Overlooked and Underserved: A Scoping Review of Social and Mental Health Outcomes Following Cardiopulmonary Rehabilitation Programming in Rural Dwellers.

Non-communicable chronic diseases, including cardiovascular and pulmonary diseases, are highly prevalent in rural areas. This population is also more susceptible to loneliness and social isolation. Rehabilitation programs are an essential component for the management of cardiopulmonary diseases and have been shown to improve several outcomes (i.e. cardiovascular health, symptom burden, and quality of life). These programs may also play a role in social health. The aim of this review is to explore the state of knowledge surrounding cardiopulmonary rehabilitation programs, loneliness, and social isolation among those living rurally. This review was developed following the Joanna Briggs Institute Guidance for Scoping reviews and it is reported following the PRISMA extension for scoping review framework (PRISMA-ScR). Eligibility criteria: studies including patients with cardiopulmonary disease, participants of a rehabilitation program (no specific criteria) and evaluating any of the following outcomes: social health, mental health, quality of life; published in English. Sources of evidence included CINAHL, PubMed, PsycINFO, ProQuest Central, grey literature and by hand. A peer-review process was followed for study selection and after data extraction using a piloted template. Eleven studies were included, and the results synthesis is presented descriptively. Few studies explored the effects of rehabilitation or peer-support programs in rural settings and even fewer studies investigated their impact on social health. Mental health and quality of life are more frequently investigated. The underrepresentation of rural dwellers within cardiopulmonary rehabilitation programming and research echo the calls to action to prioritize increased research, programming, and policy for those in rural areas.