Community based interventions for the primary prevention of cardiovascular disease in women living in rural, regional and remote areas: a scoping review

Abstract

Background: Cardiovascular disease (CVD) is the leading cause of death among women worldwide, yet prevention has historically centered on male risk profiles. For women living in rural, regional and remote settings, compared with metro settings, cardiovascular risk is higher because of the intersectionality between gender and geographical determinants such as limited access to timely care. Community-based and primary-care interventions show promise in addressing modifiable risk factors, but consolidated, gender-specific evidence for non-metropolitan contexts remains limited. Objective: This scoping review synthesises community-based interventions for primary CVD prevention among rural and regional women, mapping current approaches and gaps to inform future practice and policy toward equitable cardiovascular outcomes. Methods: A scoping review was conducted on both quantitative and qualitative publications in Medline Complete, Embase, CINAHL Complete, APA PsychINFO and AMED databases. Conclusion: This review of community-based interventions for primary CVD prevention in rural, regional and remote women found multicomponent programs (education plus coaching, goal-setting and self-monitoring) delivered in-person and in groups were more effective than single-component approaches. However, most interventions were not gender-specific, rarely co-designed, and seldom included gender-based analyses, reflecting persistent gender bias. Future research should embed co-design initiatives with women living in rural, regional and remote communities to address cardiometabolic risks and rural access barriers. Gender-disaggregated outcomes and implementation measures should also be routinely reported.