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The video recording for this presentation is not available, please download the handout for details on this systematic review.


Primary Focus:

Health & Wellness

Level of session: intermediate, mixed audience

Learning Objectives:

By the conclusion of this presentation, participants will:

Describe how health disparities affect underserved women

Identify evidence supporting the inclusion of occupational therapy in preventative care practice

Discuss occupational therapy’s role in preventative care as it relates to cardiovascular health and wellness


Heart disease causes one in three deaths each year in women (AHA, 2012). Increasing healthcare costs disproportionately affect women with low incomes and those from diverse backgrounds (CHUW, 2012). For underserved women, lack of insurance, education and variations in culture may compromise access to care (CHUW, 2012). Traditionally underserved communities are impacted to a higher degree by the burden of cardiovascular disease (CVD) than other members of the population (AHA, 2012). Research demonstrated Hispanic women as least likely to have access to medical care, while about half of African-American women are unaware of signs and symptoms of a heart attack (AHA, 2012). Comparably, 90% of women are reported as having heart disease risk factors despite the fact that 80% of heart disease may be prevented by lifestyle changes and education (AHA, 2012). Thus, preventive care and health promotion services are critical to underserved women’s health (CHUW, 2012). The availability of these services will increase the effectiveness of service delivery for this population (CHUW, 2012).

With the impact of CVD among underserved women, there is an opportunity for occupational therapy (OT) services within this population. Health promotion and disease prevention approaches are identified in the Occupational Therapy Practice Framework and OT practitioners are equipped to address cardiovascular (CV) health and wellness. (AOTA, 2014). The purpose of this session is to present a systematic review answering the following clinical question: What is the effectiveness of OT interventions (I) to promote CV health (O) in underserved women (P)? An exhaustive search using CINAHL, Scopus and PubMed retrieved 686 quantitative studies published in English between 2011-2016. Articles were screened using the inclusion criteria: studies with community-dwelling adult women from underserved populations and studies promoting CV health through interventions with methods relating to physical activity, nutrition and weight management. The 16 eligible articles were appraised using a critical review form for quantitative studies (Law & MacDermid, 2014). Synthesis revealed four intervention themes: education, physical activity, nutrition, and coaching. The implications of these results demonstrate that culturally-tailored OT interventions with a focus on lifestyle behavior change in a group format can promote CV health in underserved women.


American Heart Association [AHA]. (2012). Heart disease statistics at a glance. Retrieved July, 2016, from

American Occupational Therapy Association [AOTA]. (2014). Occupational therapy practice framework: Domain & process (3rd ed.). American Journal of Occupational Therapy, 68, S1-S48.

Committee on Health for Underserved Women [CHUW]. (2012). Committee opinion no. 516: Health care systems for underserved women. Obstetrics & Gynecology, 119(1), 206-209. doi:10.1097/01.aog.0000410163.28525.4e

Law, M. & MacDermid, J.C. (Eds.). (2014). Appendix D: Quantitative review: form and guidelines. In Evidence-based rehabilitation: A guide to practice (3rd ed.). Thorofare, NJ: SLACK.

Presentation: 43:02