THE EFFECT OF CONTINGENCY CONTRACTING ON ADHERENCE AND KNOWLEDGE OF EXERCISE REGIMENS

This study was designed to assess the effect of contingency contracting on adherence (attendance), and on patients' knowledge of the physiological principles and parameters of exercise essential for a safe exercise regimen during and following an outpatient cardiac rehabilitation program. Twentyeight patients referred for cardiac rehabilitation were alternately assigned to either a standard treatment or contingency contracting group. Both groups received one hour per week of formal education in a group setting. Weekly contingency contracts were negotiated with patients in the contracting group for eight consecutive weeks. Changes in knowledge were assessed by means of a 16-item, written examination (Exercise Knowledge Test) administered at program initiation, 4 weeks and 8 weeks. A repeated measures analysis of variance design of knowledge test scores showed significantly greater gains in knowledge in the contracting group. There were no significant differences in attendance between groups. The results of this study suggested that the contingency contracting process may be an educational intervention worthy of consideration, in addition to traditional group lectures. © 1991.