Key result
Qualitative study of NPs identifies four key factors guiding responsive CVD screening for at-risk women.
Why the study?
Gaps persist in understanding how primary care nurse practitioners approach cardiovascular screening for women at risk.
Nurse practitioners employ a dynamic, context-sensitive process called responsive cardiovascular screening to balance evidence, patient context, and system factors in CVD risk assessment for women.
May guide NP screening practices; extends qualitative theory but leaves open clinical impact.
BACKGROUND: Cardiovascular disease (CVD) remains the leading cause of death among women in the United States. Despite well-documented sex- and gender-specific risk factors, women remain underrepresented in CVD research and continue to experience gaps in prevention and early detection. Nurse practitioners (NPs) deliver a substantial proportion of primary care (PC) in the United States, positioning them at the forefront of cardiovascular prevention and risk reduction. Despite this, gaps persist in understanding how NPs approach cardiovascular screening for women at risk. PURPOSE: The purpose of this study was to explore the critical factors that influence how NPs in PC screen women at risk for CVD and to construct a theoretical understanding of the processes underlying these NP-led screening practices. METHODOLOGY: A qualitative study using Charmaz's constructivist grounded theory approach was conducted with 17 PC NPs via semi-structured interviews. Constant comparative analysis guided data collection and interpretation, with credibility ensured through memoing, peer debriefing, and an audit trail to support methodological rigor. RESULTS: Four interrelated categories emerged: (1) complexities of sex and gender in women's cardiovascular health, (2) adaptive patient-centered cardiovascular care, (3) professional knowledge integration, and (4) organizational and social determinants influencing screening practices. Together, these categories informed the theory of responsive cardiovascular screening, describing how NPs dynamically balance evidence, patient context, and system factors in CVD risk assessment. CONCLUSIONS: Nurse practitioners employ responsive cardiovascular screening practices, reflecting a dynamic, context-sensitive process. IMPLICATIONS: This framework offers actionable guidance to strengthen sex-specific cardiovascular screening and promote equitable preventive care for women.
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Nadeau et al. (2026) studied Cardiovascular disease screening in women (n=17). Nurse practitioner-led cardiovascular screening practices was evaluated on Critical factors influencing how NPs screen women at risk for CVD and theoretical understanding of the processes. A qualitative study of 17 primary care nurse practitioners identified four interrelated categories that inform a theory of responsive cardiovascular screening for women at risk.
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