Editorial: Prioritizing Cultural Relevance and Co-Production in Cardiovascular Technologies: A Call for Action 

What you need to know 

Cardiovascular disease (CVD) continues to be the foremost cause of mortality worldwide, with disproportionate impacts on racialized populations. Black, Indigenous, Hispanic, South Asian, and other equity-deserving groups experience higher rates of CVD-related illness and death than those individuals from White populations. These inequities exist because of complex intersections between genetics, systemic racism, socioeconomic barriers, and exclusionary health practices. 

Why it matters 

Digital health technologies, including wearable devices, mobile apps, and algorithm-driven diagnostics, are increasingly being utilized to enhance CVD prevention and management. Digital health tools for cardiovascular disease (CVD) can unintentionally worsen health inequities if built with a one-size-fits-all mindset.  

What must be done now 

Addressing these disparities requires the deliberate design and implementation of technologies that reflect the lived realities of marginalized communities. That means moving from designing for marginalized communities to co-producing with them. 

Intentional co-production means communities, clinicians, and developers collaborate equitably to co-design, implement, and evaluate CVD technologies. Co-production ensures that innovations are technologically sophisticated but also socially just, culturally safe, and truly responsive to those most affected by cardiovascular disease.  

Intentional co-production is not theoretical 

Intentional co-production ensures that more people will be healthier. Evidence of the effectiveness of co-production exists and can be scaled. Culturally tailored tech works:  

• The FAITH! mobile app, co-designed with African American communities, successfully improved composite cardiovascular health outcomes among its users. 
• For Hispanic populations, the SMASH platform integrated culturally meaningful messaging with real-time medication monitoring, resulting in significantly higher adherence and blood pressure control rates. 
• The OL@-OR@ app was co-developed with Māori and Pasifika communities, blending lifestyle guidance with culturally resonant content and design.  
• Indigenous communities in Northern Ontario have also emphasized the importance of culturally respectful, technology-enabled cardiac care. 

How to get there 

Editorial authors offer key takeaways for digital health creators, clinicians, and researchers: 

• Cultural relevance goes beyond translation. It’s not just about swapping languages or images. True cultural relevance integrates local values, communication styles, digital literacy, and social contexts into the core user experience. 
• Co-production from day one. Communities shouldn’t just offer feedback on a finished product. They need to be equal partners from problem definition and UI design to clinical evaluation and deployment. 
• Equity requires structural safeguards. True equity demands diverse tech teams, representative data, algorithmic transparency, and strict adherence to Indigenous data sovereignty. 
• Nurses are critical bridge-builders. Cardiovascular nurses sit at the intersection of patients, care teams, and tech developers. They are uniquely positioned to identify real-world access barriers and ground tools in patient realities. 

Cardiovascular digital health shouldn’t just be measured by clinical efficacy, but by cultural relevance, accessibility, trust, and equity. Co-production isn’t just a moral and scientific imperative. It creates better health outcomes for all. 

Authors: Saleema Allana, Ibukun Abejirinde, Emily Seto, Quynh Pham, Enid Montague, Monica Parry, Bukola Salami, Tanvir Chowdhury Turin, Jamaul Taylor, Ridah Asghar, Gavin Oudit, Akm Alamgir, Simone Cowan, Shahin Jaffer. 

Publication: Journal of Cardiovascular Nursing. 

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