Background: Cardiac rehabilitation (CR) promotes long-term positive health behaviours, such as physical activity (PA), in patients following a cardiovascular event. We have limited knowledge of long-term PA and its correlates. Therefore, this research examined both PA behaviour and socioecological correlates among elderly graduates 2-6 years following CR. Hypothesis: CR graduates will have a moderate PA level in the long term. Greater PA will be associated with various multilevel correlates.Methods: This was a retrospective, cross-sectional study which quantified PA using the Physical Activity Scale for the Elderly (PASE) and collected information about socioecological correlates at the intrapersonal, interpersonal and health service levels. Both univariate and multivariate analyses assessed PA and PA correlates. Results: The majority of the 584 participants were older (69.8 ± 9.8), male (80.3%), and well educated (75.4% ≥ some post-secondary). 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, location of primary residence, and perceived health 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 multilevel correlates at all levels of influence. Understanding correlates of long-term PA behaviour among CR graduates will help identify groups at risk for nonadherence and assist with continued program development.
IntroductionCompared to patients who only receive conventional inhospital care, patients who complete a cardiac rehabilitation (CR) program following a cardiac event experience a significant reduction in all-cause mortality 1 -3 by 20% to 25% within 3 years. 3 CR programs are traditionally short-term multifaceted interventions that include physical activity (PA) as a core element. 2,4,5 One of the overarching objectives of CR is to encourage patients to maintain PA at guidelinerecommended levels after program completion. Current Canadian PA guidelines for effective health advocate at least 150 minutes of moderate-vigorous PA per week. 6 There is some evidence that states that PA behavior among CR graduates in the short term (1 year post-CR) often fails toThe authors have no funding, financial relationships, or conflicts of interest to disclose. meet the recommendations. 7,8 There is very little evidence on PA behavior over the long term (2 or more years).Encouraging positive health behaviors among CR graduates is a complex process that involves many levels of influence. To examine these levels of influence, a comprehensive approach to health promotion must be employed, such as the socioecological model. 9 The socioecological model integrates intra-and interpersonal fa...