Abstract 1480: The Effects of a Gender-Tailored Cardiac Rehabilitation Program on Depressive Symptoms
BACKGROUND: Depression is known to co-occur with coronary heart disease (CHD). Depression may also inhibit the effectiveness of cardiac rehabilitation (CR) programs by decreasing adherence. Higher prevalence of depression in women may place them at increased risk for non-adherence.
PURPOSE: A randomized clinical trial (RCT) assessed the impact of a motivationally-enhanced, stage-of-change-matched, gender-tailored CR program for reducing depressive symptoms among women with CHD.
METHOD: A 2-group RCT compared outcomes of women in a traditional 12-week CR program to those of women receiving an augmented 12-week program that included motivational interviewing guided by the Transtheoretical Model of behavior change. Women in the experimental group also participated in a gender-tailored exercise protocol that excluded men. The Center for Epidemiological Studies Depression (CES-D) Scale was administered at baseline, post-intervention, and at 6-month follow-up. ANOVA was used to assess changes in depression scores among 225 women with complete data at all 3 time-points.
RESULTS: Baseline mean CES-D scores were 17.3 and 16.5 for the experimental and traditional groups, respectively. Post-intervention mean scores were 11.0 and 14.3; 6 months later these scores were 13.0 and 15.2, respectively. A significant group by time interaction showed that changes in depression were different for the two groups (F(2, 446) = 4.42, p=.013). Follow-up tests revealed that the means for the traditional group did not differ over time (F(2, 446) = 2.00, p=.137). By contrast the experimental group showed a significant decrease in CES-D scores from baseline to post-test (F(1, 223) = 50.34, p < .001) and despite the slight rise from post-test to 6-month follow-up, CES-D scores remained significantly lower than baseline (F(1, 223) = 19.25, p < .001).
CONCLUSIONS: This study demonstrated that a motivationally-enhanced, gender-tailored CR program reduced depressive symptoms in women when compared to a traditional program. To the extent that depression contributes to CR non-adherence, such augmented programs have potential to improve outcomes for women by maximizing their adherence. Future studies should explore the mechanisms by which such programs produce such benefits.