PC2091: Ramadan in Pediatrics Project: Medical Education Intervention for Community Pediatricians

Background: Fasting during the holy month of Ramadan is one of the primary pillars of Islam. Muslims abstain from all water, food, and medications from dawn to dusk for the duration of the entire month. Currently, the existing medical literature focuses on health outcomes among Muslim adults who fast, especially among diabetic patients. To date, there is no study that assesses fasting practices among children in the US.

This abstract is part of a multi-phase study assessing Muslim pediatric fasting practices and the current clinical practice of their physicians in Michigan. The objective of this phase of this phase of the study is to assess the efficacy of a medical education intervention aimed at pediatricians who will be caring for Muslim children in the community.

Methods: For 4 consecutive years, a 45 minute lecture was provided to medical students, pediatric residents, fellows, and attendings at various hospitals throughout the state of Michigan during weekly didactic sessions. A brief and anonymous post-lecture Qualtrics survey was administered that included questions regarding basic knowledge about Ramadan, management of diabetes for children/adolescents who fast, and physician level of comfort managing pediatric patients who fast.

Results: In total, 4 intervention cycles were completed prior to Ramadan in 2019, 2020, 2021, and 2022. Cycle 1 in 2019 included 32 participants, cycle 2 in 2020 included 22 participants, and cycle 3 in 2021 had 27 participants, and cycle 4 had 54 participants from 7 different hospital systems. Most participants identified as senior pediatrics residents (PGY2 and PGY3) in cycle 1 and 2. In cycle 3 and 4, there was an even distribution of interns and senior residents.

In cycle 1, most participants stated they had limited understanding of Ramadan fasting practices and had limited comfortability in providing anticipatory guidance for parents. Comparing cycles 2 and 3, participants showed overall improvement in comfortability providing anticipatory guidance to parents regarding the practice (p-value 0.34). In cycle 4 nearly 75% of participants felt they had an advanced or good understanding of fasting practices after the lecture. This improvement was mirrored in participants’ perceptions of the importance of providing pre-Ramadan counseling to families and ability to provide alternative prescription management.

Conclusion: Our study is the first of its kind in assessing current knowledge and clinical practice regarding Muslim pediatric fasting among physicians. In addition, it highlighted a gap and improvement in pediatricians understanding and comfort level in providing necessary anticipatory guidance for their Muslim patients and families, who make up a significant portion of patients in Southeast Michigan. Improving physicians understanding of fasting practices will help Muslim overcome any barriers they may face during Ramadan and improve physicians ability to care for Muslim patients in their community.