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Noel NL, Abrams J, Mudafort ER, Babu A, Forbes E, Hill L, Hill CC, Valbrun TG, Osian N, Wise LA, Kuohung W. Study protocol for the implementation of Centering Patients with Fibroids, a novel group education and empowerment program for patients with symptomatic uterine fibroids. Reprod Health 2024; 21:41. [PMID: 38561795 PMCID: PMC10983732 DOI: 10.1186/s12978-024-01777-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 03/16/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Black women and people with uteri have utilized collectivistic and relational practices to improve health outcomes in the face of medical racism and discrimination for decades. However, there remains a need for interventions to improve outcomes of uterine fibroids, a condition that disproportionately impacts Black people with uteri. Leveraging personalized approaches alongside evidence that demonstrates the positive impact of social and peer support on health outcomes, we adapted from CenteringPregnancy, an evidence based group prenatal care intervention, for the education and empowerment of patients with uterine fibroids. METHODS The present report provides an overview of the study design and planned implementation of CPWF in cohorts at Boston Medical Center and Emory University / Grady Memorial Hospital. After receiving training from the Centering Healthcare Institute (CHI), we adapted the 10-session CenteringPregnancy curriculum to an 8-session hybrid group intervention called Centering Patients with Fibroids (CPWF). The study began in 2022 with planned recruitment of six cohorts of 10-12 participants at each institution. We will conduct a mixed methods evaluation of the program using validated survey tools and qualitative methods, including focus groups and 1:1 interviews. DISCUSSION To date, we have successfully recruited 4 cohorts at Boston Medical Center and are actively implementing BMC Cohort 5 and the first cohort at Emory University / Grady Memorial Hospital. Evaluation of the program is forthcoming.
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Affiliation(s)
- Nyia L Noel
- Department of Obstetrics & Gynecology, Chobanian and Avedisian School of Medicine, Boston University, Boston Medical Center, Boston, MA, USA.
| | - Jasmine Abrams
- Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Estefania Rivera Mudafort
- Department of Obstetrics & Gynecology, Chobanian and Avedisian School of Medicine, Boston University, Boston Medical Center, Boston, MA, USA
| | - Anagha Babu
- Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Emma Forbes
- Department of Obstetrics & Gynecology, Chobanian and Avedisian School of Medicine, Boston University, Boston Medical Center, Boston, MA, USA
| | | | - Cherie C Hill
- Department of Obstetrics and Gynecology, Emory University School of Medicine, Atlanta, GA, USA
| | | | - Nkem Osian
- The White Dress Project, Atlanta, GA, USA
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Wendy Kuohung
- Department of Obstetrics & Gynecology, Chobanian and Avedisian School of Medicine, Boston University, Boston Medical Center, Boston, MA, USA
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Cooper NAM, Rivas C, Munro MG, Critchley HOD, Clark TJ, Matteson KA, Papadantonaki R, Yorke S, Tan A, Bofill Rodriguez M, Bongers M, Al-Hendy A, Bahamondes L, Connolly A, Farquhar C, Gray Valbrun T, Hickey M, Taylor HS, Toub D, Vannuccini S, Iliodromiti S, Khan K. Standardising outcome reporting for clinical trials of interventions for heavy menstrual bleeding: Development of a core outcome set. BJOG 2023; 130:1337-1345. [PMID: 37055716 DOI: 10.1111/1471-0528.17473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 02/20/2023] [Accepted: 02/22/2023] [Indexed: 04/15/2023]
Abstract
OBJECTIVE To develop a core outcome set for heavy menstrual bleeding (HMB). DESIGN Core outcome set (COS) development methodology described by the COMET initiative. SETTING University hospital gynaecology department, online international survey and web-based international consensus meetings. POPULATION OR SAMPLE An international collaboration of stakeholders (clinicians, patients, academics, guideline developers) from 20 countries and 6 continents. METHODS Phase 1: Systematic review of previously reported outcomes to identify potential core outcomes. Phase 2: Qualitative studies with patients to identify outcomes most important to them. Phase 3: Online two-round Delphi survey to achieve consensus about which outcomes are most important. Phase 4: A consensus meeting to finalise the COS. MAIN OUTCOME MEASURES Outcome importance was assessed in the Delphi survey on a 9-point scale. RESULTS From the 'long list' of 114, 10 outcomes were included in the final COS: subjective blood loss; flooding; menstrual cycle metrics; severity of dysmenorrhoea; number of days with dysmenorrhoea; quality of life; adverse events; patient satisfaction; number of patients going on to have further treatment for HMB and haemoglobin level. CONCLUSIONS The final COS includes variables that are feasible for use in clinical trials in all resource settings and apply to all known underlying causes of the symptom of HMB. These outcomes should be reported in all future trials of interventions, their systematic reviews, and clinical guidelines to underpin policy.
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Affiliation(s)
- Natalie A M Cooper
- Women's Health Research Unit, Wolfson Institute of Population Health, Queen Mary University London, London, UK
| | - Carol Rivas
- Social Research Institute, UCL Institute of Education, London, UK
| | - Malcolm G Munro
- Department of Obstetrics & Gynecology, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | | | - T Justin Clark
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
| | - Kristen A Matteson
- University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | | | - Sarah Yorke
- Women's Health Research Unit, Wolfson Institute of Population Health, Queen Mary University London, London, UK
| | - Alex Tan
- Women's Health Research Unit, Wolfson Institute of Population Health, Queen Mary University London, London, UK
| | | | - Marlies Bongers
- Department of Obstetrics and Gynaecology, Grow-School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Ayman Al-Hendy
- Department of Obstetrics and Gynecology, University of Chicago, Chicago, Illinois, USA
| | - Luis Bahamondes
- Department of Obstetrics and Gynaecology, School of Medical Sciences, Universidade Estadual de Campinas, Campinas, Brazil
| | | | - Cindy Farquhar
- Department of Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand
| | | | - Martha Hickey
- Department of Obstetrics and Gynaecology, University of Melbourne and The Royal Women's Hospital, Melbourne, Victoria, Australia
| | - Hugh S Taylor
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut, USA
| | - David Toub
- Medical Affairs, Gynesonics, Redwood City, California, USA
| | - Silvia Vannuccini
- Department of Obstetrics and Gynaecology, Careggi University Hospital, Florence, Italy
| | - Stamatina Iliodromiti
- Women's Health Research Unit, Wolfson Institute of Population Health, Queen Mary University London, London, UK
| | - Khalid Khan
- Department of Preventive Medicine and Public Health, University of Granada, Faculty of Medicine, Granada, Spain
- CIBER Epidemiology and Public Health, Madrid, Spain
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As-Sanie S, Black R, Giudice LC, Gray Valbrun T, Gupta J, Jones B, Laufer MR, Milspaw AT, Missmer SA, Norman A, Taylor RN, Wallace K, Williams Z, Yong PJ, Nebel RA. Assessing research gaps and unmet needs in endometriosis. Am J Obstet Gynecol 2019; 221:86-94. [PMID: 30790565 DOI: 10.1016/j.ajog.2019.02.033] [Citation(s) in RCA: 150] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 02/11/2019] [Accepted: 02/14/2019] [Indexed: 12/29/2022]
Abstract
Endometriosis, a systemic disease that is often painful and chronic, affects ∼10% of reproductive-age women. The disease can have a negative impact on a patient's physical and emotional well-being, quality of life, and productivity. Endometriosis also places significant economic and social burden on patients, their families, and society as a whole. Despite its high prevalence and cost, endometriosis remains underfunded and underresearched, greatly limiting our understanding of the disease and slowing much-needed innovation in diagnostic and treatment options. Due in part to the societal normalization of women's pain and stigma around menstrual issues, there is also a lack of disease awareness among patients, health care providers, and the public. The Society for Women's Health Research convened an interdisciplinary group of expert researchers, clinicians, and patients for a roundtable meeting to review the current state of the science on endometriosis and identify areas of need to improve a woman's diagnosis, treatment, and access to quality care. Comprehensive and interdisciplinary approaches to disease management and increased education and disease awareness for patients, health care providers, and the public are needed to remove stigma, increase timely and accurate diagnosis and treatment, and allow for new advancements.
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