Dancu Caroline A, Schexnayder Julie, Bosworth Hayden B, Lewinski Allison, Shapiro Abigail, Lanford Tiera, Clark Courtney White, Bean-Mayberry Bevanne, Zullig Leah L, Gierisch Jennifer M, Goldstein Karen M
San Francisco School of Nursing, University of California, San Francisco, California, USA.
San Francisco Veterans Affairs Medical Center, San Francisco, California, USA.
Womens Health Rep (New Rochelle). 2025 Mar 7;6(1):239-248. doi: 10.1089/whr.2024.0139. eCollection 2025.
Women have a unique risk profile for cardiovascular disease (CVD) due to underlying sociocultural and biological determinants. Current CVD prevention and treatment interventions, however, largely remain agnostic to the influences of an individual's sex assigned at birth or gender identity. This study describes a process for tailoring existing evidence-based interventions to the biological and sociocultural determinants of health for women.
This study adapted the Team-supported, Electronic Health Record (EHR)-leveraged, Active Management (TEAM) CVD preventative care intervention designed for telehealth-based remote hypertension (HTN) care in rural Veterans. Tailoring choices were informed by a 12-month process including a focused literature review, qualitative interviews with women's health experts, and feedback from providers and women Veterans on existing intervention materials.
Literature review and qualitative interview findings informed the modification of patient- and provider-facing TEAM materials. Patient-facing material modifications included the addition of information relevant to sex-specific CVD risk factors, addressing gender-related barriers to CVD risk reduction, and including diverse visual representation and inclusive language. Provider-facing materials were modified through a new EHR template to comprehensively address sex-specific CVD risk factors. These changes resulted in individualized care plans to better address gaps in HTN management among women.
Tailoring existing evidence-based interventions is an achievable and practical strategy to incorporate the sociocultural and biological determinants of CVD health specific to women. This approach could be used to adapt other programs and interventions designed to address health conditions that occur among both men and women but which are sensitive to important biological and sociocultural determinants. These findings highlight the broad discourse on sex- and gender-sensitive health care interventions and advocate for the integration of these interventions into routine clinical practice.
由于潜在的社会文化和生物学因素，女性患心血管疾病（CVD）有独特的风险特征。然而，目前的CVD预防和治疗干预措施在很大程度上仍未考虑个体出生时被指定的性别或性别认同的影响。本研究描述了一个针对女性健康的生物学和社会文化因素，调整现有循证干预措施的过程。
本研究采用了团队支持、利用电子健康记录（EHR）、主动管理（TEAM）的CVD预防护理干预措施，该措施专为农村退伍军人基于远程医疗的远程高血压（HTN）护理而设计。通过为期12个月的过程做出调整选择，包括重点文献综述、对女性健康专家的定性访谈，以及提供者和女性退伍军人对现有干预材料的反馈。
文献综述和定性访谈结果为面向患者和提供者的TEAM材料的修改提供了依据。面向患者的材料修改包括增加与特定性别的CVD风险因素相关的信息、解决与性别相关的降低CVD风险的障碍，以及采用多样化的视觉呈现和包容性语言。面向提供者的材料通过新的EHR模板进行了修改，以全面解决特定性别的CVD风险因素。这些变化产生了个性化的护理计划，以更好地解决女性高血压管理中的差距。
调整现有的循证干预措施是一种可行且实用的策略，可纳入特定于女性的CVD健康的社会文化和生物学因素。这种方法可用于调整其他旨在解决男性和女性都可能出现但对重要生物学和社会文化因素敏感的健康状况的项目和干预措施。这些发现突出了关于性别敏感的医疗保健干预措施的广泛讨论，并倡导将这些干预措施纳入常规临床实践。
