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Cardiovascular Health and Financial Hardship: Protocol for a Qualitative Citizen Science Study
Dagmar Niewold1, Evy C E van Gestel2,3, Latifa Abidi3
1Independent scholar, Amersfoort, Utrecht, The Netherlands.
Insights
Financial hardship significantly increases cardiovascular disease (CVD) risk. This citizen science study explores how financial problems lead to CVD development and delayed diagnosis, aiming to reduce health inequalities.
Area of Science:
- Public Health
- Health Disparities
- Citizen Science
Background:
- Cardiovascular disease (CVD) is a leading global cause of death.
- Financial hardship is linked to a higher risk of developing CVD.
- Limited insight exists into the experiences of individuals with financial hardship regarding CVD, particularly women.
Purpose of the Study:
- To investigate the relationship between financial hardship and CVD.
- To understand the mechanisms and contexts linking financial problems to CVD development and late recognition.
- To enable earlier recognition and prevention of CVD in both men and women experiencing financial hardship.
Main Methods:
- Utilizing a citizen science approach with qualitative lifeline interviews conducted by individuals with lived experience of financial hardship.
- Employing methods such as photo elicitation, critical-creative hermeneutic analysis, and design thinking.
- Facilitating collaboration between citizen scientists and professional scientists through weekly meetings and a dynamic learning agenda.
Main Results:
- Data collection is ongoing, with initial qualitative interviews commenced.
- Analysis of collected data is planned for 2026.
- Manuscripts detailing findings and process evaluations are anticipated in 2027.
Conclusions:
- The study aims to develop actionable recommendations for stakeholders to prevent CVD and improve early detection among financially disadvantaged populations.
- Emphasis will be placed on considering sex and gender differences in all analyses and recommendations.
- The research has the potential to contribute to reducing health inequalities associated with CVD.
Background:
Cardiovascular disease (CVD) is the leading cause of death worldwide. Individuals with lower income or experiencing financial hardship face a significantly higher risk of developing CVD. However, there is a lack of in-depth insight into their experiences with CVD, and specific attention to women is essential.
Objective:
The In a Heartbeat study aims to understand the relationship between CVD and financial hardship and enable earlier recognition and prevention of CVD among both women and men. In this study protocol, we describe our citizen science study, in which we unravel the mechanisms and contexts through which financial problems lead to the development and late recognition of CVD.
Methods:
The main data for this study are collected by citizen scientists through qualitative lifeline interviews. All citizen scientists have experience with financial hardship, and some also have experience with CVD. We hold weekly project team meetings with citizen scientists and professional scientists in which we use methods such as photo elicitation, critical-creative hermeneutic analysis, design thinking, a dynamic learning agenda, and regular individual and group evaluations of the citizen science process.
Results:
The study was funded in October 2024 and started in January 2025. Data collection started in November 2025 and is expected to end halfway through 2026. Four qualitative lifeline interviews had been conducted as of December 6, 2025. Data analyses are planned for 2026. Manuscripts reporting findings on the central research question and the process evaluations will be submitted for publication in 2027.
Conclusions:
Toward the end of the study in 2027, we will develop and disseminate concrete recommendations for various stakeholders to prevent CVD and recognize CVD earlier among people with financial hardship. In all our analyses and recommendations, we will consider sex and gender differences. Our study could contribute to a reduction in health inequalities.
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