Despite the well-known health benefits associated with regular daily physical activity, most Americans do not engage in sufficient exercise. Of particular concern are the low levels of exercise among older women, who have a heightened risk of adverse cardiovascular events. To improve our understanding of the determinants of exercise among this particularly vulnerable population, the authors undertook face-to-face interviews with 45 women who had survived a heart attack (age range = 48-88, M = 73). Upon completion of standard qualitative analytic procedures, several themes emerged as influential in shaping exercise behavior. There were multiple and connected determinants of exercise, including cognitive factors (competing demands, perceived health maintenance), life course issues (exercise as inappropriate given traditional gender expectations, positive lifelong experiences with exercise), and social and ecological environment determinants (social support, weather-related barriers). Enhancing exercise requires addressing these multifaceted and complex barriers faced by older women. Specific recommendations are provided.
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