Cardiovascular health literacy among women of reproductive age in the SAFE HEART Study: an American Heart Association Research Goes Red Initiative

Background Cardiovascular health literacy (HL) is essential for preventing cardiovascular disease (CVD), yet disparities persist among women of reproductive age, particularly those from racially and socioeconomically diverse backgrounds. Limited research has examined cardiovascular HL in this population, and effective strategies to improve cardiovascular HL remain understudied.Aims The SAFE HEART Study sought to assess and improve cardiovascular HL among women of reproductive age through a targeted educational intervention.Methods This cross-sectional and quasi-experimental study recruited women aged 18–44 years from (1) community outreach in Baltimore-Washington, D.C., and (2) the American Heart Association Research Goes Red (RGR) registry. All participants completed a validated cardiovascular HL questionnaire. Community-enrolled participants received a four-month culturally tailored educational intervention consisting of newsletters and webinars and cardiovascular HL was reassessed at follow-up. We compared the sociodemographic and cardiovascular HL scores between the RGR- and community-enrolled participants. Paired t-tests assessed pre-post changes among the community-enrolled participants who completed the intervention.Results Among 313 participants (mean age: 30.8 ± 6.3 years), 228 were community-enrolled and had higher rates of hypertension (45.2% vs. 29.4%), diabetes (40.8% vs. 14.1%), and hyperlipidemia (41.2% vs. 30.6%) than RGR-enrolled participants. Correctly identifying CVD risk factors varied, with 38.3% recognizing high cholesterol, 40.9% HDL cholesterol risk, and 38.0% diabetes-related heart disease risk. Post-intervention, community-enrolled participants improved in overall cardiovascular HL (69.8–73.9, p < 0.001), exercise (66.7–74.7, p = 0.007), diet/cholesterol (58.8–63.9, p = 0.023), and therapeutic knowledge (80.5–86.1, p = 0.010).Discussion This study is among the first to examine cardiovascular HL in a diverse cohort of women of reproductive age, revealing knowledge gaps and moderate improvements following intervention. Findings support the potential of culturally tailored education but highlight the need for sustained engagement strategies and digital tools to enhance cardiovascular HL retention and accessibility.