Centering High Risk Pregnancies Interprofessionaly (CHRPI) to Reduce Racial Disparities in Pregnancy Outcomes

Background: Despite the steady rise in use of prenatal care, significant racial disparities exist in pregnancy-related outcomes. This calls for innovative prenatal care to improve pregnancy outcomes in racial minorities. CHRPI is an innovative prenatal care model designed to address risk factors and manageable conditions particularly prevalent in African Americans that threaten their course of pregnancy. Methods: CHRPI is an outpatient model (Fig. 1) that will accept pregnant moms with risk-factors outlined by the ACOG. They are initially evaluated by a Maternal Fetal Medicine physician where management is outlined. Then, patients are placed in groups of 4 according to their expected course of pregnancy, social, and medical needs. Between medical appointments, patients will attend sessions facilitated by a multidisciplinary team to receive education on nutrition, insulin management, alarming symptoms and more. Additionally, patients will have opportunity to address individual social and medical needs with licensed clinical social workers and mid-level providers outside of groups. Lastly, CHRPI’s care extends as far as 6 months postpartum to reassess newly diagnosed conditions or risk-factors to protect future pregnancies and establish primary care upon exiting the program. Results: Compared to traditional care of high-risk patients (Fig. 2), proposed CHRPI model is expected to decrease rate of maternal and infant mortality, pre-term birth, NICU admissions, and patient satisfaction. Conclusion: CHRPI aims to reduce racial disparities in maternal and infant mortalities associated with high-risk pregnancies by utilizing an innovative multidisciplinary group approach with significant emphasis on nutrition, education, and primary care to protect future pregnancies.https://scholarscompass.vcu.edu/gradposters/1100/thumbnail.jp

YouTube Atherectomy Videos: What Industry is Telling Us About this Endovascular Procedure

BACKGROUND: Patients are turning to the Internet and YouTube for information about their providers, disease states and potential interventions. Endovascular atherectomy is a common procedure undertaken in the treatment of peripheral vascular disease especially in outpatient treatment centers despite its cost. Little is known how this procedure is portrayed in online video content. We set forth to search YouTube to gain insight to how industry and non-industry portrays this endovascular technology. METHODS: YouTube (www.youtube.com) website was accessed in July 2017 with a cleared cached web browser for the key search word “atherectomy”. The top 100 videos with greater than 100 views were examined. All results were separated into two categories - industry (I) or non-industry (NI) sources. The duration of video, age of video, total video views, academic information, cost information and if outpatient treatment center focused care were also collected. RESULTS: A total of 100 videos were examined. The videos were separated into two groups: Industry (n=20) and Non-Industry (n=80). Videos from Industry and Non-Industry were similar in content in terms of duration (4.8 ± 4.5 and 5.6 ± 4.4 minutes), creation time (3.3 ± 2.2 and 3.4 ± 1.9 years), and total views (7386 ± 14,593 and 5560 ± 13,181). Proportions of videos from each group that contained educational content were also similar (70% and 70%). However, only 7% (n=7) of the videos reference the procedure being linked to care in outpatient treatment center. Only 3% (n=3) mentioned the cost of the procedure. All of these videos from each of these categories were from non-industry sources. Conclusion: In our sampling of “Atherectomy” YouTube videos, we find similar video content in terms of duration, creation time, total views and educational content. Interestingly, the cost and its association with outpatient treatment labs is mentioned in only a minority of the videos and only from non-industry sources. These data should inform the vascular surgery community the lack of public understanding of this endovascular technology as evidenced in YouTube videos