Cardiac rehabilitation programs as secondary prevention of cardiovascular diseases are very beneficial, yet tend to be greatly underused. Emerging barriers include psychological and motivational factors, which seem to impact the ability to comply and change dietary and other lifestyle behaviors. The purpose of the present study was to evaluate psychological stressors and additional baseline characteristics for compliance to a cardiac rehabilitation program and for outcome as a result of participation. The model Stages of Changes was to be applied as another way to learn more about the dynamics of these programs. Data were collected retrospectively from 250 participants of a 2-year cardiac rehabilitation program and prospectively from 120 participants of a phase-II program. To assess psychological stressors with the instrument used in the INTERHEART survey and motivation to change with the Stages of Change model, the according questionnaires had to first be validated. These validations were conducted successfully on patients entering the phase-II program. Attrition rates were high, 58% in the 2-year and 62% in the phase-II program, the latter also suffered from very poorly attended diet classes. Six multiple regression models were developed to predict total exercise sessions attended (R²=0.42; R²=0.38), average exercise sessions attended per week (R²=0.47; R²=0.35), final treadmill time (R²=0.76), and final METs (R²=0.76). The models included an array of baseline patient characteristics. Unhealthy lifestyle habits and stressors, rather than actual medical conditions, were most often associated with non-compliance and earlier stages of Stages of Change model. Overall patients were predominantly in late pre-action stage at the beginning of the phase-II program and in action stage at the end along with improved exercise tolerance. The Stages of Change for fat reduction and fruit and vegetable increase together with food record analysis indicated that messages for dietary changes do not get heard in the phase-II program. In conclusion, attendance and outcome can be predicted with models, lifestyle habits and psychological states play an important role in non-compliance, the exercise but not nutritional component of the phase-II program seem effective for participants who manage to finish the program, and SOC may be a promising tool for program improvements.