509 - Gettin' By is Tough: Poverty Training Impacts Understanding of Individual and Structural Patient Barriers

Poster Number: 509
Publication Number: 509.116

Danielle Doctor, Maine Medical Center, Portland, ME, United States; Hannah P. Yeomans, The Barbara Bush Children's Hospital at Maine Medical Center, Portland, ME, United States; Linda Riddell, Health Economy, LLC, Cape Elizabeth, ME, United States; Amy S. Buczkowski, The Barbara Bush Children's Hospital at Maine Medical Center, Portland, ME, United States

Background: It is well known that poverty has been linked with poorer health outcomes and cognitive stress. Unfavorable attitudes from healthcare providers towards low-income individuals may contribute to health disparities. Clinical training for providers has begun to emphasize how social determinants of health related to poverty, such as housing, transportation, safety of neighborhoods, and nutrition access, can affect health outcomes. However, currently described training interventions related to poverty are inconsistent and their effects on attitudes toward poverty have not been well studied in medical trainees and professionals.

Objective:
The aim of this study was to evaluate the impact of a training session on pediatric medical providers and trainees’ attitudes toward poverty. This training session differs from other currently described poverty simulators and curricula in that it focuses on how poverty causes cognitive stress and alters decision making. We hypothesized that our training would improve attitudes toward poverty and facilitate a greater understanding of the challenges faced.


Design/Methods: Participants completed the Attitude Toward Poverty (ATP) Short Form before and after the 90-minute training session. The session consisted of participating in the ‘Gettin’ By’ game either in-person or online followed by a debriefing session. The ATP short form is a 21-item survey with Likert scale that has been validated to assess poverty-related attitudes in university students. Descriptive statistics were used to describe participants and data. Paired t-tests were run to assess changes in attitude from pre- to post-training.

Results:
Participants (n=31) consisted of pediatric attending physicians (n=8), pediatric resident physicians (n=18), medical students (n=3), and other providers (n=2). Results showed a significant increase in total score of all three ATP short form subscales: personal deficiency (p=0.02), stigma (p < 0.01), and structural perspective (p=0.02). The median percentage of participants that improved their score by one or more point amongst the queried items was 32.3% (25.8% to 38.7%).


Conclusion(s):
The score changes from pre- to post-training reflect greater understanding of barriers to care and structural issues for those living in poverty. This training session is a resource that can be easily distributed and demands fewer resources than a poverty simulation. It can provide an opportunity for medical providers and trainees to gain empathy and understanding of how poverty can negatively affect health outcomes.