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Predicting cardiac rehabilitation attendance in a gender-tailored randomized clinical trial
Beckie TM, Beckstead JW
Journal of Cardiopulmonary Rehabilitation and Prevention 2010 May-Jun;30(3):147-156
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

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% versus 77%) and education sessions (87% versus 56%). Group assignment accounted for about 5% of the variance in exercise attendance (F[1,250] = 12.755, p < 0.001) and about 24% of the variance in education attendance (F[1,250] = 77.942, p < 0.001). 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 (F[5,245] = 10.494, p < 0.001). Smoking status and marital status were significant baseline predictors of education attendance (F[5,245] = 6.115, p < 0.001) 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.
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