372 - Learning about the impact of social determinants of health on asthma in a Clinical Public Health curriculum

Asthma is a ubiquitous diagnosis in pediatric populations. CDC data reveals that in 2020 1 in 17 pediatric patients had an asthma diagnosis (1,3). Additionally, the prevalence is disproportionately higher across minority groups, with Non-Hispanic (NH) Black children constituting 12% of pediatric asthma patients versus 5% as NH White (1).

The George Washington School of Medicine (GW SMHS) holds an annual asthma summit, as part of the Clinical Public Health curriculum, challenging MS2 students to create solutions for asthma care in minority populations. Teams write “op-eds” advocating for technological, educational or policy changes regarding asthma care, bearing in mind social determinants of health.

Objective: We have explored three years of op-eds to understand how students chose to advocate for change to improve asthma management.

Design/Methods:

Over a 3-year period 46 op-ed assignments, 15/year written in teams (5 students/team) consisting of 75 students/year were collated. Using Braun and Clarks methodology a simple thematic analysis was performed on this data set. Codes were developed inductively via collaborative iteration. Based on preliminary codes, a coding dictionary was developed and applied to the data by two-independent coders (JD, MK).

Results:

Six main themes were identified: Importance of school policies; education of parents and children; home environment; use of technology; collaborative care and altering FDA regulations for asthma medication. Groups that discussed changing school policies tended to focus on optimizing school’s ability to respond to asthma exacerbations. Others focused on home environments primarily improving the condition of rental units. The utility of technology in monitoring symptom control was highlighted along with changes needed in FDA regulations and the ACA to increase insurance coverage for asthma medications.

Conclusion(s): GW SMHS uses op-eds as a pedagogical strategy to raise awareness among students about asthma and the need for advocacy in particular for minority patients. Suggestions by students demonstrated their interest in improving clinical care and advocating for patients through education, use of technology and focusing on collaborative care. In the future we hope to provide curricular time for students to enact their plans in real-life situations. This curricular strategy can be utilized by other schools to provide students with opportunities to reflect on their role as future physicians and health advocates. Medical students’ idealism, optimism, and novel approaches bring a new perspective towards changes in medicine.