Exploring uptake of cardiac rehabilitation in a minority ethnic population in England: A qualitative study

Abstract

Background: In the United Kingdom ethnic minority groups from the Indian sub-continent (India, Pakistan and Bangladesh) are at increased risk of coronary heart disease related mortality and morbidity. Variation in prevalence and outcome is in part related to access to appropriate health care. Aims: This study explores the experiences of participants following an acute cardiac event; with a specific focus on reasons for the take up of cardiac rehabilitation services. Methods: Twenty participants (12 Pakistani, 6 Indian and 2 Bangladeshi) eligible for CR were interviewed using a semi-structured format. Results: Previous negative experience of the health care service related to communication difficulties was an important factor for not engaging with cardiac rehabilitation services. The importance of interventions by professional friends and family members appeared to increase appropriate access to care. Gender and religious beliefs were also important aspects that had an impact on uptake of services. Reasons for non-attendance were also related to service provision (setting and timing of classes), practical considerations (language barrier and transport problems), and poor understanding of cardiac rehabilitation. Conclusions: The findings highlight significant barriers to uptake at the participant level which require changes at the system and provider level if uptake is to improve.