An educational intervention, consisting of telephone counseling for patient and spouse and a mailed pamphlet, was designed to improve cardiac patient attendance at six exercise programs. Attendance was tested against the pamphlet alone in a randomized, controlled trial with 174 patients and 134 spouses. Unadjusted results showed a nonsignificant increase (2%) in the first three months' attendance of the experimental group over the comparison group. However, adjustment for covariates showed that the intervention significantly increased attendance by 12% (p = 0.03) and had the strongest effect on subjects with a high school education or less. Evidence regarding the effect of spouse support was contradictory. Nonexperimental variables that significantly affected attendance, when controlling for all other variables, included exercise site, smoking, cardiac diagnosis, and patients' anticipation that their job would make them miss exercise sessions. Three quarters of the patients continued to exercise on their own after dropping out, but only one third of these people exercised at levels sufficient to maintain cardiorespiratory benefits.
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