title: Controlled comparison of retention and adherence in home- vs center-initiated exercise interventions in women ages 40-65 years: The S.W.E.A.T. Study (Sedentary Women Exercise Adherence Trial).
abstract: BACKGROUND
  In an 18-month exercise intervention in previously sedentary older women (40-65 years), we examined whether an initial 6 months of supervised exercise leads to greater long-term retention and adherence to regular physical activity than an unsupervised home-based program and whether these outcomes are influenced by the exercise intensity.
  
  
  METHODS
  Women (N = 126) were recruited from the community and randomly assigned to either center-based or home-based exercise three times/week. The center-based group attended supervised sessions for 6 months, while after 10 initial sessions the home-based group exercised at home. After 6 months both groups were home-based for a further 12 months. Within each arm, subjects were further randomized to exercise at either moderate or vigorous intensity.
  
  
  RESULTS
  The center-based group had higher retention than the home-based (97, 94, 81 versus 87, 76, and 61%) at 6, 12, and 18 months, respectively (P < 0.05). At 6 months, adherence was higher in the center-based group (84 versus 63%, P < 0.001) and energy expenditure was higher at 6 (P < 0.05) and 12 (P < 0.01) months. At 18 months, retention was higher with moderate exercise (P < 0.05), while adherence was similar with both intensities.
  
  
  CONCLUSIONS
  An initial 6 months of center-based exercise enhanced retention in both the short and the long term and promoted short-term adherence and energy expenditure. Long-term, moderate exercise retained more subjects, but had little influence on adherence.
authors.affiliation: Department of Medicine, University of Western Australia, Western Australian Institute for Medical Research, and HeartSearch, Western Australia. kaycox@cyliene.uwa.edu.au
authors.forename: K L
authors.initials: KL
authors.lastname: Cox
authors.forename: V
authors.initials: V
authors.lastname: Burke
authors.forename: T J
authors.initials: TJ
authors.lastname: Gorely
authors.forename: L J
authors.initials: LJ
authors.lastname: Beilin
authors.forename: I B
authors.initials: IB
authors.lastname: Puddey
mesh_terms: D000328:Adult; D000368:Aged; D004734:Energy Metabolism; D015444:Exercise; D005260:Female; D020446:Fitness Centers; D006801:Humans; D008875:Middle Aged; D010349:Patient Compliance; D010809:Physical Fitness