Build it and they will come: outcomes from a successful cardiac rehabilitation program at an Aboriginal Medical ServiceLyn Dimer A , Ted Dowling B C , Jane Jones B , Craig Cheetham D E , Tyra Thomas A F , Julie Smith A , Alexandra McManus G and Andrew J. Maiorana H I J
A National Heart Foundation, 334 Rokeby Road, Subiaco, WA 6008, Australia.
B Derbarl Yerrigan Health Service, 156 Wittenoom Street, East Perth, WA 6004, Australia.
C Cardiology Department, Royal Perth Hospital, Box X2213 GPO, Perth, WA 6847, Australia.
D Cardiovascular Prevention and Rehabilitation Western Australia, PO Box 654, Scarborough, WA 6922, Australia.
E School of Exercise, Sport Science and Health, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia.
F Child and Adolescent Health Service, 240 Hardey Road, Belmont, WA 6104, Australia.
G Centre of Excellence for Science, Seafood and Health and Curtin Health Innovation Research Institute, Curtin University, GPO Box U1987, Perth, WA 6845, Australia.
H School of Physiotherapy and Curtin Health Innovation Research Institute, Curtin University, GPO Box U1987, Perth, WA 6845, Australia.
I Advanced Heart Failure and Cardiac Transplant Service, Royal Perth Hospital, Box X2213 GPO, Perth, WA 6847, Australia.
J Corresponding author. Email: firstname.lastname@example.org
Submitted: 5 December 2011 Accepted: 28 May 2012 Published: 21 December 2012
Objective. Cardiovascular disease (CVD) is the leading disease burden in Aboriginal Australians, but culturally appropriate cardiac rehabilitation programs are lacking. We evaluated the uptake and effects on lifestyle, and cardiovascular risk factors, of cardiac rehabilitation at an Aboriginal Medical Service (AMS).
Methods. The program involved weekly exercise and education sessions (through ‘yarning’) for Aboriginal people with or at risk of CVD. Participants’ perceptions of the program and the impact on risk factors were evaluated following 8 weeks of attendance.
Results. In twenty-eight participants (20 females) who completed 8 weeks of sessions, body mass index (34.0 ± 5.1 v. 33.3 ± 5.2 kg m–2; P < 0.05), waist girth (113 ± 14 v. 109 ± 13 cm; P < 0.01) and blood pressure (135/78 ± 20/12 v. 120/72 ± 16/5 mmHg; P < 0.05) decreased and 6- min walk distance increased (296 ± 115 v. 345 ± 135 m; P < 0.01). ‘Yarning’ helped identify and address a range of chronic health issues including medication compliance, risk factor review and chest pain management.
Conclusions. AMS-based cardiac rehabilitation was well attended, and improved cardiovascular risk factors and health management. An AMS is an ideal location for managing cardiovascular health and provides a setting conducive to addressing a broad range of chronic conditions.
What is known about the topic? Cardiovascular disease is the leading cause of morbidity and mortality in Aboriginal Australians, but less than 5% of eligible Aboriginal people attend hospital-based cardiac rehabilitation.
What does this paper add? This is the first study to describe a culturally appropriate cardiac rehabilitation program conducted in a metropolitan Aboriginal Medical Service. It provides a detailed account of the program’s components and its effects on physical and psychosocial determinants of cardiovascular health in participants.
What are the implications for practitioners? Health management programs similar to the one evaluated in this study could be developed to suit the specific needs of other Indigenous communities around Australia to address a range of chronic conditions.
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