Cardiac rehabilitation is one of the most evidence-backed interventions for reducing post-cardiac-event mortality, yet a persistent and troubling gap exists: women, particularly those in geographically isolated areas, participate at far lower rates than men. A co-designed telehealth program targeting this exact population offers early but meaningful evidence that the gap may be closable.
The CREW (Cardiac Rehabilitation Especially for Women) program enrolled 40 women in rural and remote South Australia referred through an integrated cardiovascular network between late 2023 and late 2024. The web-based intervention comprised four educational self-management modules built with gender-specific content. Against a matched historical control group drawn from the same referral network — women who were referred before CREW's implementation — the program achieved an 82.5% cardiac rehab initiation rate (33 of 40 participants). Qualitative interviews with both enrolled women and clinicians delivering the program probed acceptability and perceived clinical value alongside the quantitative participation metrics.
This finding carries particular weight in the context of decades of documented underparticipation. Conventional in-person cardiac rehab programs have consistently shown female enrollment rates as low as 20–30% in rural settings, driven by transport burden, family caregiving responsibilities, and programs historically designed around male physiological and psychosocial profiles. The CREW program's co-design methodology — developing content with input from the target population — is a key methodological distinction that separates it from earlier telehealth pilots that simply digitized existing male-centric curricula.
That said, important limitations constrain interpretation. The cohort is small at 40 participants, and the use of matched historical controls rather than a randomized comparator limits causal inference. Completion rates and clinical outcomes such as cardiorespiratory fitness, quality of life, or readmission data are not available in the excerpt, making it difficult to assess downstream health impact. This is best read as a feasibility and acceptability signal — a necessary but not sufficient step toward a full efficacy trial. For a population this underserved, even proof of engagement is meaningful progress.
