Barriers and Facilitators to Uptake and Attendance of Secondary Cardiac Prevention Programmes for Indigenous New Zealanders

K. A
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Abstract

Aim: Cardiac Rehabilitation (CR) has good success in improving health outcomes after a heart event. There is poor enrolment and attendance of CR programmes worldwide, particularly for indigenous peoples, such as New Zealand (NZ) Maori. The present study aimed to provide in-depth interview information about barriers and facilitators of both enrolment and attendance in CR, as well as identifying potential solutions. Methods: Thirty-two semi-structured interviews with Maori referred to CR who either: did not enroll; enrolled but did not complete; and completed the programme. Interview topics were based on meta-syntheses and NZspecific information as well as suggested improvements. The transcripts were inductively analysed. Results: Barriers specific to enrolment were inadequate timing or format communication about CR. Time of day or day of week of sessions, and ability to find transportation to attend were barriers to attending. Group format and cultural focus were perceived as barriers to some, but facilitators for others (enrolment and attendance). Participants suggested ways to improve CR communication (enrolment), flexibility regarding content and timing of CR, and, provision of transport (enrolment and attendance), and, increased cultural focus (enrolment and attendance). Conclusions: Providing a greater variety and flexibility in CR programme design could potentially improve enrolment and attendance for indigenous and for non-indigenous clients. Offering CR sessions after hours, in locations that are easily accessible, having different formats such as: groups, individual versus online, or, indigenous- or European dominant-focus may mean that CR appeals to a larger group of CR patients.
新西兰土著居民接受和参加二级心脏病预防方案的障碍和促进因素
目的:心脏康复(CR)在改善心脏事件后的健康结果方面取得了良好的成功。全球范围内,特别是土著人民,如新西兰毛利人,参与和参与社会责任项目的人数很少。本研究旨在提供深入的访谈信息,了解社会责任入学和出勤率的障碍和促进因素,并确定潜在的解决方案。方法:对32名毛利人进行半结构化访谈,这些毛利人包括:未登记;已登记但未完成学业;完成了这个项目。访谈主题基于元综合和新西兰特定信息以及建议的改进。对转录本进行归纳分析。结果:参与的障碍是关于CR的时间或形式沟通不充分。一天或一周的会议时间,以及找到交通工具的能力是参加的障碍。小组形式和文化焦点对一些人来说是障碍,但对另一些人来说是促进因素(入学和出勤)。与会者提出了改善社会责任沟通(登记)、社会责任内容和时间的灵活性、提供交通(登记和出席)以及增加文化焦点(登记和出席)的方法。结论:在CR方案设计中提供更大的多样性和灵活性可能会提高土著和非土著客户的入学率和出勤率。在下班后,在容易到达的地点提供CR会议,有不同的形式,如:团体,个人与在线,或者,本地或欧洲主导的焦点可能意味着CR吸引更多的CR患者群体。
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