Barriers and facilitators of cardiovascular disease prevention services for women with prior gestational diabetes or hypertensive disorders of pregnancy in low-income, middle-income and high-income settings: a scoping review protocol

Abstract

Introduction: Women with previous pregnancy-related cardiovascular risk indicators, including gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP), have an increased risk of future cardiovascular disease (CVD). Although CVD screening and preventive care beginning in the early postpartum period are recommended, certain barriers limit access to such services. We plan to conduct a scoping review of the literature to explore and summarise evidence on the barriers and facilitators of postpartum CVD preventive services in women with a history of GDM and HDP.

Methods and analysis: This scoping review will be conducted in line with the Arksey and O'Malley's (2005) methodological framework and the Joanna Briggs Institute guidance for conducting a systematic scoping review and will follow the Evidence for Policy and Practice Information and the Coordinating Centre at the Institute of Education guidelines. The review results will be reported using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. We will search the following databases: Medline, Embase and CINAHL. We will conduct grey literature searches for registered dissertations and theses. Inclusion and exclusion criteria will be kept broad. Qualitative and quantitative studies published in English or French that investigated and reported percieved barriers or facilitators to postpartum CVD screening and preventive care among women with previous GDM and HDP will be included. Individual, interpersonal, organizational, and system level factors will be reported. Qualitative findings will be summarised narratively, and quantitative findings will be absorbed within the themes using the multisource synthesis method.

Ethics and dissemination: This review represents one objective of a larger project that was reviewed by the Ottawa Health Sciences Network Research Ethics Board (QI-184). We will disseminate knowledge emanating from this review through open-access publication, presentation/public forums on women's cardiovascular health, women's CVD prevention forums and social media. We will also present the findings of this review at the annual meeting of the Canadian Women's Heart Health Alliance.

Keywords: awareness; cardiovascular disease; postpartum women.

Figure 1. Flow chart of inclusion and exclusion of articles. CVD, cardiovascular disease.