Stages of change in exercise adherence among older cardiac clients

Objective. Further understanding of exercise adherence by investigating five stages of exercise adherence and determinants.;Design. Descriptive correlational cross-sectional.;Respondents. 352 community-dwelling older cardiac clients, including 57 in Precontemplation, 54 in Contemplation, 77 in Preparation, 81 in Action and 83 in Maintenance Stages of Exercise Adherence. Inclusion criteria: aged 65 or older, cardiac rehabilitation Phase I (CR) participant within 18 months and ambulatory without assist or with cane.;Methods. Computer-assisted telephone interview (mean completion time = 32.3 minutes, response rate = 79%). Demographic information, blood pressure (BP) and heart rate (HR) at rest and while exercising from CR chart audit.;Measures and variables from integrated health promotion and transtheoretical models. Gender, income, education, rate pressure product (HR x systolic ;Main Results. 12 months following CR, 48.9% exercised regularly; at 12-18 months, 30.3% exercised. Discriminant Analysis determinants accounted for 50% of variance. Significant contributors were: self-efficacy, behavioral PC, interpersonal support, benefits, barriers and health status. Theoretical ordering of stages was strongly confirmed by equal distances between group centroids (Precontemplation = ;Conclusions. Integrated model provided clarification of exercise adherence process and strongly implies which determinants to target for interventions with older cardiac clients in each stage of exercise adherence.