Women-focused cardiac rehabilitation delivery around the world and program enablers to support broader implementation
Notice bibliographique
Résumé
Abstract Background Cardiovascular disease prevalence in women is high globally, which leads to a great burden of disability, and it is their leading cause of death. Cardiovascular rehabilitation (CR) is an outpatient model of secondary preventive care proven to mitigate this burden; however, significantly fewer women access CR than men, and those that do are less likely to complete the program. Accordingly, women-focused (W-F) models of CR have been developed, to better engage women and optimize their outcomes. Purpose The objectives of this study were to investigate: (1) the implementation of W-F CR by programs around the globe, (2) barriers to delivery of W-F CR, as well as (3) what they would want and need in order to apply the recommendations in their CR programs, particularly with regard to patient education and counselling. Methods In this cross-sectional study, a survey was administered to CR programs via REDCap from May-July/2023. Potential respondents were identified via the International Council of Cardiovascular Prevention and Rehabilitation’s (ICCPR) network. Results 223 responses were received from 52/111 (46.8% country response rate) countries in the world with any CR, across all 6 World Health Organization regions. Thirty-three (14.8%) programs from 30 countries reported offering any W-F programming. Programs did commonly offer elements preferred by women and recommended, namely: patient choice of session time (n=151, 70.6%), informal care providers/partners invited to sessions (n=121, 57.1%), having CR staff with expertise in women and heart diseases (n=112, 53.3%), separate changerooms for women (n=38, 52.8%), and discussing CR referral with patients (n=112, 52.1%). Main barriers to delivery of W-F exercise were physical resources (n=33; 14.8%), space (n=30, 13.5%), as well as staff time (n=26, 11.7%) and expertise (n=33, 10.3%). Main barriers to delivery of W-F education were human resources (n=114, 51.1%), educational resources (n=26, 11.7%) and expertise in the content (n=74, 33.2%). Enablers of W-F education delivery were availability of materials, in multiple modalities, as well as educated staff, and financial resources. Conclusions Despite the benefits, W-F CR is not commonly offered globally. Considering the barriers and enablers identified, ICCPR is developing resources to expand delivery. Results from this survey will be used to support implementation of the W-F CR Guideline recommendations such as increasing exercise modality options and psychosocial counselling, and development of W-F educational resources. Map.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,009 | 0,021 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,002 | 0,001 |
| Communication savante | 0,003 | 0,002 |
| Science ouverte | 0,001 | 0,005 |
| Intégrité de la recherche | 0,001 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,012 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».