Physical activity behaviour 2-6 years following cardiac rehabilitation: a socio-ecological analysis

Background: Cardiac rehabilitation (CR) promotes long-term positive health behaviours, such as physical activity (PA), in patients following a cardiovascular event. Our knowledge of long-term PA, and its correlates, following CR is limited. Therefore, this research examined both PA behaviour and socio-ecological correlates among elderly graduates 2-6 years following CR.
Methods: This was a retrospective, cross-sectional study which used the Physical Activity Scale for the Elderly (PASE) to quantify PA behaviour. Information about socio-ecological correlates at the intrapersonal, interpersonal and health service levels was acquired using a purpose specific questionnaire. A descriptive examination was performed, and PA correlates were assessed through a multivariate model.
Results: There were 2544 CR graduates contacted; 905 were ineligible, 584 consented to participate (1055 either declined or could not be contacted). The majority of participants were older (69.8 ± 9.8), male (80.3%), well educated (75.3% ≥ some post-secondary), and of good perceived health (81.6% ≥ good). Average time since CR graduation was 41.5 ± 11.5 months. Seventy five percent of CR graduates reported current weekly PA levels that met, or exceeded, Canadian PA guidelines (>150 minutes of moderate-vigorous PA). Univariate analyses identified 13 PASE score correlates. Multivariate analyses identified age, PA enjoyment, current work status, CR staff support, and home location for PA as significantly associated with higher PASE scores (p<0.001). Conclusions: Three and a half years post-CR, graduates had high PA levels. Greater PA was associated with several modifiable multi-level correlates at the intrapersonal, interpersonal and health service levels. Understanding the correlates of long-term PA behaviour among CR graduates will help identify groups at risk for non-adherence as well as assist with continued program development.