A Comparison of Barriers to Use of Home- Versus Site-Based Cardiac Rehabilitation
Bibliographic record
Abstract
In Brief PURPOSE: Despite the established benefits of cardiac rehabilitation (CR), it remains significantly underutilized. It is unknown whether patient barriers to enrollment and adherence are addressed by offering choice of program type. The purpose of this study was to examine barriers to participation in CR by program type (site- vs home-based program) and the relation of these barriers to degree of program participation and exercise behavior. METHODS: One thousand eight hundred nine cardiac patients from 11 hospitals across Ontario completed a sociodemographic survey inhospital, and clinical data were extracted from medical records. They were mailed a followup survey 1 year later, which included the Cardiac Rehabilitation Barriers Scale and the Physical Activity Scale for the Elderly. Participants were also asked whether they attended CR, the type of program model attended, and the percentage of prescribed sessions completed. RESULTS: Overall, 939 patients (51.9%) participated in CR, with 96 (10.3%) participating in a home-based program. Home-based participants reported significantly greater CR barriers, including distance, than site-based participants (P < .001). Mean barrier scores were significantly and negatively related to session completion and physical activity among site-based (Ps < .05), but not home-based (NS), CR participants. CONCLUSION: The barriers to CR are significantly different among patients attending site- versus home-based programs, suggesting appropriate use of alternative models of care. Patient preferences should be considered when allocating patients to program models. Once in CR, programs should work toward identifying and tackling barriers among site-based participants. This cross-sectional study examined barriers to participation in cardiac rehabilitation (CR) in patients attending home- versus site-based programs. Home-based CR participants reported significantly greater barriers to CR utilization, particularly distance, than site-based CR participants. Results suggest that program model allocation is being appropriately undertaken to promote CR use.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".