The Heart Truth^®: Health Professionals Knowledge of Heart Disease in Women

Heart disease is the #1 killer of women in the United States. National campaigns, such as The Heart Truth^®, have successfully raised heart disease awareness among women. Yet knowledge gaps among health care providers regarding cardiovascular disease (CVD) prevention in women remain a barrier to reducing morbidity and mortality.

To address the deficit in knowledge of CVD in women among healthcare providers, The Heart Truth^® Professional Educational Campaign was developed by a consortium of federally designated National Centers of Excellence in Women’s Health. Participating organizations included the U.S. Department of Health and Human Services Office on Women’s Health; the National Heart, Lung, and Blood Institute; and the American Heart Association (AHA). Materials included continuing medical education (CME) lectures; clinical resources, such as fact sheets, tools, and guides; and clinical education materials.

What was the study?

Healthcare professionals’ baseline knowledge of CVD in women and the effectiveness of a structured educational program on provider knowledge were assessed in the study, ‘The Heart Truth Professional Educational Campaign on Women and Heart Disease: Needs Assessment and Evaluation Results,’ which was published in the Journal of Women’s Health, October, 2009.

• Participants in the study were 1,245 healthcare professionals in 11 states who voluntarily attended a 1-hour CME program based on the 2004 AHA Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women.
• Presenters, who were experts in women’s heart disease, chose a slide set from standardized materials that addressed guidelines for the prevention of heart disease in women. The 31 basic slides were supplemented with 15-20 slides of additional guidelines information of the presenter’s choice, based on audience knowledge and interests.
• Lecture attendees completed anonymous pretest and posttest forms that assessed their skills and knowledge.

What did the study find?

• Overall, the healthcare professionals answered an average of only 5.1 of 8 knowledge questions correctly in the pretest, revealing significant knowledge deficits.
• There were marked differences in the baseline knowledge among attendees. Family physicians were more knowledgeable than obstetrician/gynecologists. Registered nurses were the least knowledgeable among the groups, which also included general internists and physician assistants/nurse practitioners.
• Of the knowledge deficits revealed by the pretest:
  • 45% of participants indicated that they would initially recommend lifestyle changes alone, rather than statin therapy, for women diagnosed with coronary artery disease (CAD)
  • 38% incorrectly identified statin therapy as less effective in women compared with men for preventing CAD events
  • 27% incorrectly identified Asian American women as having a lower risk (rather than a higher risk) for type 2 diabetes
  • 21% incorrectly identified processed meat (rather than baked goods) as the principal dietary source of trans fatty acids
• Following the lecture, attendees answered 6.8 of 8 questions correctly, demonstrating the 1-hour session successfully improved knowledge and self-assessed skills and attitudes.
• Knowledge gaps still remained following the CME training.
  • 30% of participants continued to incorrectly endorse lifestyle changes alone, initially, rather than statin therapy, for women diagnosed with CVD
  • 22% incorrectly identified statin therapy as less effective in women compared with men for preventing CVD events

What are the take-home messages?

• Significant deficits in knowledge of heart disease in women exist among a cross section of healthcare providers. These findings underscore the need for credible, evidence-based educational materials on women’s heart disease for health care providers.
• The 1-hour educational programs were highly rated and were successful in improving participants’ knowledge of prevention and treatment issues regarding heart disease in women.
• Substantial knowledge gaps exist among healthcare providers regarding CVD in women.
• Healthcare professionals are encouraged to:
• Review online fact sheets and clinical guidelines
• Utilize online slide sets and lecture notes to give a presentation to colleagues.

Where can I learn more?

• Pregler, J., et al. The Heart Truth Professional Educational Campaign on Women and Heart Disease: Needs Assessment and Evaluation Results, Journal of Women’s Health, October, 18(10), p 1541-1547, 2009. doi:10.1089/jwh.2008.1260.
• The Heart Truth^® for Women Speaker's Kit
• The Heart Truth^® Professional Education Website
• The Healthy Heart Handbook for Women
• The Heart Truth^® Campaign

Additional information on the study:

• CME venues included grand rounds presentations and other clinic and hospital-based CME programs as well as free-standing CME programs. Sixty-eight presentations were made in 11 states (Arizona, Connecticut, Delaware, Massachusetts, Minnesota, Missouri, Ohio, Pennsylvania, Rhode Island, Vermont, and Wisconsin) during an 18-month period from July 2005 through December 2006.

• Organizations who were on The Heart Truth®Professional Education Advisory Panel in 2004 for the development of the materials and in 2005 for the dissemination of the materials include: the American Academy of Physician Assistants; the American College of Cardiology; the American College of Family Physicians; the American College of Obstetricians and Gynecologists; the American College of Physicians; the American Heart Association; the Association of Black Cardiologists; the Asian and Pacific Islander American Health Forum; the Association of Women's Health, Obstetric, and Neonatal Nurses; the National Hispanic Medical Association; the National Medical Association; and the Department of Health and Human Services Office on Women's Health Minority Women's Health Panel of Experts.