Predicting cardiac rehabilitation attendance in a gender-tailored randomized clinical trial

摘要

Purpose: This study compared attendance of women participating in a motivationally enhanced, gender-tailored cardiac rehabilitation (CR) program with that of women attending a traditional outpatient CR program. We also sought to determine the significant baseline predictors of attendance of the exercise and education components of the interventions. Methods: Data from 252 women with CHD in the randomized clinical trial, the Women's-Only Cardiac Rehabilitation Program, were used in this study. The experimental design used 2 treatment groups: both receiving a comprehensive, 12-week, CR program, with 1 group receiving a gender-tailored, stage-of-change matched, behavioral enhancement using individualized motivational interviewing. Results: Compared with women in the traditional CR program, women in the gender-tailored program attended significantly more of the prescribed exercise (90% vs 77%) and education sessions (87% vs 56%). Group assignment accounted for about 5% of the variance in exercise attendance (F1,250 = 12.755, P .001) and about 24% of the variance in education attendance (F1,250 = 77.942, P .001). After controlling for group assignment, the baseline characteristics of smoking status, marital status, and anxiety accounted for about 17% of the variance in exercise attendance (F5,245 = 10.494, P .001). Smoking status and marital status were significant baseline predictors of education attendance (F5,245 = 6.115, P .001) after controlling for group assignment. Conclusions: The long-standing, poor attendance of women in CR continues to be an unresolved international challenge. Gender-tailored, stage-matched, CR programs hold promise for enhancing attendance to prescribed protocols. Additional research examining the efficacy of gender-sensitive, motivationally enhanced CR for women compared with generic CR programs is warranted.