The health benefits of cardiac rehabilitation (CR) for women living with heart disease are well documented, yet women remain underrepresented in traditionally structured CR programs. This health service delivery gap has been attributed to a number of sex-related factors experienced by women, including lower rates of physician referral, travel-related barriers, competing work and caregiving responsibilities, greater cardiovascular disease severity, and number of comorbid health conditions. Whether a program specifically designed for women is able to address these barriers and facilitate women's participation is a question that has seldom been explored in the CR literature. As part of a larger study exploring whether 6 predefined principles of women's health (empowerment of women, accessible programs, broad definition of health care, high-quality of care, collaborative planning, and innovative and creative approaches) are reflected in the practices of the Women's Cardiovascular Health Initiative (WCHI) (a comprehensive CR and primary prevention program designed for women), the objective of this analysis was to explore how the principle of "accessible programs" is experienced by women participating in the WCHI.
Fourteen women previously enrolled in the WCHI program participated in a single, in-person qualitative interview. Transcripts were analyzed using a constant-comparative approach to identify relevant themes related to program accessibility.
Key themes identified included participants' experiences with acquiring physician referral, negotiating transportation issues, and navigating program schedules. Women discussed how peer support and staff members' willingness to address their health-related concerns facilitated their participation.
While a women-centered CR/primary prevention program may facilitate and encourage women's participation by providing flexible program schedules as well as peer and professional support, efforts are still required to address persistent barriers for women related to physician referral and transportation to programs.
Danielle E. Rolfe, MSc Research Associate, Women's Cardiovascular Health Initiative, Women's College Hospital, Toronto, Canada.
Erica J. Sutton, MA Research Associate, Women's Cardiovascular Health Initiative, Women's College Hospital, Toronto, Canada.
Mireille Landry, MSc Physiotherapist, Women's Cardiovascular Health Initiative, Women's College Hospital, Toronto, Canada.
Len Sternberg, MD Director of Cardiology, Women's Cardiovascular Health Initiative, Women's College Hospital, Toronto, Canada.
Jennifer A. D. Price, MScN Advanced Practice Nurse, Cardiology, Women's Cardiovascular Health Initiative, Women's College Hospital, Toronto, Canada.
Support for this project was generously provided by grants from the Ontario Nursing Foundation and Sunnybrook and Women's Health Sciences Centre and the Canadian Nurses Federation.
Correspondence Danielle E. Rolfe, MSc, 76 Grenville St, 7th Floor, Cardiology, Women's College Hospital, Toronto, Ontario, Canada, M5S 1B2 (email@example.com).