Abstract
Physical activity and cardiac rehabilitation (CR) are components of heart failure (HF) self-care. The aims of this study were to describe patterns of physical activity in African Americans (n = 30) with HF and to explore experience in CR. This was a mixed method, concurrent nested, predominantly qualitative study. Qualitative data were collected via interviews exploring typical physical activity, and CR experience. It was augmented by quantitative data measuring HF severity, self-care, functional capacity and depressive symptoms. Mean age was 60 ± 15 years; 65% were New York Heart Association (NYHA) class III HF. Forty-three percent reported that they did less than 30 min of exercise in the past week; 23% were told “nothing” about exercise by their provider, and 53% were told to do “minimal exercise”. A measure of functional capacity indicated the ability to do moderate activity. Two related themes stemmed from the narratives describing current physical activity: “given up” and “still trying”. Six participants recalled referral to CR with one person participating. There was high concordance between qualitative and quantitative data, and evidence that depression may play a role in low levels of physical activity. Findings highlight the need for strategies to increase adherence to current physical activity guidelines in this older minority population with HF.
Highlights
Heart Failure (HF) affects over 5.7 million adults in the United States with Black men and women having the highest prevalence [1]
African Americans had the highest risk of developing HF and have the highest proportion of HF that is not preceded by myocardial infarction [1].This risk differential reflects disparities in the prevalence of hypertension and diabetes, as well as the effects of disparate socioeconomic status on access to medical care
This was a sample of 30 participants who self-identified as African American but were born in many different countries including the U.S, the Caribbean and Africa
Summary
Heart Failure (HF) affects over 5.7 million adults in the United States with Black men and women having the highest prevalence [1]. In the United States, very few non-Hispanic Black adults (17.3%) meets physical activity guidelines for aerobic and muscle-strengthening activity [6], which is unfortunate given insufficient physical activity accounts for almost 12% of the risk of myocardial infarction, even after accounting for other cardiovascular risk factors [7]. Patients with low socioeconomic status report greater barriers to CR, including lack of referral, and lower enrollment and participation rates than those of higher socioeconomic status [9]. The aims of this mixed methods study were to describe the patterns of physical activity in a small sample of low-income African Americans with heart failure, and to explore the pattern of referral and participation in CR
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