Lessons learned from community- and home-based physical activity programs: A narrative review of factors influencing women's participation in cardiac rehabilitation

Sol Vidal-Almela; Brenna Czajkowski; Stephanie A Prince; Daniele Chirico; Kimberley L Way; Andrew L Pipe; Jennifer L Reed

doi:10.1177/2047487320907748

Lessons learned from community- and home-based physical activity programs: A narrative review of factors influencing women's participation in cardiac rehabilitation

Eur J Prev Cardiol. 2021 Jul 10;28(7):761-778. doi: 10.1177/2047487320907748.

Authors

Sol Vidal-Almela^{1

2

3}, Brenna Czajkowski¹, Stephanie A Prince¹, Daniele Chirico¹, Kimberley L Way¹, Andrew L Pipe^{1

4}, Jennifer L Reed^{1

2

4}

Affiliations

¹ Exercise Physiology and Cardiovascular Health Lab, Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Canada.
² School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Canada.
³ Institut du savoir Montfort, l'Hôpital Montfort, Canada.
⁴ Faculty of Medicine, University of Ottawa, Canada.

PMID: 33611528
DOI: 10.1177/2047487320907748

Abstract

Background: Cardiovascular disease remains a leading cause of death in women. Despite the well-known benefits of cardiac rehabilitation, it remains underutilized, especially among women. Physical activity programs in the community, however, attract a large female population, suggesting that they overcome barriers to physical activity encountered by women. The characteristics of interventions that extend beyond the traditional cardiac rehabilitation model and promote physical activity merit examination.

Objectives: This narrative review aimed to: (a) summarize women's barriers to attend cardiac rehabilitation; (b) examine the characteristics of community- and home-based physical activity or lifestyle coaching interventions; and (c) discuss which barriers may be addressed by these alternative programs.

Methods: Studies were included if they: (a) were published within the past 10 years; (b) included ≥70% women with a mean age ≥45 years; (c) implemented a community- or home-based physical activity intervention or a lifestyle education/behavioral coaching program; and (d) aimed to improve physical activity levels or physical function.

Results: Most interventions reported high (≥70%) participation rates and significant increases in physical activity levels at follow-up; some improved physical function and/or cardiovascular disease risk factors. Community- and home-based interventions address women's cardiac rehabilitation barriers by: implementing appealing modes of physical activity (e.g. dancing, group-walking, technology-based balance exercises); adapting the program to meet participants' needs; offering flexible options regarding timing and setting (e.g. closer to home, the workplace or faith-based institutions); and promoting social interactions.

Conclusion: Cardiac rehabilitation can be enhanced by understanding the specific needs of women; novel elements such as program offerings, convenient settings and opportunities for socialization should be considered when designing cardiac rehabilitation programs.

Keywords: Women; cardiovascular disease; dancing; exercise; secondary prevention.