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Getting older adults to initiate and maintain long-term exercise is an important public health mandate. This study is an analysis of a clinical trial of 112 sedentary adults, age 65–90 years, randomly assigned to 1 of 2 exercise interventions. We examined predictors and patterns of adherence of the 6-month home-based component of the trial. Telephone follow-up and diaries were used to assess adherence. Adherence to weekend exercise during the supervised phase of the program was the strongest predictor of subsequent home-based adherence. Adherence appeared stable throughout the intervention, indicating that adherence or nonadherence was established from the outset. The authors conclude that nonadherence can be identified early in the behavioral-change process. Future studies should focus on developing strategies for adults with chronic illnesses, depressive symptoms, and functional limitations who are nonadherent early on as they initiate and attempt to maintain exercise.

Morey, Crowley, and Kuchibhatla are with the Claude D. Pepper Older Americans Independence Center/Center on Aging; Doyle, with the School of Nursing; and MacAller, with the Dept. of Physical Therapy, Duke University Medical Center, Durham, NC 27710. Dubbert is with the Mental Health Service, Dept. of Veterans Affairs Medical Center, Jackson, MS 39216. Schenkman is with the Dept. of Rehabilitation Medicine, University of Colorado Health Services Center, Denver, CO 80262-0244. Horner is with the Office of Minority Health and Research, National Institute of Neurological Disorders and Stroke, NSC Building, Bethesda, MD 20852-9535.