# Understanding Barriers and Facilitators to Cardiovascular Rehabilitation Participation Among Rural Residents With Cardiovascular Disease in Brazil

**Authors:** Mayara Moura Alves da Cruz, Lívia Tino de Roide, Anielle Brito de Oliveira Manzatto, Luiz Carlos Marques Vanderlei, José Vitor Barbosa Boro, Marcia Rodrigues Franco, Lais Manata Vanzella, Gabriela Lima de Melo Ghisi

PMC · DOI: 10.1111/phn.70072 · Public Health Nursing (Boston, Mass.) · 2026-01-24

## TL;DR

This study identifies barriers and facilitators to cardiovascular rehabilitation participation among rural residents in Brazil, highlighting the need for better awareness and virtual access.

## Contribution

The study provides novel insights into rural-specific barriers and facilitators for cardiovascular rehabilitation in a low-resource setting in Brazil.

## Key findings

- Limited awareness of cardiovascular rehabilitation was the primary barrier among participants.
- Technological challenges hindered engagement with telerehabilitation programs.
- Family support and access to virtual programs were key facilitators for participation.

## Abstract

This study explored barriers to cardiovascular rehabilitation (CR) participation among individuals with cardiovascular disease (CVD) and risk factors in a rural, low‐resource setting.

A qualitative study using focus groups.

21 individuals (76% women, 71% with CVD risk factors, 48% with incomplete elementary education) were recruited from a public health system.

Data were collected through six focus groups and analyzed using thematic analysis.

None.

Six overarching themes emerged. Participants had limited awareness of CR, with lack of knowledge being the primary barrier. Technological challenges hindered engagement with telerehabilitation programs. Medication was the most common treatment strategy, but patients expressed a need for more information. While physical exercise was recognized as important, barriers such as lack of time and motivation prevented participation. Perceptions of health status varied, with some reporting improvements and others experiencing deterioration. Family support and access to virtual programs were identified as facilitators of CR participation.

Strategies to improve CR awareness, enhance virtual access, and strengthen patient education are needed to increase participation in rural populations.

## Linked entities

- **Diseases:** cardiovascular disease (MONDO:0004995)

## Full-text entities

- **Diseases:** CVD (MESH:D002318)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## References

48 references — full list in the complete paper: https://tomesphere.com/paper/PMC12968503/full.md

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Source: https://tomesphere.com/paper/PMC12968503