ABSTRACT
Background: Anti-Asian violence increased during the COVID-19 pandemic. Asian American/Pacific Islanders (AAPI) represent a diverse population experiencing a long history of stereotyping and exclusionism; however, this group is often left out of diversity/inclusion conversations. In academic medicine, AAPI are under-represented in leadership. We characterized the personal/professional experiences of AAPI gynecologic oncology trainees and assessed the impact of a virtual panel discussion with leaders in the field. Methods: An anonymous survey was disseminated online to trainees in/interested in gynecologic oncology fellowship who identified as AAPI, using modified snowball sampling. A virtual session with AAPI leaders in gynecologic oncology discussed themes emerging from survey responses. Session attendees completed an anonymous follow-up survey. Results were assessed quantitatively and qualitatively. Results: 44/59 (75%) respondents participated in the pre-survey; 23 (39%) participated in the virtual session. All session participants (23/23, 100%) completed the post-session survey. Participants reported increased identity-related thoughts with the COVID-19 pandemic (88% during, 61% prior). Sixty-eight percent reported that identity-related thoughts/awareness changed during the pandemic. Presence of AAPI colleagues was associated with higher perceived identity-related support from their department. Of those without AAPI coworkers, none (0%) felt 'moderately' or 'extremely well supported.' Qualitative analysis demonstrated that the panel discussion created a sense of community and encouragement, combating previously reported isolation and self-consciousness. Participants reported more connection with their heritage and identified more personal/professional topics that might be related to their cultural backgrounds. Discussion: This intervention demonstrates the opportunity to provide a supportive network for mentorship and professional development in a culturally inclusive way.
ABSTRACT
We aimed to assess the telemedicine readiness and attitudes of gynecologic oncology patients with attention to groups at risk for difficulty in accessing care, such as increased distance to care and rural populations. Gynecologic oncology patients at all stages of disease and treatment (primary, recurrence, surveillance) were asked to complete an anonymous survey during in-person outpatient appointments at an academic comprehensive cancer center. Surveys were entered into RedCAP;SPSS was used for statistical analysis. This survey was conducted prior to the COVID-19 pandemic, before the introduction of telemedicine in this practice. Of 180 patients approached, 170 completed the survey. Mean age was 59.6 years;73.4% identified as White, 23.7% as Black, and 2.9% as other race. The majority of patients had ovarian cancer (41.2%), followed by endometrial (27.1%), cervical (20.6%), vaginal/vulvar (7.1%), and other (1.2%.) The majority of patients traveled greater than 50 miles for appointments (63.8%);these patients were more likely to be from rural counties and incurred a significantly higher cost for travel per visit ($60.77 vs $37.98, p=0.026.) The majority of patients expressed interest in using telemedicine appointments (75.7%) or a smartphone app (87.5%) as a component of their cancer care. Patients with difficulty attending appointments (88.9 vs 70.2%, p=0.02), or those from rural areas (88.7% vs 69.6%, p=0.03), were especially interested in telemedicine;those with both characteristics reported 100% interest in telemedicine. The majority of patients in both urban and rural counties had the ability to access the internet and telemedicine services from home, via smart phone or computer. Patients from rural and urban counties used the internet at similarly high rates (at least daily use, 79% vs 75%.) Telemedicine is acceptable and attractive to the majority of patients even prior to the COVID-19 pandemic, and may offer financial and logistical advantages for patients who live far from gynecologic oncology care. Overall, patients have high rates of internet use and express comfort with using technology for their healthcare. Disparities in cancer outcomes for rural patients, including survival and clinical trials enrollment, have been associated with increased distance to providers and difficulty accessing care. In our study, these patients were universally interested in telemedicine. Telemedicine should be incorporated into standard practice beyond the current COVID-19 pandemic to reduce healthcare disparities related to care access. [ABSTRACT FROM AUTHOR] Copyright of Gynecologic Oncology is the property of Academic Press Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)