Assessment of Training in Health Disparities in Allergy/Immunology

A survey published last month in the Journal of Allergy and Clinical Immunology looked at training programs in allergy and immunology to assess the current curriculum and gaps in health disparities and health equity education. The study was also presented at the American Academy of Allergy, Asthma & Immunology (AAAAI) annual meeting by Nicole Ramsey, MD, PhD, of Icahn School of Medicine at Mount Sinai in New York City, and colleagues.

In this exclusive MedPage Today video, Ramsey discusses the details of her findings.

Following is a transcript of her remarks:

My name is Nicole Ramsey and I’m an instructor at the Icahn School of Medicine at Mount Sinai. Our project looked at training programs in allergy and immunology and assessed the interest, the current curriculum content, and sort of any gaps that could be found in health disparities and health equity education.

We surveyed 76 faculty and fellows as well as 32 program directors. And we were able to find some interesting themes in terms of what the faculty and fellows and program directors are concerned about in terms of health equity, what their curricula currently addresses, as well as what types of educational media they think is useful.

So there were some direct correlations. Faculty and fellows and program directors both seem to be interested in health equity education surrounding asthma, food allergy, and social determinants of health. But there were some things that were different between the two groups.

One thing that we thought was interesting is that over 50% of faculty and fellows are interested in health disparities curricula focusing on immunodeficiencies. However less than 20% of current curricula focuses on health disparities, education, and immunodeficiency. So that might be one area that we could focus on more in-depth for future health disparity in health equity educational curricula.

Another thing that we looked at was what types of education faculty and fellows and program directors might be interested in. And faculty and fellows thought that actually quick guides, quick reference guides, would be the best educational media that would be useful to them for learning about health equity. The second and third options were reading materials and lectures, whereas what they actually participate in is mostly reading materials and lectures, and very little — less than 30% — quick reference guide.

So two areas of improvement would be more health disparities content related to immunodeficiencies, and more health disparities content in the form of quick reference guides versus lectures.

Another thing that we were able to compare is looking at people that were in suburban programs versus urban programs. And we found that both areas found health disparities and health equity resources useful, but only programs that were in urban areas actually had local resources available. So about 80% of all respondents found the resources useful, 80% of urban populations had local resources available, but only 40% of suburban groups had local resources available.

So another area for improvement is in suburban areas — they need more resources too, and their patients could benefit potentially from health equity education in their providers.

Finally, we looked at some barriers that faculty and fellows and program directors thought were relevant to their patients in terms of access to care. And we found that from the program director point of view, they thought that wait times and medication costs were the most important barriers for their patients, whereas from the faculty and fellow point of view, they thought that medication non-adherence and low health literacy were the most important barriers for their patients. And of course this was just the provider’s point of view.

More studies could be done to sort of really understand what the patient point of view is and what the most important factors are. But it’s interesting that the program directors and the faculty and fellows have a different perspective on what are the most important barriers for their patients.

This project was approved by the committee of the underserved of the AAAAI. And we are considering at next year’s AAAAI meeting, having a session that would use some of this information to highlight some of the areas that we mentioned, our gaps in health equity knowledge, and health equity curricula. So focusing on immune deficiency, content areas for health equity, focusing on creating quick reference guides, and focusing on some of those barriers to care.

So we look forward to seeing you hopefully at our session next year.

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