ASMOSUS: Building student nurses’ skills in ASsessing cardiovascular risk, MOtivating change, and SUStaining a healthier lifestyle in themselves and others

The study described in this blog is funded by the Burdett Trust for Nursing.

Nurses are well placed to identify cardiovascular disease (CVD) risk and to support people in making healthier lifestyle choices to reduce the risk of developing CVD. Despite this, nurses often have high levels of overweight and obesity, smoking, alcohol consumption, and low levels of physical activity.

We worked with first year nursing students at Edinburgh Napier University and Queens’ University Belfast to develop an interactive online application (app). This educational app aimed to improve nursing students’ confidence and ability to assess cardiovascular risk, and to support patients and themselves to make healthier lifestyle choices. We wanted to understand whether the app helped students to become more confident to talk to patients about their lifestyle.

Interactive app content included the use of risk assessment tools, quizzes and decision making based on patient stories within the app.

AMOSUS app user screen

The app has been included in a first-year undergraduate nursing module at both universities. So far, students have completed surveys before and after using the app to gain understanding of whether it made a difference to their confidence and ability to talk to patients about their lifestyle. The final part of the study will invite students to take part in focus groups to explore their experiences of using the app. We expect to present the results of this study later in 2024.

If you would like to read more about the project and study team, follow the link here.

Blog contributed by Dr Bruce Forrest, Lecturer in Nursing, School of Health and Social Care, Edinburgh Napier University.

Exploring what wheelchair users need to facilitate equity of access in exercise facilities

A guest post by MSc Nursing student Siobhan Smith. Siobhan has recently submitted her dissertation and shares some of her study findings below.

Wheelchair access is a topic often not thought about until it is required, which for some people is every day. The barriers to wheelchair access extends into places such as gyms, with the World Health Organisation (WHO) highlighting how this can leave out some disabled people in experiencing the health benefits that come through physical activity (WHO, 2022).

Fortunately, health inequalities as a result of access issues for disabled people are becoming more recognised nationally, with the National Health Service (NHS) declaring their focus on addressing the issue (NHS, 2019).

Scotland’s first ever gym for disabled people opened in 2022 which further brought the spotlight on the accessibility barriers of mainstream gyms (Robertson, 2022). Experiences from this specialised gym were used in a study I conducted to assess the impact of effective accessibility on wheelchair users. The aim of the study was to speak to wheelchair users directly about what they feel should be in place to allow for better wheelchair access to gyms.

The study used interviews to gather its data. These included speaking with two groups of people, 1) wheelchair users who use mainstream gyms, and 2) wheelchair users who use the specialist gym. The data was then looked at together to gain a greater perspective. It was found that wheelchair users felt the greatest negative impact came from the lack of understanding held by gym staff, other gym users, and the wider society. The effects of this lack of understanding were seen in a variety of settings within gyms, from the ability of wheelchair users to get inside to their ability to use the equipment safely.

Study Findings

Overall, the study showed that a lack of understanding about wheelchair users in gyms can, and does, result in gyms being designed in such a way that wheelchair users are unable to use them. In the specialist gym, where access barriers have been reduced as much as possible, wheelchair users had a more enjoyable experience. This came from an increase in confidence, safety, and ability to be effectively supported.

It was found that ultimately, if a gym doesn’t have wheelchair access, as well as sufficient training and understanding by staff, then it is simply not a place where wheelchair users are able to be. It was clear that steps need to be taken to increase the understanding of disabilities held by those within gyms, both professionally and personally, as well as an increase in representation of disabled people in gyms to wider society. Increasing staff training on how to support wheelchair users in gyms was found to be an effective way to begin to reduce barriers to access, as the perceptions stemming from a lack of understanding contribute to decisions made about gym layouts and staff training priorities. The figure below shows the continuous impact these issues can have:

Figure 1. Cycle of inaccessibility in exercise facilities.

Although the research brought about important conclusions, further research is required to find out what is the best way to develop and deliver the training required to achieve the changes that need to happen to better facilitate equity of access for wheelchair users in gyms.


National Health Service. (2019).  NHS Long Term Plan. Retrieved from: [Accessed on 24/08/2023]

Robertson, D. (2022). DR Inclusive Fitness & Wellbeing. Retrieved from: [Accessed on 24/02/2023]

World Health Organisation (WHO). (2022). Disability. Retrieved from: [Accessed on 24/02/2023]

Use Heart, Know Heart

World Heart Day is an annual event established by the World Heart Federation. The objective of the day is to promote heart health and raise awareness about cardiovascular diseases (CVD), as well as educate on the importance of a heart-healthy lifestyle.

This year’s theme is “Use Heart, Know Heart.” This emphasises the importance of heart care as a global issue and knowing what preventative measures can help keep our hearts healthy.

Most people will know or have heart what habits are good for heart health, such as regular exercise and healthy eating habits, stress management and adequate sleep. Some of the lesser-known facts and aspects of CVD that people may be less aware of (and what some of our research covers), include:

  1. Women and Heart Disease: CVD is often seen as a predominantly male issue, but it’s the leading cause of death globally for women too. Symptoms vary from person to person, but women do not experience main symptoms (e.g. chest pain) more or less often than men.
  2. Silent Heart Attacks: Not all heart attacks will have chest pain – sometimes symptoms are subtle, like fatigue, shortness of breath or mild discomfort.
  3. Mental Health Impact: Certain mental health conditions, like depression, anxiety and chronic stress can increase the risk of CVD. Make sure to also take care of your mental wellbeing to take care of your heart.

Understanding these lesser-known aspects of CVD can help people take more proactive measures to protect their heart health and reduce their risk of heart-related problems. Regular check-ups, a healthy lifestyle, and awareness of risk factors are essential in the prevention and management of heart disease.

If you’d like to learn more about our research or about CVD more generally, you may wish to refer to any of the following resources:

Logo of heart and question mark