“The heart truth” about sociodemographic reporting in cardiometabolic disease risk reduction efforts in spinal cord injury rehabilitation: A scoping review

Research Objectives: To: 1) determine the proportion of cardiometabolic disease (CMD) risk reduction studies in spinal cord injury/disease (SCI/D) rehabilitation that report on sociodemographic variables; and 2) categorize current approaches to inform future quality improvement (QI) initiatives.

Design: A scoping review of scientific evidence was conducted in alignment with the PRISMA-ScR guidelines. Three databases were included in the search (MEDLINE, CINAHL, Embase) and a total of 20 articles were extracted for preliminary analyses. Studies were classified into categories based on type and evaluated for inclusion of sociodemographic variables.

Setting: N/A

Participants: N/A

Interventions: N/A

Main Outcome Measures: The primary outcome measure was the reporting of sociodemographic variables, along with the specific factors included (i.e., sex, gender identity, racial and ethnic identity, employment status, relationship status, etc.). A secondary measure involved classifying studies under 4 types (diagnosis, prognosis, harm, or therapy) as defined by the Users’ Guide to Medical Literature

Results: Sociodemographic variables beyond biological sex were heavily underreported (n=6) despite being interrelated with the prevalence of CMD risk factors. Ethnicity was the most reported variable (n=4), followed by race and education level (n=2). Studies primarily fell under the categories of diagnosis (n=8) and therapy (n=11), with the latter related to physical activity and drug treatments targeting the 4 key CMD risk factors (hypertension, dyslipidemia, obesity, diabetes mellitus).

Conclusions: While studies report on the general increased prevalence of CMD in the SCI/D population, there is minimal reporting of intersecting sociodemographic variables that may influence level of risk. As well, there is no report of an implemented QI initiative directly influencing rehabilitative care. Further classifications will determine whether studies in literature translate findings into clinical practice to bring heart health to the forefront.

Author(s) Disclosures: The authors have no conflicts of interest to disclose.