Predicting Cardiac Rehabilitation Attendance in a Gender-Tailored Randomized Clinical Trial

In Brief 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. This randomized clinical trial found that compared with traditional cardiac rehabilitation, women participating in a motivationally enhanced, gender-tailored cardiac rehabilitation program improved attendance of both the exercise and education sessions. Significant baseline predictors of atten-dance, after controlling for group assignment, were smoking status, mari-tal status, and anxiety level.