Evaluating Culturally Adapted Cardiac Rehabilitation: A Mixed Methods Review

Objective: this mixed methods review aimed to identify and evaluate studies that developed and assessed culturally adapted cardiac rehabilitation programmes for ethnic minority patients. Introduction: Ethnic minorities face several barriers when attending cardiac rehabilitation programmes. Culturally sensitive cardiac education programmes exist and provide evidence of their value. There is a need for review-based research to collate current understanding and evaluate the studies and outcomes. To the best of the authors’ knowledge, this is the first review providing additional insight into the impact of culturally adapted cardiac rehabilitation programmes on ethnic minority patients. Methods: A convergent segregated mixed methods review was undertaken and reported according to JBI methodology. A systematic search was conducted by two blind reviewers assisted by Covidence© software. Nine electronic databases were searched including; Amed, CINAHL Plus, PubMed, Cochrane, Embase, Medline, Scopus, SPORTDiscus and Web of Science from inception to June 2025. Studies were included if they designed interventions for and included adult ethnic minority patients and report on culturally tailored interventions any outcomes related to the tailored cardiac rehabilitation programme. Any type of design was acceptable including mixed methods, qualitative or qualitative. Critical appraisal, narrative synthesis and certainty assessment of evidence was undertaken to summarise findings. Results: Six studies met the inclusion criteria (3 qualitative, 2 mixed methods, 1 quantitative). Overall study quality was moderate. Cultural adaptations with moderate confidence in benefits included community collaboration, bilingual or culturally matched staff and single-sex classes. Findings suggest culturally adapted cardiac rehabilitation is received positively, with potential to improve physical, social and mental wellbeing among ethnic patients. Conclusions: Culturally adapted cardiac rehabilitation may support engagement and improve health outcomes for ethnic patients, however further high-quality research is needed to confirm effectiveness and guide service development.