University Health serves a 28 county service region in South Texas that includes Bexar County, Texas. Bexar County is the largest population center of South Texas with a total population of almost 2 million residents and includes the San Antonio metropolitan region (the seventh largest in the U.S.). Residents in this area are disproportionately impacted by numerous health disparities including poor maternal health, high rates of preterm births, and high rates of deliveries by caesarean section. To address these disparities and improve and advance maternal health and health equity for women in Bexar County, Texas, Bexar County Hospital District dba University Health proposes the Mujeres con Confianza program, an education-focused intervention designed to improve diagnosis and treatment of endometriosis, polycystic ovary syndrome, and fibroids in women of childbearing age.
Mujeres con Confianza consists of both provider and patient education on endometriosis, PCOS, and fibroids. For the provider education component, a clinical champion will be chosen for each participating program site. The clinical champions will use systematic practice-based interventions to educate health care providers and staff about 1) screening and treatment guidelines and updates, 2) barriers to accessing screening and treatment, 3) the need to increase screening, particularly among at-risk and ethnic groups, 4) review the most recent USPSTF guideline recommendations, and 5) provide treatment protocols. Providers and staff at participating clinics will receive tailored education facilitated by members of their team along with the Medical Director and administrative leadership. In-person education sessions and self-paced modules on University Health’s Learning Central will be created and assigned, annually, for completion to clinic providers and staff. Physical education materials with content from the Centers for Disease Control and Prevention (CDC) and National Institutes of Health (NIH) will be used to increase provider and staff knowledge promoting positive change.
The Mujeres con Confianza program curriculum and educational resources for patients on endometriosis, PCOS and fibroids will be developed utilizing NIH and CDC resources and a review of evidence based literature. The curriculum will consist of three educational sessions focused on 1) awareness of endometriosis, PCOS, and fibroids, 2) diagnosis and treatment options for these conditions and 3) patient activation/self-advocacy. Patients will receive education from a bilingual, culturally competent health educator who is from the local community and shares life experiences with the target population. The curriculum sessions will be completed in one-on-one and group settings both in person and virtually, giving patients an opportunity to select the most convenient option and will be offered on a monthly basis.
Patients will be recruited via email and postage mail invitations as well as mailing inserts in their monthly bill. The program’s Health Educator will follow up with phone calls to answer questions, encourage enrollment and obtain registration information. One session will be presented weekly for a total of three different classes each month. To complete the program, the patient must complete all three sessions as well as the pre and post surveys. Incentives will be provided to patients at the completion of each pre and post survey. Additionally, a program Health Educator will attend community events and activities to reach community members with culturally sensitive educational resources on endometriosis, fibroids and PCOS.