Gender Differences in Cardiac Rehabilitation Information Needs, Barriers and Participation Decisions Among Patients With Coronary Heart Disease: Fairlie Decomposition Analysis

AIM: Cardiac rehabilitation (CR) is an effective intervention for improving outcomes in patients with coronary heart disease (CHD). However, the actual participation rate is unsatisfactory and exhibits significant gender disparities. This study aimed to investigate gender-specific determinants of the decision to participate in CR among patients with CHD, together with underlying causes. DESIGN: Cross-sectional study. METHODS: A cross-sectional survey of 264 patients with CHD from 3 Chinese tertiary hospitals between February 2024 and February 2025. Data were collected using questionnaires based on the Information Need in Cardiac Rehabilitation scale, the Chinese version of Cardiac Rehabilitation Barriers Scale, the Family APGAR index questionnaire, and the International Physical Activity Questionnaire-Short Form. RESULTS: = 11.351, p = 0.001). Logistic regression analysis for men indicated that the facilitators of the decision to participate in CR were the level of family functioning and ≥ 2 comorbidities. The barriers included emergency/safety information needs and functional status. For women, the facilitators were retirement, family functioning level, being overweight/obesity, ≥ 2 comorbidities, and work/vocational/social factors. The barriers included medication information needs, logistical factors, and functional status. Fairlie decomposition revealed gender differences primarily driven by work/vocational/social factors (contribution: 71.19%), functional status (50.50%), and retirement (-39.16%) (all p < 0.05). IMPACT: This study highlights the necessity of gender-specific interventions during the decision-making phase for CR. Healthcare professionals should tailor CR strategies to address women's social role barriers and men's emergency risk concerns, while enhancing family functioning and targeting support for functional status and work-related factors. REPORTING METHOD: STROBE checklist, cross-sectional. PATIENT OR PUBLIC CONTRIBUTION: Three tertiary hospitals assisted in participant recruitment.