501 - Development of a Novel Curriculum for Inequities in Newborn Care (CINC) Informed by Pediatric Resident and Community Engagement

Friday, April 28, 2023

5:15 PM – 7:15 PM ET

Poster Number: 501
Publication Number: 501.125

Shamita Punjabi, Lucile Packard Children's Hospital Stanford, San Francisco, CA, United States; Christina M. Konecny, Lucile Packard Children's Hospital Stanford, Palo Alto, CA, United States; Evangelina Molina, Stanford, Redwood City, CA, United States; Amber Gautam, UCSF Benioff Children's Hospital San Francisco, San Francisco, CA, United States; Rebecca Webb, UCSF Benioff Children's Hospital San Francisco, San Francisco, CA, United States; Kayla L. Karvonen, UCSF, San Francisco, CA, United States; Sophia SY. Park, UCSF Benioff Children's Hospital Oakland, Oakland, CA, United States; William T. Gravley, UCSF Benioff Children's Hospital Oakland, Oakland, CA, United States; Laura Robertson, UCSF Benioff Children's Hospital Oakland, Oakland, CA, United States; Paulina Hume, Kaiser Permanente - Oakland Medical Center, Oakland, CA, United States; Alana Corre, Kaiser Permanente - Oakland Medical Center, Oakland, CA, United States; Keegan F. Bowers, Kaiser Permanente Pediatric Care Center, Berkeley, CA, United States; Deundra Hundon, Stanford University School of Medicine, San Francisco, CA, United States; Marna Armstead, SisterWeb Community Doula Network, San Francisco, CA, United States; Ashley R. Randolph, GLO Preemies, sacramento, CA, United States; Stephanie Fong Gomez, Kaiser Permanente - Oakland Medical Center, Oakland, CA, United States; Nami Jhaveri, Kaiser Permanente - Oakland Medical Center, Oakland, CA, United States; Heather Briscoe, University of California, San Francisco, School of Medicine, San Francisco, CA, United States; Becky Blankenburg, Stanford University School of Medicine, Palo Alto, CA, United States; Elizabeth Blecharczyk, Stanford University, San Francisco, CA, United States; Genevieve Kinsey, UCSF Benioff Children's Hospital Oakland, Oakland, CA, United States

Presenting Author(s)

Shamita Punjabi, MD (she/her/hers)

Physician
Lucile Packard Children's Hospital Stanford
San Francisco, California, United States

Background:

Inequities in health care are a well-identified contributor to adverse outcomes in neonates of vulnerable populations. Focus groups of pediatric trainees that explored gaps in newborn health inequities education at 4 Bay Area academic medical centers, demonstrated that trainees are able to spotlight inequities in their rotations, but feel helpless to address them given a lack of action-based tools, inequities learning and reflection, and faculty role-modeling. These findings suggest that residents desire action-oriented education to address inequities.

Objective: To develop a novel curriculum to address inequities in newborn care using qualitative data from pediatric residents and the expertise of a multi-institutional team of pediatric providers and community partners.

Design/Methods: A 22 member research team of pediatric trainees and faculty from 4 pediatric residency programs and community partners from 2 community organizations participated in the design of the Curriculum for Inequities in Newborn Care (CINC). Kerns Curriculum Development was used to develop the curriculum. Qualitative data obtained from 4 pediatric resident focus groups at Stanford Medicine informed the foundational themes of the curriculum. A key component of the curriculum, a Health Equity Check-in, encourages daily, team-based reflection on implicit bias and equitable communication. We piloted CINC June-December 2022 during the 4 week Stanford Newborn Nursery and Intermediate Nursery rotation. Faculty completed a pre-orientation and 3-month post surveys. Residents completed both pre- and post- rotation surveys, and the Jefferson Empathy Scale.

Results: Seventeen residents and 12 faculty participated in the pilot curriculum, with a 100% response rate to the pre-survey and 48% response to the post-survey. After implementation of CINC, residents and faculty demonstrated increased recognition of health inequities and increased time spent reflecting on them. They endorsed taking actions more consistently to address inequities while on service, and that they will continue to implement changes in their clinical practice based on the curriculum. Post-CINC implementation, residents witnessed more role modeling and discussion of health inequities initiated by faculty.

Conclusion(s): An action-oriented curriculum for inequities in newborn care demonstrated that equipping trainees and faculty with tools to address inequities will not only increase recognition and awareness of them, but can lead to continued implementation of new interventions to reduce inequities in clinical care.