Uterine fibroids (UF), smooth muscle neoplasms of the myometrium, affect nearly 80% of women before age 50 years and impact the lives of 26 million women in the United States alone. Non-Hispanic Black women, experience 2-3 times the incidence of UF, earlier onset of disease, and greater disease severity (larger tumor size, more numerous tumors, and heavier bleeding) than non-Hispanic white women. Symptomatic UF dramatically reduce quality of life, causing severe bleeding, anemia, pain, infertility, and complications of pregnancy and delivery. Uterine fibroids remain the primary indication for hysterectomy in the United States.
At Boston Medical Center (BMC), clinicians in the OB/GYN department see hundreds of patients and perform at least 200 UF-related surgeries each year. BMC is the largest safety-net hospital in New England, with over 70% of the patient population coming from underserved communities. Over two-thirds of BMC’s population identify as Black – a population shown to experience the highest UF burden. Beyond this disproportionate burden of disease among Black women, evidence also shows that implicit racial bias within the healthcare system has been directly linked to delivery of lower quality care for patients of color. It was with this health inequity in mind that the Centering(patientswith)Fibroids (CPWF) intervention was developed. Adapted from the Centering Healthcare Institute’s model of group care, our program prioritizes a multidisciplinary, patient-centered, and evidence-based approach to patient care for women diagnosed with UF. More specifically, the CPWF intervention was designed to engage and empower patient participants, with the end goal of improving patient knowledge, understanding of their health condition, and available treatment options. With this approach, patients’ mistrust of the healthcare system will be understood and addressed, thereby improving outpatient healthcare resources, and improving patient outcomes.