5 research outputs found

    Development and implementation of guided, self-directed learning modules in graduate medical education

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    This study sought to investigate the use of interactive iBook learning modules as a guided, self-directed learning resource for trainees within an obstetrics and gynecology residency program. The implementation of an iBook learning module as a supplement to lecture was studied in comparison to teaching sessions with lecture only

    Upstream oncology: identifying social determinants of health in a gynecologic oncology population

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    Introduction: Social determinants of health (SDoH) are the factors that affect a patient’s health quality and outcomes and contribute to health disparities. Evidence suggests that clinical care contributes only 20% to patients’ health outcomes, while the remainder is under the influence of upstream factors. The upstream approach to healthcare aims to address SDoH before they contribute to less ideal outcomes downstream. Several SDoH may contribute to outcomes for cancer patients. This Upstream Gynecologic Oncology Initiative seeks to identify which SDoH affect a population of patients with gynecologic malignancies. Hypothesis: This study hypothesizes that women receiving care for gynecologic malignancies are affected by specific SDoH among the categories of housing, food, transportation, finances, health literacy and social support. This study aims to identify the frequency of these six social factors among the outpatient gynecologic oncology population at the University of Iowa. Methods: This needs assessment is the first phase in a quality improvement project assessing the SDoH affecting women with gynecologic cancers. Two hundred twenty-two patients receiving outpatient care for gynecologic malignancies completed an anonymous needs assessment survey. Validated survey questions regarding housing, food, transportation, finances, health literacy and social support were used to identify needs. Responses were considered positive if any degree of need was reported. Results: Responses demonstrated the most substantial need in the categories of social support (32%), health literacy (28%) and financial stability (24%). Less need was reported in the categories of food (11%), transportation (5%) and housing (4%). Fifty-seven percent of women reported at least one social need among the six categories screened. Conclusion: Upstream SDoH, most notably social support, health literacy and financial stability are identified to be present and likely contributing to health quality, outcomes, and disparities within this gynecologic oncology patient population. Overall, these findings support the idea that SDoH should be assessed for each unique patient population - and for each patient receiving care for gynecologic cancer. While social support was the most frequently reported SDoH, many patients already received adequate help at home; suggesting that meaningful efforts should next be directed at improving health literacy in the population. Appreciation and assessment of SDoH potential to impact care and management should be used to design a routine screening tool for the study population and organize resources to address or mitigate the identified needs

    COVID-19 expands food insecurity disparities among rural, high-risk obstetrics patients

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    Objective: To compare rural and urban food insecurity in a high-risk obstetrics population prior to and during the COVID-19 pandemic. Methods: Utilizing convenience sampling of high-risk obstetrics patients, validated survey questions assessed self-reported food insecurity from March - October 2019 (pre-COVID-19) and March - October 2020 (COVID-19). Chi-squared analysis compared food insecurity between these two periods and among patients living in rural vs. urban counties.Results: A total of 1089 (pre-COVID-19) and 1246 (COVID-19) screenings were completed. Compared to 2019, the prevalence of food insecurity in 2020 was significantly higher from March-June only (7.8% pre-COVID-19 vs. 11.4 % COVID-19, p=0.04). Despite pre-COVID-19 similarity, rural patients reported significantly higher food insecurity prevalence during COVID-19 than urban counterparts (12.9% rural vs. 8.2% urban, p<0.01). Conclusions: The COVID-19 pandemic was associated with a disproportionate effect on food insecurity among rural patients with high-risk pregnancies. Rural health systems and agencies should explore proactive screening and intervention efforts to mitigate the adverse, downstream health effects of food insecurity
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