{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T09:08:57Z","timestamp":1793351337501,"version":"4.5.0"},"reference-count":30,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2024,4,17]],"date-time":"2024-04-17T00:00:00Z","timestamp":1713312000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["GNT1169893"],"award-info":[{"award-number":["GNT1169893"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Flinders Foundation Health Seeding Grant","award":["FF 043380"],"award-info":[{"award-number":["FF 043380"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Rehabil"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate cardiac rehabilitation utilisation and effectiveness, factors, needs and barriers associated with non-completion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>We used the mixed-methods design with concurrent triangulation of a retrospective cohort and a qualitative study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Economically disadvantaged areas in rural Australia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Patients (\u226518 years) referred to cardiac rehabilitation through a central referral system and living in rural areas of low socioeconomic status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main measures<\/jats:title>\n                    <jats:p>A Cox survival model balanced by inverse probability weighting was used to assess the association between cardiac rehabilitation utilization and 12-month mortality\/cardiovascular readmissions. Associations with non-completion were tested by logistic regression. Barriers and needs to cardiac rehabilitation completion were investigated through a thematic analysis of semi-structured interviews and focus groups (n\u2009=\u200928).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 16,159 eligible separations, 44.3% were referred, and 11.2% completed cardiac rehabilitation. Completing programme (HR 0.65; 95%CI 0.57\u20130.74; p\u2009&lt;\u20090.001) led to a lower risk of cardiovascular readmission\/death. Living alone (OR 1.38; 95%CI 1.00\u20131.89; p\u2009=\u20090.048), having diabetes (OR 1.48; 95%CI 1.02\u20132.13; p\u2009=\u20090.037), or having depression (OR 1.54; 95%CI 1.14\u20132.08; p\u2009=\u20090.005), were associated with a higher risk of non-completion whereas enrolment in a telehealth programme was associated with a lower risk of non-completion (OR 0.26; 95%CI 0.18\u20130.38; p\u2009&lt;\u20090.001). Themes related to logistic issues, social support, transition of care challenges, lack of care integration, and of person-centeredness emerged as barriers to completion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Cardiac rehabilitation completion was low but effective in reducing mortality\/cardiovascular readmissions. Understanding and addressing barriers and needs through mixed methods can help tailor cardiac rehabilitation programmes to vulnerable populations and improve completion and outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02692155241236998","type":"journal-article","created":{"date-parts":[[2024,4,17]],"date-time":"2024-04-17T18:45:15Z","timestamp":1713379515000},"page":"837-854","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":18,"title":["Clinical effectiveness of cardiac rehabilitation and barriers to completion in patients of low socioeconomic status in rural areas: A mixed-methods study"],"prefix":"10.1177","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7848-3183","authenticated-orcid":false,"given":"Alline","family":"Beleigoli","sequence":"first","affiliation":[{"name":"Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hila Ariela","family":"Dafny","sequence":"additional","affiliation":[{"name":"Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5421-9604","authenticated-orcid":false,"given":"Maria Alejandra","family":"Pinero de Plaza","sequence":"additional","affiliation":[{"name":"Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Hutchinson","sequence":"additional","affiliation":[{"name":"Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tania","family":"Marin","sequence":"additional","affiliation":[{"name":"Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joyce S.","family":"Ramos","sequence":"additional","affiliation":[{"name":"Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orathai","family":"Suebkinorn","sequence":"additional","affiliation":[{"name":"Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lemlem G.","family":"Gebremichael","sequence":"additional","affiliation":[{"name":"Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norma B.","family":"Bulamu","sequence":"additional","affiliation":[{"name":"Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy","family":"Keech","sequence":"additional","affiliation":[{"name":"Health Translation SA, Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Ludlow","sequence":"additional","affiliation":[{"name":"Heart Foundation of Australia, Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeroen","family":"Hendriks","sequence":"additional","affiliation":[{"name":"Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Versace","sequence":"additional","affiliation":[{"name":"Deakin Rural Health, Deakin University, Burwood, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robyn A.","family":"Clark","sequence":"additional","affiliation":[{"name":"Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,4,17]]},"reference":[{"key":"bibr1-02692155241236998","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.029652"},{"key":"bibr2-02692155241236998","unstructured":"Census of Population and Housing: Reflecting Australia\n                      2018. 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