(883) A simple intervention to improve equity in approach and enrollment for obstetric research

Friday, February 10, 2023

10:30 AM – 12:00 PM

Objective: Non-white populations are those at greatest need of interventions to improve maternal/neonatal health, yet are least represented in research. We aimed to determine if a simple intervention, including formation of a Research Equity Committee and a dashboard detailing approach and enrollment statistics by race, could improve equitable inclusion in obstetric research.

Study Design: We prospectively evaluated the impact of this intervention on the inclusion of self-reported Black birthing people in actively enrolling obstetrical studies at one academic university from July 2021 to June 2022. The intervention had 4 components: (1) Research personnel submitted dashboards every 3 months to the Research Equity Committee. (2) Approach and enrollment by race were compared to expected racial breakdown (goal 60% Black birthing patients based on site demographics). (3) Study teams with rates of approach and/or enrollment of Black birthing people below goal met with the Committee for root cause analysis (RCA) and action planning. (4) All dashboards, RCAs, and action plans were presented to research faculty and staff at 3-month intervals. Studies submitting >1 dashboard were included. Cochran-Armitage evaluated for trends in inclusion of Black birthing people over time.

Results: Seven qualifying prospective studies submitted 23 equity dashboards over the study period, which encompassed 692 patients. Six RCA and action planning meetings (among 4 studies) were held. Themes of developed action plans included: ensuring standardized selection for patients to approach, standardized scripts for recruitment, and study expansion to more diverse sites. Of the 4 studies which underwent RCA, 1 demonstrated significant increases in approach (p=0.002) and enrollment (p=0.02) of Black birthing people, while the other 3 demonstrated improvements after the intervention, although non-significant, likely due to small sample size (Figure).

Conclusion: A simple intervention can improve approach and enrollment of populations most at need of effective interventions in obstetric research.

Primary & Presenting Author(s)

Rebecca F. Hamm, MD,MSCE (she/her/hers)
Assistant Professor of Obstetrics and Gynecology
Department of Obstetrics & Gynecology, Perelman School of Medicine, University of Pennsylvania
Philadelphia, Pennsylvania, United States

Coauthor(s)

MM
Meaghan McCabe
Maternal and Child Health Research Center, Project Manager
University of Pennsylvania
Philadelphia, Pennsylvania, United States
Samuel Parry, MD
Perelman School of Medicine, University of Pennsylvania
Philadelphia, Pennsylvania, United States
Lisa D. Levine, MD, MSCE (she/her/hers)
Associate Professor
Perelman School of Medicine, University of Pennsylvania
Philadelphia, Pennsylvania, United States