Improving Access to Expanded Genetic Carrier Screening Through Multimodal Interventions.

IF 3 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Lauren N Meiss, Shefali Pathy, Sarah E Baxley
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引用次数: 0

Abstract

Objective: The American College of Obstetricians and Gynecologists recommends offering genetic carrier screening (GCS) to all patients desiring pregnancy or who currently are pregnant. At our urban academic center, we observed that not all appropriate patients were offered GCS. This study aimed to target identified barriers, including health care provider comfort in offering GCS and lack of standardized resources, ultimately increasing the number of patients offered this testing. Methods: This project was implemented in an urban academic medical center's obstetrics and gynecology (OBGYN) clinic. A needs assessment was performed to determine the baseline comfort level of OBGYN providers regarding expanded GCS and identify barriers. Interventions, including a didactic educational session and template changes in the electronic medical record, were tailored to address the identified concerns. The impact of these interventions was evaluated using a postdidactic evaluation, statistical analyses, and tracked documentation of GCS counseling. Results: The average mean number of visits with documentation of GCS preference in the initial obstetric visit in the preintervention period (August to November 2020) was 38%. Preintervention needs assessment revealed limited provider comfort with offering expanded GCS. Evaluations following the didactic session demonstrated a significant increase in providers' comfort levels, particularly regarding pre- and post-GCS test counseling. The average number of visits documenting carrier screening preference substantially increased during and after the study period. Statistical analyses confirmed the significance of these improvements. Conclusions: Despite identified challenges and limitations, targeted educational interventions proved effective in improving provider confidence and increasing the number of visits with documentation of GCS preference.

通过多模式干预改善扩大遗传携带者筛查的可及性。
目的:美国妇产科医师学会建议对所有希望怀孕或正在怀孕的患者进行基因携带者筛查(GCS)。在我们的城市学术中心,我们观察到并非所有合适的患者都接受了GCS治疗。本研究旨在针对已确定的障碍,包括卫生保健提供者提供GCS的舒适性和缺乏标准化资源,最终增加提供该测试的患者数量。方法:本项目在某城市学术医疗中心妇产科(OBGYN)门诊实施。进行需求评估,以确定OBGYN提供者对扩展GCS的基线舒适度,并确定障碍。干预措施,包括说教式教育会议和电子病历的模板更改,都是针对已确定的问题量身定制的。这些干预措施的影响是通过教学后评估、统计分析和跟踪GCS咨询的文件来评估的。结果:在干预前期间(2020年8月至11月),初次产科就诊中有GCS偏好记录的平均就诊次数为38%。干预前需求评估显示,有限的提供者对提供扩展的GCS感到满意。教学课程后的评估显示,提供者的舒适度显著提高,特别是在gcs测试前和测试后的咨询方面。在研究期间和研究结束后,记录携带者筛查偏好的平均访问次数大幅增加。统计分析证实了这些改进的重要性。结论:尽管存在明确的挑战和局限性,但有针对性的教育干预被证明在提高提供者信心和增加GCS偏好的就诊次数方面是有效的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of women's health
Journal of women's health 医学-妇产科学
CiteScore
6.60
自引率
5.70%
发文量
197
审稿时长
2 months
期刊介绍: Journal of Women''s Health is the primary source of information for meeting the challenges of providing optimal health care for women throughout their lifespan. The Journal delivers cutting-edge advancements in diagnostic procedures, therapeutic protocols for the management of diseases, and innovative research in gender-based biology that impacts patient care and treatment. Journal of Women’s Health coverage includes: -Internal Medicine Endocrinology- Cardiology- Oncology- Obstetrics/Gynecology- Urogynecology- Psychiatry- Neurology- Nutrition- Sex-Based Biology- Complementary Medicine- Sports Medicine- Surgery- Medical Education- Public Policy.
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