School of Kinesiology and Health Science

Effects of cardiac rehabilitation referral strategies on referral and enrollment rates

2013-05-22T19:57:10Z

Effects of cardiac rehabilitation referral strategies on referral and enrollment rates Gravely-Witte, Shannon; Leung, Yvonne; Nariani, Rajiv; Tamim, Hala; Oh, Paul; Chan, Victoria; Grace, Sherry Despite recommendations in clinical practice guidelines, evidence suggests that utilization of cardiac rehabilitation (CR) following indicated cardiac events is low. Referral strategies, such as automatic referral, have been advocated to improve CR utilization. In this Review, we evaluate the effects of referral strategies on rates of CR referral and enrollment. Referral strategies are categorized as ‘automatic’ (the use of electronic health records or systematic discharge order sets), as ‘liaison’ (discussions with allied healthcare providers), or as ‘other’ (for example, the use of motivational letter to patients). The highest rates of CR referral have been achieved in studies implementing automatic referral orders, whereas the highest rates of CR enrollment have resulted from a combination of automatic and liaison methods. Overall, innovative referral strategies significantly increase CR utilization. While further investigation is needed, institutions should evaluate their CR referral practice in light of these findings.

Publishing Trends and Open Access Journals at York University

2013-05-22T19:41:25Z

Publishing Trends and Open Access Journals at York University Nariani, R.; Fernandez, L. As the fields of scholarly communication and academic publishing change rapidly, science librarians are highlighting different aspects of scholarly communication to their academic community. York University Libraries support open access publishers in the form of institutional memberships and subsidized article processing charges. Learn the factors that lead faculty to choose OA journals over subscription-based journals. The results of their recently conducted Canadian Association of Research Libraries (CARL) survey for OA funding will also be discussed.

Barriers to Cardiac Rehabilitation: Does Age Make a Difference?

2013-05-22T17:43:50Z

Barriers to Cardiac Rehabilitation: Does Age Make a Difference? Grace, Sherry L.; Shanmugasegaram, Shamila; Gravely-Witte, Shannon; Brual, Janette; Suskin, Neville; Stewart, Donna E. PURPOSE: To quantitatively investigate age differences in barriers to cardiac rehabilitation (CR) enrollment and participation. METHODS: Cardiac outpatients (N = 1,273, mean age = 65.9 ± 11.2) completed a mailed survey to discern barriers to CR enrollment and participation. Both enrollees and nonenrollees were asked to rate 18 CR barriers on a 5-point Likert scale. RESULTS: Of the respondents, 535 (43%) reported participating in CR at 1 of 40 sites, with younger patients being more likely to participate (P=.002). Older age was positively related to total CR barriers (P<.001). Older patients more strongly endorsed the following CR barriers: already exercising at home (P=.001), confidence in ability to selfmanage their condition (P=.003), perception of exercise as tiring or painful (P=.001), not knowing about CR (P=.001), lack of physician encouragement (P<.001), comorbidities (P<.001), and perception that CR would not improve their health (P<.001). CONCLUSION: Given that the benefits of CR are achieved in older patients as well as the young, interventions to overcome these modifiable barriers to enrollment and participation are needed.

The prevalence and correlates of mind-body therapy practices in acute coronary syndrome patients

2013-05-22T18:30:41Z

The prevalence and correlates of mind-body therapy practices in acute coronary syndrome patients Leung, Y.W.; Tamim, H.; Stewart, D.E.; Arthur, H.M.; Grace, Sherry L. Objectives: While the benefits of mind-body therapy (MBT) for cardiac secondary prevention continues to be investigated, the prevalence of such practices by cardiac patients is not well known. The aim of this study was to quantitatively examine the prevalence of MBT practice and its sociodemographic, clinical, psychosocial and behavioral correlates among patients with acute coronary syndrome (ACS). Methods: Six hundred and sixty-one ACS in-patients (75% response rate) recruited from three hospitals completed a demographic survey, and clinical data were extracted from charts. Four hundred and sixty five patients (81% retention rate; 110 (23.7%) female) responded to an 18month post-discharge survey that queried about MBT use and its correlates. Results: One hundred and sixty-three (35.1%) ACS patients practised MBT in their lifetime, and 118 (25.4%) were currently practising. MBT users were more often women (OR = 2.98), nonwhite (OR = 2.17), had higher levels of education (OR = 2.22), past smokers (OR = 3.33), reported poorer mental health (OR =2.15), and engaged in more exercise (OR =1.65). Conclusion: One-third of ACS patients practised some form of MBT. The greater MBT practice among female ACS patients is noteworthy, given their generally lower physical activity and lower receipt of evidence-based treatments including cardiac rehabilitation. In addition, there is some evidence that MBT can promote mental well-being, and thus such practice might reduce risk related to negative affect in cardiac patients.