Patient Experiences and Behavioral Changes Following Cardiovascular Risk Assessment During Pregnancy and Postpartum

Cardiovascular disease (CVD) is the leading cause of maternal mortality in the United States. Two major hospital networks implemented a novel CVD risk assessment of pregnant and postpartum patients to standardize identification of patients with previously unknown CVD or at risk to develop CVD. This qualitative study explored the experience of being identified as at CVD risk in a purposive sample of 10 obstetric patients. Participants varied by age, race/ethnicity, language (English/Spanish), and comorbidities. Interviews focused on patients' awareness, emotional responses, clinician-patient communication, and behavioral intentions. Thematic analysis using Atlas.ti 8 revealed a limited understanding of the association between CVD and pregnancy complications and lifetime CVD risk. Positive risk assessments triggered surprise and concern. Overall, patients evaluated the clinician-patient communication positively but found information too cursory and varied in strategies to find out more details. Several patients initiated immediate lifestyle changes, while others waited for guidance from clinicians. The study underscores the need to engage patients in the implementation of screening tests and to improve health literacy to facilitate follow up care and behavior change.