“Standing out like a sore thumb”: exploring socio-cultural influences on adherence to cardiac rehabilitation

Exercise-based rehabilitation forms a key part of the UK National Health Service patient-care pathway for cardiac rehabilitation (CR).Only around half of all eligible patients attend core CR, however, with social inequalities affecting participation.Few qualitative studies have explored indepth the key factors influencing engagement with CR, specifically from a sociological theoretical, and ethnographic perspective.Utilising an ethnographic approach allowed us to get a sense of the embodied experiences of 10 participants attending or declining core CR, together with a further seven family members/significant others.This provided in-depth appreciation of participants' lifeworld contexts as key influences on CR participation.The article draws on these qualitative data and focuses on 1) participants' initial thoughts about CR; and 2) navigating the field of CR, analysed via thematic analysis.We utilise a Bourdieusian theoretical perspective to theorise the findings, including salient socio-cultural factors influencing attendance/non-attendance and (non)adherence.The article findings highlight how perceptions of CR and the ability to navigate the field are strongly influenced by habitus and capital, and how personal biographies and socio-material conditions affect adherence to CR programmes.The study provides original insights into embodied experiences of exercise-based CR, and novel understandings of the reasons for dropout/poor adherence, theorised from a Bourdieusian perspective.