Understanding gender differences in exercise from a social ecological perspective during and after cardiac rehabilitation

Coronary heart disease (CHD) is the leading cause of death in Canada. One potential explanation for this is cardiac patients' poor exercise fitness. Indeed, although an increase in exercise fitness associated with cardiac rehabilitation (CR) programs is observed, this benefit only occurs in patients who adhere to their exercise prescriptions during and after completing CR. Unfortunately, research has consistently shown that female CHD patients are significantly more likely to have lower exercise adherence and higher drop-out rates during and after completing CR. As a result, female patients may be less likely to achieve the exercise fitness needed to prevent subsequent recurrence and / or mortality compared to male patients. Therefore, an intervention to reduce the gender disparity in exercise during and after completing CR is warranted. Before doing so, however, it is imperative to identify common and gender-specific correlates of exercise that are phase-specific in order to tailor the intervention to the needs of each gender. Therefore, the current project will use a concurrent-mixed method approach (i.e., use qualitative and quantitatve methods)to identify common and gender-specific social ecological correlates of exercise in patients during and after completing CR across 10 programs in Nova Scotia, New Brunswick, and Newfoundland. This will be done via a quantitative study that follows patients during and after CR (i.e., up to 1 year) and a qualitative study that interviews' patients, family members or friends, CR staff, and members from community organizations across the 3 provinces. Importantly, this will be the first study to utilize a social ecological mixed-method approach with these particular patients, which will provide the much needed information to develop a multi-level exercise intervention for Atlantic Canadians living with CHD that will improve their longevity and quality of life.