United States

Background: Refugee families (both adults and children) face numerous health inequalities, barriers, and disparities to accessing healthcare services and oftentimes present with complex medical and social needs unfamiliar to healthcare providers. It is therefore critical to analyze these health issues and healthcare requirements amongst this minoritized population. This study examines barriers to care and acculturation among refugee and underserved families with children in Roanoke, Virginia. This study aims to add to needs-assessments to enhance pediatric refugee healthcare models in Roanoke and similar resettlement areas.
Methods: A 10-item questionnaire in 2023 and an 18-item questionnaire in 2024 were administered to attendees at community events for refugee and immigrant children in Roanoke City. The survey included questions about healthcare barriers including language interpretation needs and difficulty scheduling medical appointments as well as acculturation topics, including perceived familial safety and usage of resettlement resource aid. The questionnaires were adapted from screening tools, including the Accountable Health Communities Screening Tool and the Hispanic Community Health Study Acculturation Questionnaire.
Results: 149 respondents completed the questionnaires across both years. 62.9% (2023) and 79.5% (2024) identified Spanish as their preferred language. 13.9% (2023) and 54.1% (2024) found obtaining personal transportation to medical appointments challenging. 65.8% (2024) of families did not use any local resettlement resources and 41.0% (2024) reported significant familial support during these periods. 97.2% (2024) were provided with a language interpreter during clinic and hospital visits, and 91.2% (2024) preferred a human interpreter for translation in these settings.
Conclusion: Personal transportation may not be feasible for families with financial constraints, preventing access to medical care. Familial support systems were shown to positively impact the acculturation process for these families, and there is an opportunity for community outreach to increase awareness of unused local resources to aid in resettlement. Language interpreter use may improve patient ease and understanding during medical visits. Further analysis of healthcare needs within this community emphasizes the importance of advocating for resources that assist in equitable healthcare delivery and acculturation in similar-sized resettlement communities.

AMA Research Challenge 2024 

Barriers in Access to Medical Care amongst Underserved Minoritized Families in Southwest Virginia

Welcome to the **largest national, multi-specialty research** event featuring research from more than 750 medical students, residents, fellows, and international medical graduates.

Use the buttons below or navigation menu to access the event.
 

[![](https://assets.underline.io/markdown_image/1/image/20e1e77aa954efeac7a15d84c85eb383.jpg)](https://underline.io/events/468/sessions?searchGroup=all)
 
[![](https://assets.underline.io/markdown_image/1/image/068522d81aca0b68a369787c7dfccd1b.jpg)](https://underline.io/events/468/posters?searchGroup=all)
 
[![](https://assets.underline.io/markdown_image/1/image/d3971ece79d5e5575b178bdc2c8bbfae.jpg)](https://underline.io/events/468/help-desk)
 

#### Event Details

The 2024 American Medical Association Research Challenge includes a poster symposium hall and a semifinals hall with the top scored research. **Log in at any time throughout the event to:**

* **View posters and presentations** on a variety of topics and specialties
* **Score posters in the semifinals** to help decide the top five finalists (AMA member exclusive opportunity)
* **Connect with participants** and provide feedback to help advance their research

At the conclusion of this event, the AMA will announce the top five finalists who will advance to the AMA Research Challenge finals, present their research to an elite panel of judges, and compete to win a $10,000 grand prize presented by Laurel Road. 

### Grand Prize Sponsor

AMA would like to thank Laurel Road for sponsoring a $10,000 grand prize for the winner of the AMA Research Challenge. Laurel Road is not involved in winner selection process. The winner will be announced on February 20, 2025 during the AMA Research Challenge finals. Payment of the grand prize will be directly from Laurel Road. See the AMA Research Challenge Official Rules for terms and conditions.

[![](https://assets.underline.io/uploads/markdown_image/1/image/611e331d4a0eba0920f240cfc04b4d77.png)](https://www.laurelroad.com/)

You need to log in with the email address you registered with. Access credentials have been sent to your email. 

Please be sure to check your spam and other email folders if you do not see an email confirmation right away.

Please log in to explore this event.

**There is no registration fee for this event! **

If you have used the AMA Research Challenge platform previously, please click the ‘Log-in’ button below. If you do not remember your password, please click “forgot password” and follow prompts to reset your password. After resetting your password, please refresh your webpage to access the platform.

Register to explore research in a variety of topics. AMA members get exclusive access to score posters in the semifinals. 

**Please use this link [here](https://www.ama-assn.org/member-benefits/events/ama-research-challenge) to register for free.**

Registration Is Required

Join the AMA Research Challenge poster symposium and semifinals to explore top research posters and score posters in the semifinals (an AMA member exclusive opportunity).

poster

Abstract Title
Black and White Menthol Smokers’ Perceptions of the FDA’s Proposed Ban on Menthol Cigarettes 

Background
Menthol as a characterizing flavor in cigarettes is a critical public health issue due, in large part, to targeted tobacco industry marketing that has led to Black adults disproportionately using a product that is more addictive and harder to quit. Recent estimates indicate that 81% of Black adults who smoke and 34%-51% of adults who smoke in other racial/ethnic minority groups use menthol cigarettes. In April 2022, FDA announced its commitment to advance a product standard banning menthol in cigarettes and prohibiting characterizing flavors other than tobacco in cigars. To-date, no federal menthol cigarette or flavored cigar (MC/FC) product standards (commonly called ‘bans’) have been enacted, despite evidence that these actions could potentially improve public health and promote smoking cessation.

Methods
Study participants were registered workers on Amazon’s Mechanical Turk (MTurk) who opted into the study between July 2023 and January 2024. Eligible participants (n=3,200) completed a survey assessing perceptions and perceived impacts of the FDA’s proposed product standard limiting characterizing flavors in MC/FC. Eligible participants were African American/Black or White adults (> 21 years of age) who had been menthol cigarette smokers for at least one year and were using a computer with a United States IP address.

Results
There was no difference in favor/opposition to the proposed MC/FC ban with 37.2% of Black and 34.5% of White adults who smoke menthol cigarettes stating that they were in favor of the ban (p=0.13). Notably, while overall endorsement of beliefs that menthol cigarettes are more addictive, harmful, and harder to quit than non-menthol cigarettes was low overall, Black participants in this study were more likely than White participants to endorse these beliefs. A greater proportion of Black adults also demonstrated support for the FDA's proposed rationale for the product standard. Both groups were concerned that a MC/FC ban would lead to increased policing and victimization in their community (95.3% overall) and other vulnerable communities (90.9% overall).

Conclusion
Our research has produced several key findings, including identification of factors associated with support of or opposition to the ban, racial differences in perceptions of the proposed ban, determination of specific concerns related to the impact of the ban, and participant intentions for future tobacco use or cessation following the ban. This data will serve to inform the FDA’s policies on menthol flavoring and assist public health researchers in planning for best smoking cessation practices in anticipation of the proposed policy shift.



Black and White Menthol Smokers’ Perceptions of the FDA’s Proposed Ban on Menthol Cigarettes

Abstract Title
Breathing Easier: A Breath of Fresh Air in Albuterol Education

Background
Inadequate inhaler technique among patients with COPD remains a pervasive issue, with multiple studies demonstrating the alarming number of patients misinformed about proper inhaler techniques, leading to significant morbidity and impaired quality of life. Current literature has shown that up to 50% of patients utilizing albuterol have improper handling techniques. These findings underscore the critical need for effective educational interventions, considering that proper albuterol use has been correlated with decreased mortality in patients diagnosed with COPD.

Methods
In 2023, the Luke Society clinic partnered with the University of Texas Medical Branch (UTMB) School of Respiratory Care and embarked on a targeted educational program to bolster albuterol technique knowledge among patients with pulmonary conditions. The initiative aims to minimize improper albuterol techniques and ultimately decrease emergency visits stemming from COPD or asthma exacerbations. Our approach involves a thorough education tutorial on the proper
albuterol inhaler technique facilitated by the School of Health Professions (SHP) Respiratory Care faculty and Respiratory Therapy (RT) student volunteers. The RT faculty initially vets the patient’s knowledge of albuterol use and then teaches the proper technique.

Results
Over the last year, this interprofessional initiative has improved proper inhaler technique among our patient population, which primarily comprises individuals with low literacy levels and those facing homelessness. The results of this partnership highlight the importance of tailoring educational strategies to meet the unique needs of Galveston’s underserved community.

Conclusion
The ongoing challenges of enhancing albuterol technique awareness necessitate our continued interprofessional collaboration with SHP Respiratory Care. Future initiatives include developing accessible educational materials, such as pamphlets, to support patients in reinforcing proper technique between clinic visits.

Breathing Easier: A Breath of Fresh Air in Albuterol Education

This research project focuses on examining the integration of artificial intelligence (AI) into urologic practice, highlighting both its promising advancements and the substantial ethical, legal, and regulatory challenges it poses. The study emphasizes the urgent need for an adaptable regulatory framework to ensure the safe and effective deployment of AI technologies in urology. Our participation involved conducting a multifaceted investigation, consisting of a literature review, the development and administration of a comprehensive survey, and in-depth interviews with key stakeholders within the urology community. Through these phases, we evaluated the level of awareness among urologists and patients regarding AI’s risks and complexities, including patient safety, privacy concerns, and regulatory intricacies. By elucidating these issues and capturing nuanced insights into the implications of regulation and implementation of these emerging technologies, our research seeks to empower the urology community in shaping the future of AI integration in healthcare. Ultimately, our goal is to influence responsible AI adoption, foster collaboration between stakeholders, and contribute to the refinement of regulatory frameworks in urology practice.

Bridging Perspectives: Examining the Landscape of AI in Urology

Abstract Title
Bridging the Gap: Examining the Healthcare Limitations due to Latina Physician Shortage
Background
According to 2022 data, women make up 37.6% of the U.S. physician population. However, Hispanic women represent only 2.4% of medical professionals, facing significant disparities across specialties. This study examines existing literature addressing these disparities among Latina and Hispanic women physicians, focusing on key challenges contributing to their scarcity in various specialties. Addressing these issues is essential for overcoming systemic barriers and promoting diversity in medicine.
Methods
A comprehensive literature review used databases like Still OneSearch, DynaMed, Google Scholar, and PubMed. It searched for articles on "Latina physicians in specialties," "Latino or Hispanic physician underrepresentation," and "Latinas in Medicine." Filters were applied to select peer-reviewed sources published from 2018 to 2023. Studies were cited in AMA format, highlighting key findings on the underrepresentation of Latina women in medical specialties.
Results
Hispanic provider representation remains significantly low (6.9%) compared to their US population (19.1%). This underrepresentation is more pronounced among Hispanic women, who make up less than 3% of practicing physicians, medical school faculty, and matriculants as of 2019. Recent data shows a 4.5% increase in Hispanic medical matriculants between 2022 - 2023. However, barriers like discrimination, burnout, and imposter syndrome lead to higher attrition, hindering progression into residency and beyond.
Studies highlight the importance of Hispanic representation in medicine for cultural concordance and addressing implicit biases. Spanish-speaking Hispanic providers show improved outcomes in chronic disease control and patient adherence. Notably, 35.6% of Hispanic women physicians are proficient in Spanish, enhancing healthcare for Hispanic patients. The representation of Hispanic physicians varies across specialties, with primary care having the highest numbers and geriatric medicine the highest relative value at 9.4%. Studies on Hispanic women in specialties are scarce and often combine women and ethnic minorities. A 2021 study in plastic surgery from 2015-2019 showed 42.7% female but only 6.6% Hispanic representation.
Conclusion
Studies on Hispanic patient care highlight improved language proficiency, cultural empathy, and patient outcomes demonstrated by Hispanic providers. The underrepresentation of Latina physicians highlights broader issues in recruitment, inadequate support, and limited advancement opportunities within medical education and professional systems. The recent U.S. Supreme Court decision restricting race or ethnicity considerations in admissions exacerbates challenges in enhancing Latino representation in medicine, particularly in specialty fields. A lack of research on Hispanic women in specialty medicine leaves a significant gap in equitable representation and underutilized opportunities to improve healthcare outcomes for Hispanic communities.


Bridging the Gap: Examining the Healthcare Limitations due to Latina Physician Shortage

Background
Regulatory bodies such as the Joint Commission, have required health systems to screen patients for health-related social needs (HRSNs) to address social determinants of health (SDH), which influence individual and community health outcomes. Key screenings include housing instability, food insecurity, and transportation instability. 
Despite these efforts, there remains a gap in understanding the interconnections between various HRSNs. Addressing this gap is crucial for developing comprehensive interventions that target multiple SDH. This study aims to characterize the associations between key HRSNs. 

Methods
This prospective cross-sectional study at an adult urban primary care clinic from October 2021 through October 2023 saw volunteers screen patients for HRSNs: food insecurity; unemployment; less than high school education; housing instability; difficulty affording medications; and lack of access to transportation, utilities, phone, and medicine or any healthcare. Binary logistic regression determined associations between demographic factors: race, ethnicity, gender, and age and the HRSNs examined. Pearson correlation coefficients assessed linear relationships between HRSNs.

Results
Volunteers screened 2153 patients identifying 49.34% with at least one HRSN. Binary logistic regression revealed no significant association between HRSNs and patient age (p=0.260), race (p=0.889, p=0.875), Hispanic ethnicity (p=0.652), gender (p=0.319).
Pearson correlation coefficients identified significant associations: strong between food insecurity and difficulty affording utilities (r=0.447); moderate between food insecurity and difficulty accessing transportation (r=0.22), phone (r=0.286), and medicine or any healthcare (r=0.313). Housing insecurity correlated with transportation issues (r=0.200) and difficulty affording utilities with difficulty accessing medicine or any healthcare (r=0.306). A strong correlation was found between difficulty accessing medicine or any healthcare and affording medications (r=0.694).

Conclusion
Our results reveal significant relationships among HRSNs, indicating interconnected challenges. Food insecurity positively correlates with 4 HRSNs, all of which can impact a patient’s overall health. Although studies that examine screening for food insecurity have not shown improved outcomes, interventions addressing SDH through housing or income support have proven beneficial. Targeted interventions for the HRSNs experienced by food insecure patients may prove valuable. 
Other associations support the need for comprehensive interventions. The link between medicine/healthcare access and affordability as well as housing instability and transportation issues underscores the interconnected challenges and the importance of integrated solutions. These findings suggest that HRSNs rarely exist in isolation, illustrating the need for multi-faceted interventions to effectively meet needs and improve outcomes of vulnerable populations.



Characterization of Interactions Between Health-Related Social Needs

Background
University-sponsored mobile health vans are a popular method of supporting individuals with significant barriers to receiving healthcare by tailoring services to the community’s needs. Their main challenges are longevity and sustainability. Departure of an established van program from a community without other programming in place can have negative effects on the neighborhood’s health. These weaknesses must be addressed prior to developing this program.

Methods
Eight qualitative interviews were conducted with key informants to provide a deeper understanding of mobile health financing and operations sustainability. These interviews focused on the programs at five reputed university-affiliated mobile health vans in different stages of sustainability. Participants were identified through snowball sampling. All interviews were recorded using Zoom. Transcripts were coded and analyzed using NVIVO. 

Results
Four emerging themes of funding, affiliation, sustainability, and community focus were identified. A series of recommendation questions were developed from the specific findings of each theme and compiled into a guide. The main downfalls of mobile health vans stem from inconsistent funding and universities not being fully committed to communities. Vans can sidestep most limiting factors they run into by having preemptive plans in place and a clear mission statement that the university can stay grounded to. 

Conclusion
University-sponsored mobile health vans have potential if they are created with the community at the center of their intentions. The recommendations developed from this qualitative analysis will help to create a sustainability and implementation guide for university-sponsored mobile health vans and secure support for communities in need.

Creating a Sustainability and Implementation Guide for University-Sponsored Mobile Health Vans

ChatGPT-3.5, or the "Generative Pre-trained Transformer 3.5," is an artificial intelligence (AI) chatbot that is pre-trained on a diverse range of internet text to understand and generate human-like text. This internet text may contain inherent biases that perpetuate debunked medical misconceptions, potentially worsening health disparities among patients. It is hypothesized that ChatGPT-3.5 correctly identifies a disease/clinical diagnosis as having a trend towards one gender over another, but mistakenly over-represents this prevalence ratio. The model was interrogated 20 times in a row with the following prompt: “Compose a brief presentation of a patient presenting with [CONDITON]. Please include complete demographic information.” It was presented with four medical conditions that are more commonly diagnosed in females (anxiety, domestic abuse, osteoporosis, and UTI) and four medical conditions more commonly diagnosed in males (autism, HIV/AIDS, myocardial infarction, and COPD). This study showed that ChatGPT-3.5 exhibited gender bias when asked to create a patient presentation for osteoporosis, domestic abuse, and autism. These results shed light on the detrimental effects of excessive reliance on artificial intelligence (AI) in patient care, where patients may inaccurately self-diagnose based on outdated information.

Decoding Bias in ChatGPT-3.5: Does Artificial Intelligence Truly Know Best?

Abstract Title: Development of a new questionnaire to assess the social impact of Non-Communicable Diseases.

Background: Non-communicable diseases (NCDs) have a considerable impact on an
individual's social life. Life-long medication, fear of death, dietary restrictions, hospital admissions, dependency on caregivers, and strained interpersonal relationships play a role. The available questionnaires measure only individual aspects of social impact.

Objective: To develop and validate a comprehensive questionnaire to assess the social impact of NCDs.

Methods: A cross-sectional study was conducted among patients and caregivers
seeking care at a tertiary care hospital for diabetes, hypertension, chronic obstructive pulmonary disease (COPD), stroke, coronary artery disease (CAD), and cancer. Thirty patients, each with the above diseases, were administered the Cousineau Self-Perceived Burden Scale to assess perceived burden among patients, the Caregiver Burden Scale to assess caregiver burden, EuroQol-5D-3L to assess the quality of life, and face validated questions of sociodemographic details, cost of healthcare, and stress due to disease.
Rasch Analysis was performed to identify items that lie within the traditional bounds of mean-square item fit. The Delphi method with ten subject experts was used to identify the questions that would be included in the final tool.

Results: The data consists of 150 observations, with 86 categorical questions
subdivided into various domains. From this, a total of 34 questions were extracted by Rasch analysis. The new questionnaire had good internal consistency (Cronbach’s
alpha: 0.969, 95% CI:0.96-0.98). The questionnaire was finalized after reaching
a consensus among subject experts.

Conclusion: The social impact questionnaire developed consisted of 30 questions and has good internal consistency and can be used to measure the social impact of NCDs.

Development of a new tool to assess the Social Impact scale of Non-Communicable Diseases.

Abstract Title
“Ecological Stressors and Mental Health of Adolescent Migrants in Athens, Greece.”

Background
In Europe, political and cultural reactions have "securitized" refugees, depicting them as threats. Media emphasizes their "otherness" and neglects their perspectives, obscuring their daily struggles and exacerbating psychological distress. Children and youth are particularly affected, as adverse experiences during pre-migration, transit, and post-migration correlate with long-term physiological and psychological issues.

Methods
The participants (ages 10-25), originating from Afghanistan, Iran, Iraq, the Congo, Cameroon, or Uganda, were recruited from refugee community centers in Athens. A 47-question survey included: 1) Refugee Health Screener (RHS) and 2) Demographics and Ecological Risk. The RHS had fourteen 0-4 scale questions and a 0-10 distress thermometer. Scores ≥12 on questions 1-14, or ≥5 on the thermometer, indicated likely emotional distress. The second subsection covered demographics and post-migration ecological risk factors, converted into binary variables with "1" indicating present risk. The seven risk factors were parental death, presence of a close friend, residential mobility, water security, food security, health care security, and access to electricity. Each participant received a cumulative risk score from 0 (no risk) to 8 (all risks present).

Results
All but 2 participants reached the threshold for emotional distress. Significant positive Point Biserial correlations were each found between lack of access to clean water and electricity and RHS scores. A positive correlation also existed between perceived negative attitudes from their host society and RHS scores. The mean cumulative risk score was 2.20. There was a positive correlation between cumulative risk score and the distress thermometer. Ecological cumulative risk was positively correlated with the number of physical (but not psychological) symptoms reported on the RHS.

Conclusion
The study highlights the impact of cumulative risk on youth refugee well-being. While no significant correlation was found between overall Refugee Health Screener (RHS) scores and cumulative risk, there was a significant correlation between cumulative risk and RHS physical symptom scores, suggesting somatization as a defense mechanism. Lack of access to clean water and electricity correlated with overall RHS scores, indicating physical and psychological symptoms like anxiety, depression, and PTSD. These factors are significant due to their foundational role in physiological and safety needs. Pre-migration trauma predicts mental disorders and PTSD, but post-migration factors are equally crucial for mental health. Post-migration stressors can influence recovery, highlighting the need for therapeutic interventions addressing broader conditions affecting refugees and asylum seekers.


Ecological Stressors and Mental Health of Adolescent Migrants in Athens, Greece

Background
The United States Department of Health and Human Services reports that overdose deaths due to synthetic opioids, such as fentanyl, has increased 103-fold since 1999, with the largest increase starting in 2019. Legalized in Georgia in July 2023, fentanyl test strips (FTS) are an underutilized resource in the fight against the opioid epidemic. As a novel harm-reduction tool, it is crucial to educate future physicians on the importance and uses of FTS. Near-peer teaching is a technique in medical school education that provides advantages to both the trainee and instructor. 

Methods
Pre-clerkship students engaged in a 1-hour training session, incorporated into the harm-reduction curriculum, focusing on FTS and Narcan. The session involved a knowledge-based lecture on the “Hows and Whys” of FTS and hands-on demonstration using an FTS. Students received a survey before and after the workshop, which consisted of 5 questions, separated by knowledge and attitudes. These results were analyzed using t-tests to identify significant differences in both knowledge and attitudes.

Results
Overall, 144 pre-clerkship medical students completed the pre- and post-surveys, which showed a significant growth of knowledge regarding legality, possible applications, and usages (p < 0.001). Additionally, students indicated improved perceptions towards the use of FTS, especially the use not only among high-risk patient populations but also as a broad harm-reduction measure in a diverse patient population, including non-chronic or recreational drug users (p < 0.001). 

Conclusion
Through near-peer teaching and demonstration, pre-clerkship medical students improved their knowledge of and attitudes towards both FTS generally and the importance of FTS in addressing the opioid crisis and overdose deaths. As a preventative, inexpensive, and relatively new strategy to fight the opioid epidemic, it is vital to educate medical students on FTS across the United States. Through a 1-hour training workshop, other healthcare schools and residency programs can easily practice preventative medicine and contribute to saving lives against the addictive forces of opioids. This would greatly expand the number of students and healthcare workers trained to administer harm reduction tactics, such as FTS. Furthermore, a decreased knowledge gap and positive improvement in attitude towards FTS suggests that near-peer teaching is an effective instrument that should be utilized in medical education more often. Additionally, we recognize that its use among multiple graduate schools would further the integration of and partnership between many healthcare professionals.

Premium content

Downloads

Next from AMA Research Challenge 2024

Black and White Menthol Smokers’ Perceptions of the FDA’s Proposed Ban on Menthol Cigarettes

Similar lecture

Exploring Caregiver’s Perspectives on the Barriers to Accessing Behavioral Healthcare for their Children