Assessment, Bladder Health Education, Continence Promotion, and Restoration to Improve Urinary Incontinence Care among Women at Howard University in Washington DC (ABCs-in ¬DC)

Howard University, Washington DC

Investigators

Linked publications, trials & patents

Abstract

ABSTRACT While urinary incontinence (UI) is a chronic debilitating condition with social stigma and significant economic burden, few Non-Hispanic Black and Hispanic women with UI receive care due to interplay of multiple factors and barriers including not limited to fear, costs, inconvenience, and poor provider-patient relationships. We propose to comprehensively evaluate health determinants and barriers leading to disparities in UI care, and then to adapt and evaluate the implementation of a behavioral bladder therapy intervention for patient-centered UI treatment. “Assessment, Bladder Health Education, Continence Promotion and Restoration” (ABC for Bladder Health) among Non-Hispanic Black and Hispanic women with UI in Washington DC (WDC). The rationale for this proposal is that while UI is a chronic debilitating condition with social stigma and significant economic burden, few minority women suffering from UI receive safe and effective UI treatments representing a gap between available evidence-based effective treatments and actual practice. The conceptual frameworks for this proposal are RE-AIM 3.0, with emphasis on health disparities as a fundamental and driving force of health and implementation outcomes, and Warnecke’s Population Level Determinants of Health model with interplay between multiple factors driving disparities. Our aims are to 1) establish the health determinants and barriers in UI through multiple stakeholder engagement and adapt the ABC for Bladder Health intervention to be meaningful for minority women, 2) evaluate the implementation strategies for the ABC for Bladder Health intervention among Non-Hispanic Black and Hispanic women in WDC, and 3) examine patient-centered health outcomes. We will describe health determinants and barriers in UI care by engaging stakeholders, determine differences in implementation outcomes, and examine patient-centered health outcomes pre- and postimplementation of ABC for Bladder Health among Non-Hispanic Black and Hispanic women suffering from UI. Patient-centered outcomes include barriers, knowledge of UI care, care seeking behavior, UI symptoms, cure, treatment satisfaction, and adherence to UI treatment among Non-Hispanic Black and Hispanic women suffering from UI. This project will not only contribute to a better understanding of barriers to UI care but will also directly reduce health disparities in UI care in this population with the use of the adapted ABC for Bladder Health. This proposal is devoted to gain a greater scientific knowledge about the influence of health determinants and defining mechanisms leading to disparities in UI care (Aim 1) and how we can use obtained knowledge to successfully implement an intervention (Aims 2 & 3) to reduce negative burden from UI among Non-Hispanic Black and Hispanic women.