Mitigating Reproductive Health Disparities in Young Women of Color: Remote Learning to Foster Cultural Responsiveness in Medical Residents

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PROJECT SUMMARY/ABSTRACT Black and Latina girls (young women of color) are heavily burdened by poor reproductive health outcomes1-2. These health inequities are perpetuated, in part, by provider-level factors operative in healthcare disparities (i.e., clinical uncertainty and poor communication)3. These factors highlight inadequate medical training. Consistent with NIMHD’s Research Priorities in Clinical and Health Services Research, specifically cultural competence and patient-clinician communication4, the current project aims to improve health care quality for young women of color by targeting this training gap. The study will develop an mLearning course and utilize simulation-based assessment to facilitate training and assessment in effective and high-quality reproductive healthcare for young women of color. Candidate. I am a health services researcher with a background in prevention science for health risk behaviors with significant racial and ethnic disparities. I am applying for a five-year K23 Career Development Award to obtain training, mentorship, and research experience to become an expert (capable of obtaining R01 level funding) in health and healthcare equity for minoritized pediatric populations, in particular young women of color. Mentoring. I have put together an exceptional mentoring team with extensive and complementary expertise consistent with the study’s aims and my career development objectives. Dr. Sheana Bull is the Primary mentor renowned for her work in digital health and digital education. My co-mentorship includes: Dr. Christina Studts (dissemination and implementation science in pediatric populations), Dr. Evelinn Borrayo (using mixed- methods, health disparities, and health services), Dr. Jeffery Barsuk (medical education and simulation-based mastery learning), and Dr. Christopher Houck (adolescent reproductive health interventions). Research. The aims of the proposed project are to (1) integrate a synthesis of the literature, formative stake-holder data, and an expert panel to guide the development of an mLearning prototype; (2) conduct iterative rounds of cognitive interviews with residents, attendings, and program directors using a formative rapid cycle to refine and finalize the mLearning course; and (3) evaluate preliminary effectiveness of the mLearning course via a small scale randomized control trial in a sample of residents who receive the mLearning course versus a waitlist control. Training. Specific training in the context of health and healthcare disparities will include: the development of effective evidence-based digital health tools, dissemination and implementation strategies (including hybrid research designs), advanced mixed-methods skills, and simulation-based medical education. This training will be achieved through intensive mentored training, participation in mentored research and primary research, directed readings, coursework, webinars, and training institutes. Guided by my excellent mentorship team, these training and research experiences will establish my career as an independent, federally funded health services researcher developing digital health and simulated interventions to address pediatric minority health and healthcare disparities through accessible, responsive, and high-quality healthcare.