title: Women's Health Behaviours and Psychosocial Well-Being by Cardiac Rehabilitation Program Model: A Randomized Controlled Trial.
abstract: Cardiac rehabilitation (CR) is associated with significantly lower mortality and improved psychosocial well-being. However, women are less likely to participate than men. This trial tested whether participation in women-only CR results in better health behaviours and psychosocial outcomes than do other models.
  
  
  
  Cardiac Rehabilitation for her Heart Event Recovery (CR4HER) was a single-blind randomized trial with 3 parallel arms. Low-risk cardiac patients were recruited from 6 sites in Ontario. Consenting participants completed surveys assessing health behaviours (physical activity, diet, medication adherence, smoking) and psychosocial well-being (social support, quality of life, depressive symptoms) and wore pedometers for 7 days. After intake assessment, eligible participants were randomized to mixed-sex, women-only, or home-based CR. Participants were mailed follow-up surveys and pedometers 6 months later.
  
  
  
  One hundred sixty-nine patients were randomized, and 116 (68.6%) were retained. Self-reported physical activity increased among women in mixed-sex and women-only CR groups (per protocol and as treated, P < 0.05). Diet improved among women in women-only CR groups (as treated, P < 0.05). Quality of life improved among women in mixed-sex (per protocol and as treated, P < 0.05) and women-only CR groups (per protocol, P < 0.05; as treated, P < 0.01). After testing, women in the mixed-sex CR group had higher anxiety symptoms than did those in the women-only group (per protocol, P = 0.017), and those in the mixed-sex CR group had higher depressive symptoms than did those in the women-only group (as treated, P = 0.001). Analyses adjusted for confounding variables revealed no significant differences in any outcome by model. Post hoc equivalency tests were computed on a per-protocol basis, and all outcomes were equivalent by model.
  
  
  
  Behavioural and psychosocial outcomes were largely equivalent regardless of model; however, women-only programs may confer an advantage for anxiety and depressive symptoms.
authors: York University, Toronto, Ontario, Canada.
authors: Liz
authors: L
authors: Midence
authors: Hamilton Health Sciences Centre, Hamilton, Ontario, Canada.
authors: Heather M
authors: HM
authors: Arthur
authors: University Health Network, Toronto, Ontario, Canada.
authors: Paul
authors: P
authors: Oh
authors: University Health Network, Toronto, Ontario, Canada.
authors: Donna E
authors: DE
authors: Stewart
authors: York University, Toronto, Ontario, Canada; University Health Network, Toronto, Ontario, Canada. Electronic address: sgrace@yorku.ca.
authors: Sherry L
authors: SL
authors: Grace
mesh_terms: D000368:Aged; D001007:Anxiety / Q000628:therapy; D000072038:Cardiac Rehabilitation; D003863:Depression / Q000628:therapy; D004032:Diet; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011788:Quality of Life; D016037:Single-Blind Method; D016387:Women's Health