Objective To examine whether the addition of online MI chats to a web-based, group behavioral obesity treatment program augments weight loss outcomes relative to the web-based online weight control program alone. Methods Healthy individuals (N=398, 24% minority) with overweight/obesity were randomized to a 36-session group internet behavioral weight control treatment (BT) or the same group internet treatment plus 6 individual MI chat sessions (BT+MI). Both conditions received weekly synchronous online chat group sessions for 6 months followed by 12 monthly group chats. Participants in both groups received identical behavioral lessons and individualized therapist feedback on progress toward meeting exercise and calorie goals. BT+MI also received 6 individual MI sessions delivered by a separate MI counselor via web chat. Weight loss was measured at 6- and 18-months. Results There were no significant differences in weight loss between BT (−5.5±6.0 kg) and BT+MI (−5.1±6.3 kg) at 6-months or at 18-months (−3.3±7.1 kg vs −3.5±7.7 for BT and BT+MI, respectively). Attendance at group chats did not differ between groups, nor did self–monitoring patterns, suggesting comparable engagement in the weight control program in both conditions. Conclusions Online MI chat sessions are not a viable strategy to enhance web-based weight control treatment outcomes.

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Purpose Cardiac rehabilitation (CR) is a program of structured exercise and interventions for coronary risk factor reduction that reduces morbidity and mortality following a major cardiac event. Although a dose response relationship between number of CR sessions completed and health outcomes has been demonstrated, adherence with CR is not high. In this study we examined associations between number ofsessions completed within CR and patient demographics, clinical characteristics, smoking status, and socioeconomic status (SES). Methods Multiple LogisticRegression and Classification and Regression Tree (CART) modeling were used to examine associations between participant characteristics measured at CR intake and number of sessions completed in a prospectively collected CR clinical database (N=1658). Results Current smoking, lower-SES, non-surgical diagnosis, exercise-limiting comorbidities, and lower age independently predicted fewer sessions completed. The CART analysis illustrates how combinations of these characteristics (i.e., risk profiles) predict number of sessions completed. Those with the highest-risk profile for non-adherence (less than 65 years old, current smoker, lower-SES) completed on average 9 sessions while those with the lowest-risk profile (greater than 72 years old, not current smoker, higher-SES, surgical diagnosis) completed on average 27 sessions. Conclusions Younger individuals, as well as those who report smoking, economic challenges, or have a non-surgical diagnosis, may require additional support to maintain CR session attendance.

Purpose: Clinical interventions in programs such as cardiac rehabilitation (CR) are guided by clinical characteristics of participating patients. This study describes changes in CR participant characteristics over 20 yr. Methods:To examine changes in patient characteristics over time, we analyzed data from 1996 to 2015 (n = 5396) garnered from a systematically and prospectively gathered database. Linear, logistic, multinomial logistic or negative binomial regression were used, as appropriate. Effects of sex and index diagnosis were considered both as interactions and as additive effects.Results: Analyses revealed that mean age increased (60.7 to 64.2 yr), enrollment of women increased (26.8% to 29.6%), and index diagnosis has shifted; coronary artery bypass surgery decreased (37.2% to 21.6%) while heart valve (HV) repair/replace increased (0 to 11.4%). Risk factors also shifted with increases in body mass index (28.7 vs 29.6 kg/m 2 ), obesity (33.2% to 39.6%), hypertension (51% to 62.5%), type 2 diabetes mellitus (17.3% to 21.7%), and those reporting current smoking (6.6% to 8.4%). Directly measured peak aerobic capacity remained relatively stable throughout. The proportion of patients on statin therapy increased from 63.6% to 98.9% coinciding with significant improvements in lipid levels.Conclusions: Compared to 1996, participants entering CR in 2015 were older, more overweight, and had a higher prevalence of coronary risk factors. Lipid values improved substantially concurrent with increased statin use. While the percentage of female participants increased, they continue to be underrepresented. HV patients now constitute 11.4% of the patients enrolled. Clinical programs need to recognize changing characteristics of attendees to best tailor interventions.