Aims: This study aimed to identify demographic and health characteristics associated with perceived likelihood of uptake of digitally-delivered cardiac rehabilitation among breast cancer survivors, and to explore intervention topics and service fees.
Methods: Breast cancer survivors (n=208) completed a cross-sectional survey collecting likelihood of uptake of digitally-delivered cardiac rehabilitation, demographic and health characteristics, knowledge of treatment side-effects, exercise behaviour, intervention interests (e.g., diet, fatigue), and service fees. Ordered logistic regression models were used to examine associations between demographic and health characteristics and likelihood of intervention uptake (1) generally, (2) before, (3) during, and (4) after treatment.
Results: Participants had a mean age of 57(11) years and BMI of 27(6) kg/m2. Participants were generally representative of the Australian breast cancer population, however those meeting exercise guidelines (44% meeting both aerobic and resistance) were oversampled. Living in an outer regional area was consistently identified as the strongest predictor of likelihood of uptake at all phases (OR=3.86-8.57). Receiving a high number of cardiotoxic treatments was associated with higher uptake generally (OR=1.4). In comparison, those with higher BMI’s (OR=0.93-0.95) and lower education (OR=0.30-0.48) were less likely to uptake during various treatment phases. More comorbidities were associated with lower odds of uptake during treatment (OR=0.66). Secondary outcomes highlighted the need for education about cardiotoxic treatment effects, and multifaceted interventions that are free or low cost (median, IQR=10, 10-15 AUD).
Conclusions: Digitally-delivered cardiac rehabilitation may help address equity of access issues for those living regionally, and may help reach those at high risk of cardiotoxicity. However, those with a high BMI, low education, and comorbidities may be at risk of falling through the gaps with this model. This information can inform future research and the development of intervention techniques that are critical to improve the delivery of a digital-service model that is effective, equitable, and accessible.