Long-term exercise adherence after public health training in at-risk adults

Abstract Objectives Sustainment of healthy exercise behavior is essential in preventing cardiovascular disease and diabetes. Few studies have explored long-term exercise adherence after an exercise referral scheme. The objective of this study was to examine 12-month exercise adherence after an exercise intervention program. Methods This was a pragmatic follow-up study in at-risk people performed between June 2012 and January 2014. The main outcome measure was self-reported single-item exercise adherence. Secondary outcomes were change in exercise level, quality of life rated on a visual analog scale and self-rated health. Predictors of long-term exercise adherence were assessed by logistic regression, estimating crude odds-ratios (OR) and 95% confidence intervals (95% CIs) and adjusting for age, gender, education, smoking, moderate and vigorous exercise. Results In total, 214 adults (mean age 58.8 ± 11.97 years, 71% women) participated in the study and received a 12-week training intervention: 62% had hypertension, 64% dyslipidemia and 15% impaired glucose tolerance. Attrition rate was 84% ( n = 179). During the 12-month follow-up, 48% ( n = 85) reported long-term exercise adherence. The main predictors of long-term exercise adherence were participation in sport activities at baseline (adjusted odds-ratio [aOR] 4.22, 95% CI 1.72–10.40), self-rated health (aOR 2.60, 1.00–6.75) and quality of life (aOR 2.39, 1.03–5.54). Long-term non-adherence was associated with low education (< 10 years; aOR 3.27, 1.14–9.43) and age < 50 years (aOR 3.53, 1.32–9.43). Conclusions In this pragmatic study, long-term exercise adherence was associated with participation in sport activities and self-rated health at baseline.