Heike Thiel de Bocanegra

Refugee Women’s Receptiveness for Virtual Engagement on Reproductive Health During the COVID-19 Pandemic

Abstract Background Refugee women who leave their country due to persecution and violence have multiple barriers to sexual and reproductive health (SRH) services. The COVID-19 pandemic added an additional barrier to in-person reproductive health education, dialogue, and clinical care. This study aimed to assess the potential of using virtual group meetings as a forum for refugee women to learn about and discuss reproductive health concerns such as cervical cancer screening, family planning, childbirth, and postpartum care. Method We conducted semi-structured interviews with 36 refugee women and stakeholders to assess factors that impact refugee women’s receptiveness for virtual platforms to obtain information and engage in discussions on reproductive health. Thematic analysis was conducted using the software Dedoose. Results Openness to engage in virtual platforms varied by refugee community, women’s demographic, and life experience. The women’s involvement with local refugee groups facilitated their engagement with virtual platforms. Furthermore, individuals’ family structure and marital relationship, along with literacy and English proficiency, and access to and familiarity with technology impacted engagement. Virtual groups needed to mirror confidentiality and women expressed a strong preference that groups were all-women. Conclusion Refugee women are receptive to virtual groups on SRH when they are offered in a culturally appropriate manner that considers the living situations and access to technology after arrival to the USA. Findings from this study provide a framework to develop and tailor effective virtual or hybrid virtual-in-person programs for women in refugee communities.

Impact of an educational tool on young women’s knowledge of cervical cancer screening recommendations

Abstract Purpose Current cervical cancer screening guidelines recommend 3-year screening intervals, in contrast to the previous recommendation of annual screening, to prevent over screening and overtreatment. We evaluated the impact of viewing a tablet-based educational tool prior to seeing a clinician on young women’s knowledge and understanding of cervical cancer screening, HPV vaccination follow-up of abnormal pap smears, and comfort in communicating with their providers. Methods This cross-sectional study was part of a cluster-randomized study of fourteen primary care clinics from January 2015 to December 2016. We developed the cervical cancer education tool in English and Spanish using a community-based approach that included formative work and cognitive interviewing. Clinics were randomized to use the intervention (tablet-based patient education tool) or to participate as a control group. We administered surveys to a convenience sample of 229 English- or Spanish-speaking women aged 19 to 35 years in these clinics. We used descriptive analyses and logistic regression models with cluster-robust standard errors to compare differences among the two groups. Results Compared to women seen in control clinics, women seen in intervention clinics demonstrated greater knowledge regarding human papilloma virus (HPV (p = 0.004) and understanding (p < 0.001) of cervical cancer screening. Comfort in communicating with providers was not statistically different (p = 0.053). Women in the intervention group felt that the tool helped them understand that an abnormal Pap smear does not require immediate treatment (61.5%). Conclusion Innovative online patient education that is offered prior to patients’ interaction with their clinicians can improve their knowledge about cervical cancer prevention and treatment.