Cardiac rehab is a proven but underused therapy in women, but tailored resources aim to change that

For women with cardiovascular disease, cardiac rehabilitation programs save lives, but are still underused. New resources could help more women take control of their cardiac health.

Cardiovascular diseases (CVD) remain a significant global health challenge, claiming countless lives and causing disability worldwide. While historically seen as a predominantly male issue, it’s crucial to recognize that CVD affects women just as profoundly.

Despite advancements in acute care, women with CVD face higher risks of recurrent events and death, highlighting the need for effective strategies to prevent recurrences in women with CVD. This is called secondary prevention.

Cardiovascular rehabilitation (CR) stands as a proven outpatient model for secondary preventive care, yet its potential, especially for women, remains underused. Meta-analyses have shown fewer women than men are referred to CR programs, and even after referral, women are less likely than men to enrol and adhere.

Women-focused resources for cardiac rehab

The emergence of women-focused cardiac rehabilitation programs has been a pivotal shift towards addressing this disparity. Despite their potential to cater to women’s unique needs, these programs are not yet widely available. A recent global survey conducted by the International Council of Cardiovascular Prevention and Rehabilitation (ICCPR) underscores this gap, revealing that only 50 out of 111 countries with CR offer any women-focused services.

Cardiac College video about heart health and exercise.

Recognizing this gap, ICCPR recently released the first Clinical Practice Guidelines on women-focused CR delivery. However, the implementation of these guidelines remains a challenge due to the lack of trained staff and resources in most CR programs.

In response, our team of researchers, multidisciplinary clinical staff and patient partners embarked on a journey to co-design evidence-informed, theoretically based education tailored specifically for women in CR. This initiative — called “Cardiac College for Women” — aimed to bridge the gap in women’s cardiac education by providing comprehensive resources accessible to patients, health-care professionals and decision-makers.

The educational materials encompass various formats, including short videos, webinars, animated videos and written resources, to cater to diverse learning preferences in English and French.

The content was curated to address specific areas identified through literature reviews and needs assessments, such as menopause, hormonal therapy, exercise considerations and psychosocial well-being. Efforts were also made to ensure gender inclusivity and cultural sensitivity throughout the development process.

Developing and evaluating resources

The development of Cardiac College for Women followed a meticulous multi-phase process, guided by principles of adult learning and patient-centred care and funded by the Canadian Institutes of Health Research. A multidisciplinary steering committee comprising health-care professionals, researchers and patient education experts was formed to oversee the initiative.

Drawing from existing evidence and input from patients, clinical staff and researchers, the curriculum was designed to cover essential topics in women’s cardiac health, including the impact of sex and gender on CVD management.

Cardiac College video about overcoming barriers to prioritizing health.

To validate and refine the educational materials, extensive consultations were conducted with CR programs and patients. Feedback from focus groups and surveys underscored the demand for women-focused education and highlighted preferred delivery modes, such as interactive webinars and peer support groups. Additionally, patient engagement was prioritized, with individuals providing valuable insights into content relevance and accessibility.

These efforts resulted in a comprehensive suite of educational resources under the umbrella of Cardiac College for Women. From informative videos to tailored curriculum sessions, these materials aim to empower women with the knowledge and skills needed to manage their cardiac health effectively.

Furthermore, evaluation studies currently under peer review confirmed these resources were both effective and useful for patients, and feasible for staff to implement. Participants significantly improved their knowledge of cardiac health, improved their diets and also increased their daily step count.

By providing evidence-based and accessible resources, Cardiac College for Women aspires to empower women to take control of their cardiovascular health and reduce their risk of future cardiac events. The ultimate goal is to ensure equitable access to high-quality CR for all women worldwide.