Identifying barriers to participation in cardiac prevention and rehabilitation programmes via decision tree analysis: establishing targets for remedial interventions

Reges, Orna; Vilchinsky, Noa; Leibowitz, Morton; Khaskia, Abdulrahem; Mosseri, Morris; Kark, Jeremy D.

doi:10.1136/openhrt-2014-000097

Cited by 16 publications

(17 citation statements)

References 31 publications

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“…We observed positive associations between IPV variables and HCS utilization among Arab women, while these associations were negative among Jewish women. While these various patterns might attest to different patterns of HCS utilization in the general Arab and Jewish populations in Israel [54,56,58], it might also indicate dissimilar help seeking patterns among Arab women experiencing IPV [61,62]. It could be that high use of medical HCS among Arab women in our study points to access problems in seeking help through social and mental HCS.…”

Section: Hcs Utilization Patterns In Relation To Ipv Differ By Ethnicitymentioning

confidence: 77%

“…Generally, despite provision of universal HCS since 1994 [53] and equality of access to care under law, utilization of, and access to HCS in Israel still differs dramatically between Arab and Jewish citizens [54,55]. For example, Arab minority citizens use less specialist care [55] and cardiac prevention rehabilitation programs [56]. Arabs also live in peripheral areas in Israel's southern and northern regions, where some services are less available or accessible [57,58].…”

Section: Hcs Utilization Screening and Receiving Information Among mentioning

confidence: 99%

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Patterns of healthcare services utilization associated with intimate partner violence (IPV): Effects of IPV screening and receiving information on support services in a cohort of perinatal women

et al. 2020

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BackgroundWhile women experiencing intimate partner violence (IPV) face significant health consequences, their patterns of healthcare services (HCS) utilization are unclear, as are the effects of IPV screening and receiving information on these patterns. OPEN ACCESSCitation: Daoud N, Kraun L, Sergienko R, Batat N, Shoham-Vardi I, Davidovitch N, et al. (2020) Patterns of healthcare services utilization associated with intimate partner violence (IPV): Effects of IPV screening and receiving information on support services in a cohort of perinatal women. PLoS ONE 15(1): e0228088. https://doi. ResultsAny IPV and IPV types had significant associations with some HCS utilization variables, with different directions and patterns for the ethnic groups. Experiencing IPV was associated with higher HCS utilization among Arab women, lower utilization in Jewish women. Arab women experiencing IPV were twice as likely to visit a gynecologist than women not experiencing IPV (AOR (95% CI) was 2.00, 1.14-3.51 for any IPV; 2.17, 1.23-3.81 for emotional and/or verbal IPV, and 1.83, 1.04-3.22, for social and economic IPV). Among Jewish women, experiencing any IPV was associated with lower likelihood of emergency-room visits (0.62, 0.41-0.93); and experiencing physical and/or sexual IPV was associated with lower likelihood of family physician visits (OR = 0.20, 0.05-0.82). Both IPV screening and receiving information were associated with lower HCS utilization among Arab women only. ConclusionsDifferent HCS utilization patterns among women who reported experiencing versus not experiencing IPV in different ethnic groups suggest complex relationships that hinge on how HCS address women's needs, starting with IPV screening and providing information. This might inform tailored programs to tackle IPV at the HCS, particularly for minority women. Complex association between experiencing IPV and HCS useDespite these findings, other studies paint a more ambivalent picture of HCS utilization among women experiencing IPV [20]. Such studies suggest that many of these women face barriers limiting their ability to seek help via HCS, and that they might use these services less Patterns of healthcare services utilization associated with intimate partner violence PLOS ONE | https://doi.org/10.

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Section: Hcs Utilization Patterns In Relation To Ipv Differ By Ethnicitymentioning

confidence: 77%

Section: Hcs Utilization Screening and Receiving Information Among mentioning

confidence: 99%

Patterns of healthcare services utilization associated with intimate partner violence (IPV): Effects of IPV screening and receiving information on support services in a cohort of perinatal women

et al. 2020

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“…In order to preserve statistical power, the number of splits was limited to three and number of patients in child nodes was restricted to 20 and above, thereby restricting the number of levels. Similar criteria have been used in previous decision tree analyses involving similar size samples (Reges et al, 2014). To validate resultant decision-trees a 5-fold cross-validation procedure was applied with misclassification risk estimate, overall accuracy percentage and cross-validation risk estimate calculated.…”

Section: Discussionmentioning

confidence: 99%

Anxiety and Depression After a Cardiac Event: Prevalence and Predictors

et al. 2020

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Introduction: Patients who are anxious or depressed after an acute cardiac event are at increased risk of a subsequent event and premature death. It is therefore important to identify these patients early in order to initiate supportive or even preventive measures. In the present study, we report on the prevalence of anxiety and depression during the first 12 months after an acute cardiac event, and the patient characteristics predictive of increased anxiety and depression risk in early and late convalescence. Methods: We recruited a sample of 911 patients with acute myocardial infarction (AMI), acute coronary syndrome (ACS), and/or unstable angina (UA), and/or undergoing coronary artery bypass graft surgery (CABGS). Patients completed the Hospital Anxiety and Depression Scale (HADS) close to the time of their event, and again during early (2-4 months post-event) and late (6-12 months post-event) convalescence. Using HADS-A and HADS-D cutoffs of 8+, prevalence rates for anxiety, depression, and comorbid anxiety and depression were determined for each timepoint. Chi-square tests and odds ratios were used to identify baseline patient characteristics associated with increased anxiety and depression risk over 12 months. Results: Anxiety rates were 43, 28, and 27% at the time of the event, early, and late convalescence. Depression rates were 22, 17, and 15%, respectively. Factors consistently associated with increased anxiety and depression risk were history of depression, financial strain, poor self-rated health, low socioeconomic status, younger age (<55 years), and smoking. Obesity, diabetes, and social isolation (living alone or being unpartnered) were identified as important albeit less significant risk factors. Neither sex nor event type were predictive of anxiety or depression. Conclusion: This large patient sample provided the opportunity to identify rates of anxiety and depression during the 12 months after a cardiac event and key patient characteristics for increased risk. These risk factors are easily identifiable at the time of the event, and could be used to guide the targeting of support programs for patients at risk.

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“…3 Barriers to engagement, attendance and adherence within the pathway have been widely studied and shown to include patient-level factors (eg, illness perception, beliefs about treatment, social support, family responsibilities, work constraints); service-level factors (eg, programme accessibility, travel time, referral); sociodemographic factors (eg, older age, female, ethnic minority, low education levels, comorbidities); and psychological factors (eg, depression, anxiety). 4–9 …”

Section: Introductionmentioning

confidence: 99%

Gender differences in the factors predicting initial engagement at cardiac rehabilitation

2018

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ObjectiveTo determine whether there are gender differences in the factors that predict attendance at the initial cardiac rehabilitation baseline assessment (CR engagement) after referral.MethodsUsing data from the National Audit of Cardiac Rehabilitation, we analysed data on 95 638 patients referred to CR following a cardiovascular diagnosis/treatment between 2013 and 2016. Eighteen factors that have been shown in previous research to be important predictors of CR participation were investigated and grouped into four categories: sociodemographic factors, cardiac risk factors, patient medical status and service-level factors. Logistic binary regression models were built for male patients and female patients, assessing the likelihood for CR engagement. Each included predictors such as age, number of comorbidities and social deprivation score.ResultsThere were no important differences in the factors that predict the likelihood of CR engagement in men and women. Seven factors associated with a reduced probability of CR engagement, and eight factors associated with increased probability, were identified. Fourteen of the 15 factors identified as predicting the likelihood for engagement/non-engagement were the same for both men and women. Increasing age, being South Asian or non-white ethnicity (other than Black) and being single were all associated with a reduced likelihood of attending an initial CR baseline assessment in both men and women. Male patients with diabetes were 11% less likely to engage with CR; however, there was no significant association in women. Results showed that the overwhelmingly important determinant of CR engagement observed in both men and women was receiving an invitation to attend an assessment session (OR 4.223 men/4.033women; p<0.05).ConclusionsConsideration of gender differences in predictors of CR uptake should probably be more nuanced and informed by the stage of the patient care pathway.

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Identifying barriers to participation in cardiac prevention and rehabilitation programmes via decision tree analysis: establishing targets for remedial interventions

Cited by 16 publications

References 31 publications

Patterns of healthcare services utilization associated with intimate partner violence (IPV): Effects of IPV screening and receiving information on support services in a cohort of perinatal women

Patterns of healthcare services utilization associated with intimate partner violence (IPV): Effects of IPV screening and receiving information on support services in a cohort of perinatal women

Anxiety and Depression After a Cardiac Event: Prevalence and Predictors

Gender differences in the factors predicting initial engagement at cardiac rehabilitation

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