Empowering Women and Providers for Improved Care of Urinary Incontinence: EMPOWER Study

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Urinary incontinence is a chronic and serious condition with a high rate of incidence that is associated with poor sleep quality, depression, social isolation, and neurological or cognitive problems. Urinary incontinence is common among women, effecting over 25% of all adult women globally, but it is often underdiagnosed. Researchers suspect that urinary incontinence prevalence rates are difficult to capture due to cultural perceptions of urinary incontinence, methodological differences, survey items that yield differential responses due to wording, differences in case definitions and having access to validated measures. While the consequences of urinary incontinence (UI) are not fatal, the burden on individuals with UI is significant and has a profound effect on quality of life. Research has concluded that while there are many effective interventions for urinary incontinence, methods to diagnose and treat urinary incontinence lack sensitivity to adequately identify all who suffer with this condition. We seek to increase awareness of this problem. Moreover, because racial disparities in the diagnosis and treatment of chronic medical conditions are common, it is suspected that there may also be a diagnosis and treatment disparity for urinary incontinence among African American (AA) women. There is a gap in the existing literature and we do not know if AA women are diagnosed and treated less frequently for urinary incontinence compared to other women. Our goal is to understand the diagnosis and management of urinary incontinence in African American women, both from the standpoint of incidence and treatment rates, and from the standpoint of the illness experience of affected women. In this study, we will develop, apply and refine a search criteria to identify urinary incontinence in AA women from EHR data. We will utilize this criteria to evaluate and identify any racial disparities in the diagnosis of urinary incontinence in AA women and racial disparities in the treatment rates and types of treatment provided. We will also interview African American women who are affected by urinary incontinence and who participated in the AHRQ funded “Empowering Women and Providers for Improved Care of Urinary Incontinence: EMPOWER Study”. Focused interviews will characterize the experience of illness, diagnosis and treatment of the problem. We will code the data to identify themes in the responses and interpret these themes with EHR data findings to provide empirically informed guidance and a deeper understanding of addressing UI in African American women.