insurance coverage.
objectiveTo assess the hierarchy of multiple barriers (ie, sociodemographic, systemic, illness related, psychological and cultural) to participation in CPRP of Jewish and Arab patients served by a regional hospital in Israel.
methodsPatients with ACS (N=420) were interviewed during hospitalisation about potential barriers and subsequently about participation in CPRP. Decision tree analysis determined, hierarchically, the best predictors of participation in CPRP.
resultsEthnicity was the salient predictor of participation in CPRP (61.1% (95% CI 55.6% to 66.5%) of Jewish patients versus 17.2% (95% CI 11.2% to 24.9%) of Arab patients). Among Jewish patients the dominant determinant was a recommendation for CPRP in the hospital discharge letter (32.5% (95% CI 23.1% to 43.1%) vs 71.9% (95% CI 65.8% to 77.6%) participation without and with a recommendation, respectively). Other major hierarchical determinants included age, discharge diagnosis, socioeconomic position and perceived benefits of exercise. Among Arab patients, anxiety was the main predictor (5.5% (95% CI 1.1% to 14.1%) vs 27.9% (95% CI 17.7% to 40.0%) participation among those with high vs lower anxiety levels). Additional contributors were a predischarge visit to the rehabilitation centre (familiarisation) and car ownership (access).
conclusionsUtilisation of decision tree analysis enables us to identify the key barriers to participation in CPRP in an ethnic-specific mode. Interventions to improve participation can then be designed to address each group's specific barriers.
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