Barriers to physical activity maintenance after cardiac rehabilitation

PURPOSE: Little is known about the contextual determinants for the maintenance of physical activity after cardiac rehabilitation. This study aimed to examine perceived social, psychological, and health-related barriers to the maintenance of physical activity among phase 2 cardiac rehabilitation graduates. METHODS: Researchers using an open-ended format asked 160 participants (121 men and 39 women) 6 months after rehabilitation to identify perceived barriers to physical activity maintenance. The content of the participant responses was analyzed through categorization and coding of data, with independent review used to assess accuracy and reliability of decision rules. A social ecologic perspective was used for secondary coding and categorization. A χ ² analysis of categories was conducted to explore differences by gender, ethnicity, education, and employment. RESULTS: Four categories were developed from the coded responses: intrapersonal, interpersonal, environmental, and organizational. In their responses, 93% of the participants reported intrapersonal barriers, with 24% reporting interpersonal barriers, 18% reporting environmental barriers, and 11% reporting organizational barriers. Years of education contributed significantly to acceptance of an inactive lifestyle among those less educated (χ ² = 32.489; P = .028). Employment status showed significant differences for work as a barrier among those employed full-time (χ ² = 13.570, P = .004). Barriers to physical activity by gender showed significant differences for interpersonal barriers as a whole (χ ² = 6.804; P = .009). CONCLUSIONS: The open-ended format provided rich narrative data regarding barriers to the maintenance of physical activity. The acknowledgment of barriers, particularly from a social ecologic perspective, is needed to guide innovative, multilevel interventions for promoting physical activity maintenance among those with diagnosed coronary heart disease.