Publications by authors named "Sherry Grace"
CO-CREATION-HF protocol: clinical trial to evaluate the impact of a comprehensive and hybrid cardiac rehabilitation model on patients with heart failure.
Front Cardiovasc Med
November 2024
Introduction: Comprehensive, hybrid cardiac rehabilitation (CR) models have been scantly investigated in heart failure (HF) populations, particularly in low-resource settings. CO-CREATION-HF aims to evaluate the effectiveness of such a model compared to supervised exercise alone.
Methods And Analysis: A 2 parallel-arm, multi-center randomized clinical superiority trial will be conducted with blinded outcome assessment.
Introduction: The aim of this study was to pilot test a question prompt list (QPL) about cardiovascular disease (CVD) risk reduction after hypertensive pregnancy (HDP).
Methods: In a prospective cohort study of adult women who had HDP given the QPL before and surveyed after a physician visit, we assessed perceived person-centred care, self-efficacy for self-management, perceived self-management and QPL feasibility.
Results: Twenty-three women participated: 57% of diverse ethno-cultural groups, 65% < 40 years of age and 48% immigrants.
A curriculum was developed to address the dearth of women-focused cardiac rehabilitation (CR) education. This study investigated: (1) patient utilization of the education; (2) acceptability and applicability of the education; as well as (3) patient and CR providers' experiences implementing it. This was a multi-site, mixed-methods study.
View Article and Find Full Text PDFObjective: To test the measurement properties of the revised version of the English Cardiac Rehabilitation Barriers Scale (CRBS-R), suitable for hybrid delivery, structural validity, internal reliability, as well as face, cross-cultural, construct and criterion validity were assessed.
Design: Cross-sectional study, where participants completed an online survey via Qualtrics (2023-2024).
Setting: Multicentre, with cardiac rehabilitation (CR) programmes recruiting patients globally; most patients stemmed from a hybrid programme in Iran and supervised programme in Brazil.
Translation, Cultural Adaptation of the Portuguese Provider Attitudes toward Cardiac Rehabilitation and Referral (PACRR-P) Scale and Assessment of Its' Measurement Properties.
Healthcare (Basel)
September 2024
Background/objectives: Access to cardiac rehabilitation (CR) is contingent upon physician referrals, yet these are often inadequate, particularly in low-resource settings. This multi-method study aimed to translate, culturally adapt, and validate the Portuguese version of the Provider Attitudes toward CR and Referral (PACRR-P) scale, as well as to identify key factors influencing CR referral in a Latin American context for the first time.
Methods: The PACRR was translated into Brazilian Portuguese through a rigorous process involving independent translation, back-translation, and expert panel review to ensure face, content, and cross-cultural validity.
Objective: To test the limited efficacy of women-focused educational materials within supervised cardiac rehabilitation (CR) for the first time when compared to standard co-educational CR.
Methods: A multi-site, prospective, pilot study with blinded outcome assessment was conducted at two Canadian CR programs. At intake, participants selected women-only CR with women-focused education (12 weeks) or a standard co-educational program (16 weeks).
Article Synopsis
- Major advancements in medical and surgical treatment for cardiovascular disease (CVD) over the past century have led to improved survival rates and shorter hospital stays, increasing the need for ongoing cardiovascular risk management.
- Despite these advancements, post-discharge care often relies on outdated rehabilitation models that don't adequately address the long-term needs of survivors living with CVD.
- The paper advocates for reframing cardiac rehabilitation into a broader concept of supporting cardiovascular health through the "5 P's": personalization, processes, patient-centered care, parlance, and partnership, to better engage survivors and improve their outcomes.
Article Synopsis
- This study investigates the information needs of cardiac patients using the Information Needs in Cardiac Rehabilitation short version (INCR-S) scale across different global regions.
- It involved 1,601 patients from 19 countries and found that while knowledge of cardiac health topics was rated highly important, knowledge sufficiency varied significantly, especially between high- and middle-income countries.
- The INCR-S scale proved to be a valid and reliable tool, revealing crucial gaps in patients’ knowledge regarding topics like medications, nutrition, and support resources.
Background: The Provider Attitudes toward CR and Referral (PACRR) scale was translated into Simplified Chinese and psychometric validation ensued.
Methods: Brislin's Translation Model was applied, with two independent forward translations followed by back-translation. Experts assessed the face, content and cross-cultural validity of items, and item analysis followed.
Article Synopsis
- The final chapter reviews the current state of cardiovascular care for women in Canada, outlining existing challenges and opportunities.
- It highlights 12 actionable recommendations aimed at closing knowledge gaps and addressing disparities in care.
- The ultimate goal is to improve heart health outcomes for women across the country.
Background: Women are less likely than men to use cardiac rehabilitation (CR); thus, women-focused (W-F) CR was developed. Implementation of W-F CR globally was investigated, as well as barriers and enablers to its delivery.
Methods: In this cross-sectional study, a survey was administered to CR programs via Research Electronic Data Capture (REDCap) from May to July, 2023.
Objectives: There are substantial variations in entry criteria for heart failure (HF) clinics, leading to variations in whom providers refer for these life-saving services. This study investigated actual versus ideal HF clinic inclusion or exclusion criteria and how that related to referring providers' perspectives of ideal criteria.
Design, Setting And Participants: Two cross-sectional surveys were administered via research electronic data capture to clinic providers and referrers (eg, cardiologists, family physicians and nurse practitioners) across Canada.
Background: Cardiac rehabilitation (CR) registries have the potential to support quality improvement (QImp). This study investigated the QImp needs of International CR Registry-participating programs and their evaluation of its' supports.
Methods: ICRR offers comparative outcome dashboards and QImp sessions, among other features.
Article Synopsis
- Clinical guidelines stress the importance of influenza and COVID-19 vaccinations for cardiac patients due to their higher health risks.
- A study conducted in a Spanish cardiac rehabilitation program involved a 40-minute educational session, which significantly improved participants' knowledge and attitudes about vaccinations.
- Despite the positive impact of education, vaccination rates remained low, highlighting the need for further research and targeted educational efforts to encourage higher vaccine uptake among cardiac patients.
Importance: While effective, cardiovascular rehabilitation (CR) as traditionally delivered is not well implemented in lower-resource settings.
Objective: To test the noninferiority of hybrid CR compared with traditional CR in terms of cardiovascular events.
Design, Setting, And Participants: This pragmatic, multicenter, parallel arm, open-label randomized clinical trial (the Hybrid Cardiac Rehabilitation Trial [HYCARET]) with blinded outcome assessment was conducted at 6 referral centers in Chile.
Background: Cardiac rehabilitation (CR) is a proven model of secondary prevention, but new sites, providing quality care, are needed in low-resource settings. This study (1) described the development of International Council of Cardiovascular Prevention and Rehabilitation's (ICCPR) Program Certification and (2a) tested its implementation, considering (b) appropriateness of quality standards for these settings.
Methods: The Steering Committee finalized 13 standards, requiring 70% be met.
Background: Despite their differential risk factor burden, context and often different forms of heart disease, cardiac rehabilitation (CR) programs generally do not provide women with needed secondary prevention information specific to them.
Objective: to co-design evidence-informed, theory-based comprehensive women-focused education, building from Health e-University's Cardiac College for CR.
Methods: A multi-disciplinary, multi-stakeholder steering committee (N = 18) oversaw the four-phase development of the women-focused curriculum.
Objective: : To translate and culturally adapt the Information Needs in Cardiac Rehabilitation (INCR) questionnaire into Korean and perform psychometric validation.
Methods: : The original English version of the INCR, in which patients are asked to rate the importance of 55 topics, was translated into Korean (INCR-K) and culturally adapted. The INCR-K was tested on 101 cardiac rehabilitation (CR) participants at Kangwon National University Hospital and Seoul National University Bundang Hospital in Korea.
Article Synopsis
- Cardiac rehabilitation programs are not widely used, especially among women, prompting a study on the barriers they face across different world regions and how these barriers differ based on enrollment status.* -
- The study involved over 2,160 patients from 16 countries, revealing that while women's barriers were not significantly higher overall, they were greater in specific regions, particularly due to a lack of awareness about cardiac rehabilitation.* -
- Key barriers for nonenrolled women included lack of knowledge and program contact, while enrolled women struggled with distance and family responsibilities, indicating the need for tailored support strategies to address these issues, especially for unemployed women.*
Background: Heart failure (HF) care providers are gatekeepers for patients to appropriately access lifesaving HF clinics.
Objective: The aim of this study was to investigate referring providers' perceptions regarding referral to HF clinics, including the impact of provider specialty and the coronavirus disease pandemic.
Methods: An exploratory, sequential design was used in this mixed-methods study.
Cardiovascular disease is a leading cause of death, morbidity, disability, and reduced health-related quality of life, as well as economic burden worldwide, with some 80% of disease burden occurring in the low- and middle-income country (LMIC) settings. With increasing numbers of people living longer with symptomatic disease, the effectiveness and accessibility of secondary preventative and rehabilitative health services have never been more important. Whilst LMICs experience the highest prevalence and mortality rates, the global approach to secondary prevention and cardiac rehabilitation, which mitigates this burden, has traditionally been driven from clinical guidelines emanating from high-income settings.
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