Infertility
Conditions
Keywords
Infertility Patient Navigator (PN), Under-resourced patients, Cycle based testing, Urology appointments, Health Literacy, Boston Medical Center
Brief summary
This investigators will conduct a pilot study investigating the implementation of an infertility Patient Navigator (PN) program to mitigate challenges for underserved individuals at Boston Medical Center (BMC) seeking infertility care. The primary objective is to assess whether the PN program can significantly reduce time to completion of infertility evaluation and to initiation of fertility treatment (if recommended) for infertile patients from an underserved patient population. The study aims are to: 1. evaluate the impact of the PN program on timelines including obtaining commercial insurance coverage for infertility, expediting labwork/imaging, weight management, and partner urology appointments, and initiating fertility treatment; and 2. ascertain the medical literacy of participants with a validated tool to assess the impact of low medical literacy on PN facilitation. Participants will be contacted by the PN and provided with a survey instrument that will test their medical literacy. Then the PN will assist with scheduling cycle-based testing including labwork and uterine cavity evaluation, the partner's urology appointment, the patient's appointments such weight management/nutrition referral, mammograms (if indicated by age), and insurance counseling if the participant's current insurance does not cover infertility diagnostic testing and treatment. These tasks are part of pursuing fertility care at BMC. Duration of evaluation and time to treatment in age-matched control patients from the year prior that did not have PN services will be utilized as a comparison group. Regression analyses will be conducted to explore the association between utilization of a PN and pregnancy rates, considering potential confounding factors. Establishment of the pilot program will enable the investigators to apply for a larger institutional patient care grant going forward. Strategies developed through this research can may enhance fertility care access for underserved communities across various healthcare settings. By tailoring interventions to populations not usually able to access specialized healthcare services, this study pioneers a paradigm shift towards inclusivity and equity in reproductive medicine.
Interventions
BEHAVIORALInfertility Patient Navigator
Assistance with infertility evaluation including scheduling appointments
Sponsors
Boston Medical Center
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Intervention model description
One group intervention with age-matched historical controls
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 43 Years
Healthy volunteers
No
Inclusion criteria
Intervention cases * A new patient at BMC Reproductive Endocrinology for the diagnosis of infertility from July 1, 2024 to January 31, 2025 Controls * A new patient at BMC Reproductive Endocrinology for the diagnosis of infertility from July 1, 2023 to January 31, 2024.
Exclusion criteria
* Patients in whom fertility treatment with their own eggs is not recommended, egg freezing or oncofertility cycles. * Non-English speaking
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time to complete infertility evaluation | 12 months | This outcome will be assessed by data abstracted from the electronic medical record (EMR). |
| Time to start fertility treatments | 12 months | This outcome will be assessed by data abstracted from the EMR. |
| Wait time for urology appointments | 12 months | This outcome will be assessed by data abstracted from the EMR. |
| Wait time for weight management appointments | 12 months | This outcome will be assessed by data abstracted from the electronic medical record. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pregnancy rate | 12 months | This outcome will be assessed by data abstracted from the EMR by dividing the number of pregnancies by the number of participants. |
| Time to live birth | 12 months | This outcome will be assessed by data abstracted from the EMR. |
| Frequency of PN contacts in Intervention Group | 12 months | This outcome will be assessed from data documented by the PN study records for each participant in the Intervention group |
| Number of PN contacts in Intervention Group | 12 months | This outcome will be assessed from data documented by the PN study records for each participant in the Intervention group |
| Duration of PN contacts in Intervention Group | 12 months | This outcome will be assessed from data documented by the PN study records for each participant in the Intervention group |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORWendy Kuohung, MD
Boston Medical Center
Outcome results
None listed