Bumrah, C, Women Leading Healthy Change: Promoting Healthcare Self-advocacy and Health Literacy in Vulnerable Populations

Introduction: Women Leading Health Change (WLHC) is a student-led organization at the University of Cincinnati College of Medicine that promotes healthcare self-advocacy and health literacy amongst vulnerable populations in Cincinnati, Ohio. WLHC implements student-created women’s sexual and mental health educational curricula to provide women in Cincinnati with the resources and knowledge necessary to navigate an increasingly complex healthcare system. Throughout its eleven year history, WLHC has expanded its educational curriculum to three sites within Cincinnati. Two of the participating community centers, Off the Streets and First Step Home, serve the needs of women with histories of substance use, sex trafficking, and/or exploitation. Bethany House Services strives to empower unhoused and at-risk families to achieve housing stability and long-term self-sufficiency. The first five weeks of the curriculum emphasize women’s sexual health education, the second five weeks focus on mental health education, and the final week is an open forum for feedback from the class. The curriculum is taught at these three sites during the fall and the spring. Since 2011, WLHC has worked to achieve three measurable goals: 1. Demonstrate program efficacy through short- and long-term retention of relevant health knowledge by participants; 2. Enhance participant self-advocacy in navigating the healthcare system; 3. Develop medical students’ communication with and empathy for this vulnerable population.

Methods: To assess whether these three goals are achieved, WLHC utilizes quantitative and qualitative research methods. During the curriculum’s first session, class participants complete a pre-survey that gathers demographic information, assesses their experience interacting with healthcare professionals, and shares how confident they feel advocating for their health. This survey is administered again after the class participants have completed the 11-week curriculum. Additionally, class participants take a pre-quiz before each session and a post-quiz after each session to measure understanding of the material presented. Furthermore, medical students complete a survey before and after teaching the curriculum to assess changes in their perspective related to treating this patient population. Finally, the curriculum includes ample opportunity for feedback from both class participants and medical students. 

Results: During the 2021-2022 WLHC sessions, class participants (N=99) showed statistically significant (P<0.05) improvement in medical understanding, confidence, and self-advocacy in navigating the healthcare system. Additionally, in nine out of twelve classes, class participants showed statistically significant knowledge retention, as assessed by their post-quiz scores after each session (P<0.05). Finally, medical students (N=24) showed statistically significant growth in perspective and satisfaction when working with this patient population (P<0.05). 

Conclusions: By engaging with the WLHC curriculum, class participants displayed a significant increase in understanding and retention of health knowledge, as well as increased self-advocacy. Furthermore, medical students developed a better understanding of vulnerable patient populations by interacting with class participants. 

Presenting author contact information: Ceimoani Bumrah, bumrahci@mail.uc.edu, (952) 649-8947

Key words/Tags: women’s health, mental health, self-advocacy, healthcare, vulnerable patient populations