Women are at-risk and underserved in the area of cardiovascular health. Of the millions of patients with coronary artery disease (CAD) who are candidates for cardiac rehabilitation (CR), only 5% to 22% typically participate, and they are mostly men. The literature calls for novel rehabilitative approaches for women with CAD. The goal of this study is three-fold: to enhance the rehabilitation of women after acute coronary events, to challenge assumptions about women with CAD, and to assist women in reducing risk factors that threaten their health with a stage-matched, gender-sensitive program.
The aims of this study are to compare improvements in physical and psychosocial functioning of participants in a 12-week women's-only phase II CR program with those seen in women attending a traditional, less gender-focused phase II CR program of the same length, and to compare maintenance of these improvements at 37 weeks. A single blind, 2-group longitudinal clinical trial design, employing random assignment, will be used. A sample of 400 women who have experienced a myocardial infarction, coronary revascularization, percutaneous coronary intervention, or angina, and who are referred to a phase II CR program will be randomly assigned to 1 of 2 groups. The experimental group will receive a 12-week, 36 session program involving gender-sensitive education and counseling. The second group will receive a traditional CR program. The Transtheoretical Model of Behavior Change will be used to tailor the behavioral intervention to maximize risk factor modification. Regardless of their stage of change and regardless of the risk behavior, each participant will be taught the stage-appropriate processes promoting self-efficacy for maximizing risk factor modification. The psychosocial outcomes will include perceived health status, quality of life, anxiety, depression, and social support. The physiological outcomes will include blood pressure, body mass index, body fat composition, strength, lipid profile, fasting glucose, functional capacity, and exercise activity. Statistical analysis will include descriptive statistics and correlation coefficients to determined the relationship among the variables. MANOVA will be used for hypothesis testing. The proposed study, conducted by a new investigator, has clinical and public health significance because of its potential to promote healthy behaviors and reduce the burden of CAD in an underserved population who largely do not attend traditional CR programs. The findings have the potential to influence a paradigm shift for clinical practice and lead to important policy changes.
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