Web-based cardiac rehab program boosts participation among rural women with heart disease

Fewer women are part of cardiac rehabilitation programs, particularly in rural or remote communities, but Flinders University researchers have found that a web-based program tailored for women in rural and remote communities can help change this situation.

CREW (Cardiac Rehabilitation Especially for Women) is a specific care pathway program developed by the Flinders University-led CHAP Project (Country Heart Attack Prevention) and tested through a study to determine whether the program can be successfully delivered, adopted and accepted by women with cardiovascular disease and cardiac rehabilitation clinicians in rural and remote communities.

The paper is published in the journal Heart, Lung and Circulation.

“The lack of women-focused programs is a major barrier,” says Flinders University researcher Dr. Joyce Ramos, “but home-based cardiac rehabilitation using telehealth and gender-tailored approaches may help address these challenges.”

The study involved 40 women in rural or remote South Australia who were referred to cardiac rehabilitation through the integrated Cardiovascular Clinical Network (iCCNet) between November 2023 and November 2024. They were invited to use the CREW program, which included four educational modules designed to support self-management, and their completion rates were assessed using digital records.

The participants recorded high rates of cardiac rehabilitation initiation (82.5%) and completion (60%). They also reported high satisfaction with most program components.

“These findings highlight the value of a women-focused approach to support women in engaging with their heart health,” Ramos says. “They should also increase clinicians’ awareness about the importance of recognizing and addressing women’s unique needs throughout the cardiac rehabilitation journey.”

Interviews conducted with CREW participants and clinicians delivering cardiac rehabilitation explored the CREW program’s feasibility, acceptability and perceived value.

This analysis identified several themes that underlined the CREW program’s strengths: It empowers women in cardiac rehabilitation; reinforces the value of telehealth-based cardiac rehabilitation for women’s participation; and addresses challenges and resource pressures facing health staff and systems. It also offered recommendations for program enhancement.

“The CREW program is feasible and acceptable to women and clinicians, which shows this women-focused, web-based model shows promise for addressing gender disparities in cardiac rehabilitation access in rural and remote communities.”

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Sadie Harley

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Andrew Zinin

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