Creating a Women’s Health Coalition at a Student Run Free Clinic: A Model for Increasing Access to and Quality of Care

Abstract

Introduction: At the beginning of 2021, the Indiana University Student Outreach Clinic (IU SOC) conducted an internal audit of cervical cytology and sexually transmitted infection (STI) screening, which showed low rates of preventive screenings and inconsistent follow-up, thereby demonstrating a need to increase reproductive healthcare access to underserved women in Indianapolis.  Methods: To increase access, multiple teams were created within the Women’s Health Coalition (WHC), ensuring robust education, follow-up, and other necessary coordination for patient care. Additionally, the WHC expanded to host a twice-monthly referral-based women’s health clinic that provided care for patients with various chief concerns and preventive care needs. Protocols for wet-mount microscopy and sexual assault were created based on national guidelines, and annual training were provided to all members of the WHC. Community partnerships were formed to expand resources, including ultrasounds, mammograms, and contraception services. Results: The IU SOC increased the prenatal and gynecological services offered over nine months through this initiative. Notably, a higher number of services were offered to patients who qualified for screenings in 2021 than in the prior four years combined, including cervical cytology (24.1% [Confidence Interval (CI) 18.6%, 29.7% vs. 4.2%] [CI 2.9%, 5.5%]), mammogram referrals (23.1% [CI 15.8%, 30.3%] vs. 2.3% [CI 1.0%, 3.6%]), and STI/human immunodeficiency virus (HIV)/Hepatitis testing (54.6% [CI 50.2%, 59.0%] vs 8.1% [CI 6.8%, 9.3%]). Conclusion: Given the success of the WHC, our approach may serve as a student-run model for other patient populations.