United States

Background
Although several MD programs emphasize basic sciences, clinical skills, and biomedical research, very few prioritize health policy and the business of medicine. The executive board of the Healthcare Delivery Interest Group (HDIG) at the Medical College of Georgia (MCG) implemented the Healthcare Equity Case Competition in partnership with the University of Aberdeen (UofA) to address this gap through international collaboration. This report describes this educational initiative, initial participant feedback, and future opportunities for growth. 

Methods
The HDIG executive board developed a case about the hypothetical repeal of the Affordable Care Act (ACA), prompting teams to propose an alternative model for the United States&#39; healthcare system, addressing cost, accessibility, effectiveness, insurance market stability, and transition for individuals previously covered by the ACA. The complexity of the case required students to examine global health systems and leverage existing knowledge from their own national frameworks. HDIG deliberately paired MCG and UofA students within each team. Students gave oral presentations at their respective institutions through a Teams meeting, enabling synchronous sharing with the partner institution. 

Results
In total, 39 students from the Medical College of Georgia and 11 University of Aberdeen students participated in the MCG x UofA Healthcare Equity Case Competition. To analyze whether the competition met its educational objectives, a feedback questionnaire was distributed to all participants, using a 10-point rating scale (1 = least satisfied, 10 = most satisfied). The responses indicated that the event was valuable to the education of the medical students who participated. Students reported international collaboration and faculty mentorship as key to their understanding of the case objectives. Among 24 respondents, paired t-tests demonstrated statistically significant improvements (p&lt;0.05) in self-perceived understanding of the US healthcare system, comparative healthcare models, global health equity, and public health policy. Free-response questions provided insight into changes that could be implemented to increase efficiency for future events.

Conclusion
Unlike other cross-institutional initiatives, this competition incorporated students from different countries within the same teams, requiring the cooperation of diverse knowledge bases and perspectives—an intentional challenge that enriched learning but necessitated coordination. Logistical barriers like costs, time zones, and curricular differences may limit scalability. This event provides a replicable framework for other institutions to utilize integrated international teams as a means of incorporating health policy topics into a comprehensive curriculum that extends beyond the classroom.

AMA Research Challenge 2025 

Reimagining U.S. Healthcare: A Student-Led, Transatlantic Case Competition on Health Policy

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#### 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:**

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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.<br><br>

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AMA Research Challenge 2024 

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).

Background
Although several MD programs emphasize basic sciences, clinical skills, and biomedical research, very few prioritize health policy and the business of medicine. The executive board of the Healthcare Delivery Interest Group (HDIG) at the Medical College of Georgia (MCG) implemented the Healthcare Equity Case Competition in partnership with the University of Aberdeen (UofA) to address this gap through international collaboration. This report describes this educational initiative, initial participant feedback, and future opportunities for growth. 

Methods
The HDIG executive board developed a case about the hypothetical repeal of the Affordable Care Act (ACA), prompting teams to propose an alternative model for the United States' healthcare system, addressing cost, accessibility, effectiveness, insurance market stability, and transition for individuals previously covered by the ACA. The complexity of the case required students to examine global health systems and leverage existing knowledge from their own national frameworks. HDIG deliberately paired MCG and UofA students within each team. Students gave oral presentations at their respective institutions through a Teams meeting, enabling synchronous sharing with the partner institution. 

Results
In total, 39 students from the Medical College of Georgia and 11 University of Aberdeen students participated in the MCG x UofA Healthcare Equity Case Competition. To analyze whether the competition met its educational objectives, a feedback questionnaire was distributed to all participants, using a 10-point rating scale (1 = least satisfied, 10 = most satisfied). The responses indicated that the event was valuable to the education of the medical students who participated. Students reported international collaboration and faculty mentorship as key to their understanding of the case objectives. Among 24 respondents, paired t-tests demonstrated statistically significant improvements (p<0.05) in self-perceived understanding of the US healthcare system, comparative healthcare models, global health equity, and public health policy. Free-response questions provided insight into changes that could be implemented to increase efficiency for future events.

Conclusion
Unlike other cross-institutional initiatives, this competition incorporated students from different countries within the same teams, requiring the cooperation of diverse knowledge bases and perspectives—an intentional challenge that enriched learning but necessitated coordination. Logistical barriers like costs, time zones, and curricular differences may limit scalability. This event provides a replicable framework for other institutions to utilize integrated international teams as a means of incorporating health policy topics into a comprehensive curriculum that extends beyond the classroom.

poster

Congratulations to all the researchers who have qualified for the AMA Research Challenge virtual poster symposium and semifinals!

Welcome to the **largest national, multi-specialty research event** featuring research from nearly 1,000 medical students, residents, fellows, and international medical graduates across six topic areas - basic science, clinical and translational research, clinical vignettes, health systems science, medical education, and public health and health policy.

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#### Event Details
The 2025 AMA Research Challenge includes the following symposium halls:
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At the conclusion of this event, the AMA announced the top five finalists who advanced to the AMA Research Challenge final round, presented their research to an elite panel of judges, and competed to win a $10,000 grand prize presented by Laurel Road.

**Addison Shenk, a fourth-year medical student from Edward Via Virginia College of Osteopathic Medicine, was the winner of the 2025 AMA Research Challenge and was awarded the grand prize of $10,000, presented by Laurel Road.**

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#### Recognized Institutions
In 2025, 1,400 abstracts were submitted across six topic areas representing 174 medical schools and more than 150 residency and health care institutions. [See if your institution is represented this year!](https://drive.google.com/file/d/1eFrTqCmCeobx9pr5drJK2hllvsIpFNOY/view?usp=drive_link)

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Background
Simulation in surgical education is of growing interest across medical schools. Barriers to implementation include resources like infrastructure, materials, and physician time. Based on previous surgery clerkship feedback, we aimed to create a multicomponent didactic session for the surgery clerkship. Session goals included developing surgical skills and encouraging student participation in surgical care. We hypothesized that the session would be highly valued by medical students on their surgery clerkship.
Methods
Using simulation trainers provided by the Department of Surgery for resident and fellow education, a single two-hour hands-on didactic session of knot tying, fundamentals of laparoscopic surgery (FLS), and focused assessment with sonography for trauma (FAST) was created for third-year medical students during their surgery clerkship. Session facilitators included 3 attending surgeons, 3-4 residents, and 1 fourth-year medical student. Students were surveyed on their experience using a 5-point Likert scale, pick all that apply, and free responses. Likert scale perception decision was determined relative to weighted mean.
Results
Most respondents highly praised the didactic. Knot-tying respondents reported that it helped them appreciate that their skills had improved (81%, n=37) and that they needed more practice to become proficient (59.4%, n=37). FLS respondents recognized they needed more practice to become proficient (78.9%, n=19) and that practicing on a laparoscopic trainer could be helpful in their training (73.7%, n=19). FAST respondents reported that practicing ultrasound with peers was helpful (81%, n=38) and that they could incorporate ultrasound skills in their careers (75.8%, n=38). Regarding session takeaways, 75% of free responses noted that the experience offered an opportunity to practice and develop valuable practical skills (n=20). The most common free response feedback was that respondents wished to spend more time on FLS and FAST (39.1%) (n=23).
Conclusion
Under the leadership of surgical faculty and residents, the use of available training resources led to a highly valued didactic session by students. This highlights the potential utility of simulation in medical student surgical education. Two of six yearly clerkship cohorts have participated, and data collection is ongoing. Future investigations will explore how these sessions shape preparedness for surgical rotations, overall clerkship experience, and perception of surgeons.


The Benefits of a Multicomponent Didactic Session for Surgical Clerkship Students

Background
The lymphatic system plays a vital role in fluid homeostasis, immune surveillance, and lipid transport from the gastrointestinal tract. It is implicated in the pathophysiology of numerous conditions, including lymphedema, cancer metastasis, autoimmune diseases, and infectious processes. Despite this, prior analyses of undergraduate medical curricula have identified is proportionate underrepresentation of lymphatic system content relative to other organ systems.
This educational gap may contribute to decreased physician confidence in recognizing and managing lymphatic disorders, potentially delaying diagnoses or misdirecting treatment early in clinical careers. The aim of this study was to assess the current scope, quality, and perceived adequacy of lymphatic system education in U.S. allopathic medical schools.

Methods
An IRB-approved, anonymous 10-minute survey was distributed to medical students and faculty at U.S. allopathic medical schools. Questions assessed time spent on lymphatic system education, teaching methods used, perceived quality of instruction, and confidence in managing lymphatic disorders. A separate subset of the survey was administered to faculty to evaluate institutional curricular practices and perspectives. Data was analyzed using descriptive statistics and thematic
analysis.

Results
A total of 201 respondents completed the survey. When asked about dedicated instructional time on the lymphatic system—defined as total hours across lectures, small groups, or clinical case discussions—35% reported 3 hours, 25% reported 2 hours, and 11% reported only 1 hour of iinstruction. Only 2% reported 5 or more hours. Most instruction was lecture-based (54%), with limited use of small groups (21%) or clinical case discussions (18%). The perceived quality of lymphatic education was rated as "poor" or "fair" by 54% of respondents, with only 14% rating it as "good" or "excellent." Confidence in managing lymphatic disorders was low: 63% reported feeling "not confident" or "slightly confident" in recognizing and treating these conditions. Additionally, 51% reported no formal assessment of lymphatic knowledge in medical school. Among 23 faculty respondents, over 75% rated current lymphatic instruction as inadequate and reported that it is rarely formally assessed.

Conclusion
These findings highlight a significant gap in lymphatic system education across U.S. allopathic medical curricula, suggesting a need for increased instructional time, integration into clinical cases, and inclusion in clinical skills training and formal assessments. Given the lymphatic system's role in diverse pathologies, targeted curricular reforms are warranted to better prepare future physicians
to diagnose and manage lymphatic disorders.

Assessing the Gaps: Lymphatic System Education in U.S. Allopathic Medical Curricula

Background: Success in transcranial microsurgery and endoscopic skull base surgery is predicated on one’s knowledge in surgical neuroanatomy. While graphic depictions aim to present the 3D anatomy, technical skills must be developed through hands-on practice. To address this, a dedicated microsurgical neuroanatomy laboratory—the first of its kind in Indiana—was established in 2025 at the Indiana University School of Medicine. Led by the senior author, the lab promotes surgical artistry through anatomical precision, repetition, and interdisciplinary collaboration. The objective of this study is to describe the inception and collaborative development of a skull base
lab at Indiana University.

Methods: The lab has been supported through personal funds and industry support. As a joint effort between the Departments of Neurological Surgery and Otolaryngology, fellows were selected from an international pool of applicants. Each fellow received a latex-injected, alcohol-preserved head and had full access to complete neurosurgical equipment, Mayfield headrests, endoscopes, microscopes, drills, aspirators, and professional photography equipment. Daily dissections followed a stepwise approach, with each step captured by high-resolution 2D/3D
images and photogrammetry. Media acquired from the lab was later combined with surgical videos so that the understanding of the microsurgical anatomy can be translated into the operating room. Weekly neuroanatomy meetings were also held to foster peer learning and mentorship.

Results: In its first year, the lab is set to train seven international fellows, with fellowships ranging from 3-12 months. The overlapping time period between the fellows facilitates international dissemination of ideas and techniques. Dissections encompassing open and endoscopic skull base approaches of the anterior, middle, and posterior fossa were performed. The present fellows report significant improvements in 3D orientation, technical confidence, and surgical fluency.

Conclusion: The IU microsurgical neuroanatomy lab offers a transformative and internationally collaborative model for neurosurgical education. The lab merges anatomical precision, simulation, and mentorship to prepare the next generation of neurosurgeons.

The Indiana University Microsurgical Neuroanatomy Laboratory: A Training and Innovation Center

Background:
Medical students experience greater rates of psychological issues, including burnout and anxiety, which may have lasting effects on their future careers. To help address this increased risk, California Northstate University College of Medicine introduced a 4th year Wellness elective, which combines elements of mindfulness meditation, physician compassion and communication training, leadership training, and humanities in medicine. This study evaluated the impact of this course on the levels of burnout, self-compassion, and anxiety of medical students.

Methods:
A survey was administered to 4th year students, both those enrolled in HLT810 and those not taking the course. The survey consisted of demographic questions as well as measurements for burnout, self-compassion, and anxiety. The survey was given prior to beginning the course and again after it was completed. The Oldenburg Burnout Inventory was used to measure student burnout, exhaustion, and disengagement. The Self-Compassion Scale was used to evaluate self-compassion, self-judgment, mindfulness, and self-kindness. The General Anxiety Disorder-7 questionnaire was used to measure anxiety levels. For students who took the elective, two-tailed paired t-tests were performed to assess for differences in these metrics before and after completing the course, with p < 0.05 being significant. Unpaired t-tests were used to compare students who did not take the course to students who completed the course.

Results:
There were no significant differences in anxiety levels, self-compassion, and burnout between students who completed the HLT810 elective and those who did not. However, for the students who completed the elective, there were significantly lower total burnout and disengagement scores after taking the course (p = 0.043 and p = 0.034, respectively), as well as significantly higher self-kindness, humanity, and mindfulness scores (p = 0.00254, p = 0.0162, and p = 0.0396, respectively). These students also had significantly higher total self-compassion scores after completing the course (p = 0.0122). For students who did not take the course, engagement scores were significantly higher after the course concluded (p = 0.024) but there were no other findings of significance.

Conclusion:
Students who completed HLT810 had statistically significant decreased levels of burnout and as well as increased self-compassion after taking the course. While additional investigation is needed due to the small sample size (n = 38), these findings suggest that a 4th year wellness elective course may offer meaningful benefits for medical student well-being.

The Effects of Mindfulness and Wellness Curriculum on Burnout, Self-Compassion, and Anxiety

Background
Patients increasingly consult online resources and Artificial Intelligence (AI) chatbots for medical information. However, post pandemic aggravation of medical misinformation and recent blossom of AI has raised concerns about the quality and comprehensibility of such sources. Adequate, easy to understand, and accurate patient education is crucial in procedural outcome and prognosis, especially for procedures that warrant meticulous postoperative management, such as tracheostomy.
Methods
We evaluated five popular and high-ranking AI chatbots - ChatGPT, DeepSeek, Google Gemini, Microsoft Copilot, and Grok 3 - alongside responses from a senior otolaryngologist, addressing 12 Frequently Asked Questions (FAQs) on tracheostomy care. FAQ selection was guided by a combination of search-listening tools (Google Trends, KeywordsPeopleUse, AlsoAsked, AnswerThePublic, Kwrds.ai), manual Google searches, and clinician input to reflect authentic patient language. Three blinded, board-certified otolaryngologists independently rated each response’s accuracy, clarity, relevance, completeness, usefulness, and reference reliability using the Quality Analysis of Medical Artificial Intelligence (QAMAI), a standardized instrument developed to assess AI-generated contents. Overall preferences and reasons for suboptimal response ranking were also assessed by reviewers. Readability and descriptive text analysis were evaluated using Textstat and Natural Language Toolkit library in Python (Python Software Foundation), employing Simple Measure of Gobbledygook (SMOG), Flesch-Kincaid Grade Level (FKGL) and Reading Ease (FKRE) metrics.
Results
Across the 12 FAQs, there were no significant differences in accuracy between AI-generated and otolaryngologist-generated responses. Google Gemini has higher overall preference and QAMAI score compared to Microsoft Copilot (p<0.05). In terms of completeness, Gemini (p<0.001), DeepSeek (p<0.05), Grok 3 (p<0.05), and ChatGPT (p<0.05) outperformed the otolaryngologist, and each provided content deemed of “good quality” by QAMAI standards. However, Gemini has the reading time (p<.001), highest word (p<.001), long word (p<.001), and difficult word counts (p<.001). Readability analyses revealed that all models have high reading level of at least 10th-13th grade. Inter rater reliability among the three reviewers was 78%.
Conclusion
AI chatbots are a promising tool for accurate, on-demand, and comprehensive health information for patient and families considering or managing tracheostomy care. Google Gemini demonstrated strength in content completeness and overall preference, highlighting the potential of AI to supplement time-limited physician-patient interactions. However, all AI and otolaryngologist generated responses surpassed the American Medical Association’s recommended 6th grade reading level, indicating a need for readability optimization. Future studies should focus on refining the readability of AI-generated content and assessing patient preferences across models. 


The Role of Artificial Intelligence in Addressing Patient Inquires on Tracheostomy Care

BACKGROUND: Surgical education often relies on costly task trainers or two-dimensional surgical videos. Photogrammetry, the process of constructing three-dimensional (3D) models from two-dimensional (2D) images, offers a cost-savings solution while providing a customizable 3D surgical experience. This technique for building photogrammetry-based 3D models allows for the creation of virtual teaching modules and aimed to enhance options for surgical education. While photogrammetry has been used to build models for teaching anatomy, its application in procedural simulation remains limited. Additionally, open carpal tunnel release (OCTR) achieves outcomes comparable to the endoscopic approach, yet virtual reality (VR) training simulations for this open technique have not been explored. This study introduces a low-cost VR OCTR surgical teaching module using photogrammetry to explore production feasibility and educational value across surgical disciplines.

METHODS: A VR OCTR module was created using photogrammetry to generate virtual hand and wrist models from intraoperative cadaveric dissections. Filming was conducted in an academic anatomy lab, demonstrating a five-step OCTR procedure on cadaveric right arms. Serial photographs were captured from multiple angles using a Nikon Z8 camera, with drapes placed to minimize visual distractions. 3D models were rendered via photogrammetry software and refined with open-source tools. The models were viewed through a Meta Quest 3 headset and the teaching module was narrated by a hand surgeon using the MedicalHolodeck Surgical and Anatomical VR application. Surgical trainees and faculty from plastic surgery, orthopedics, and neurosurgery provided feedback for further model development.

RESULTS: This VR module was built using accessible tools and software. High resolution photographs resulted in the anatomically accurate 3D models used to highlight essential anatomy and surgical landmarks in the teaching module. The seven-minute module was noted to be conceptually clear and appropriately concise. Feedback emphasized its usefulness in reinforcing anatomical knowledge, visualizing operative steps, and noting structures to avoid during surgery. In-house development of the modules highlights its customizability for institutional specific learning goals, cost-effectiveness and feasibility for broader institutional adoption, compared to commercial subspecialty specific private platforms for VR surgical training. These findings support the educational potential of photogrammetry-based VR and guide further pilot studies, expansion to medical students and an upcoming randomized trial comparing VR to standard 2D training.

CONCLUSION: Photogrammetry can produce low-cost 3D models for virtual reality teaching modules in surgical education and training. By leveraging accessible technology and cadaveric dissections, this method enhances educational access and sets the stage for wider implementation and outcomes-based research.


The Novel Application of Photogrammetry in Building Virtual Reality Modules for Surgical Education

Abstract Title: Reported Levels of Student Stress and Protective Nature of Resiliency Among First Year U.S. Medical Students - A Single Institution, Pilot Study

Background:
Medical training for M.D. candidates in the United States involves four years of combined didactic and clinical learning. Medical students often experience stressors related to academics and social life that can lead to burnout and clinical depression in medical school. This study aimed to identify key problem areas pertaining to stress and wellbeing among first-year medical students at one accredited M.D. institution by administering the Medical Student Stress Scale (MSSS), a survey that was calibrated and validated by researchers at a single institution looking to identify a precise measurement tool to evaluate medical student stress.

Methods
The MSSS, a 22-item questionnaire, was administered to first year medical students twice during 2024-2025 academic calendar, in the fall and spring. The MSSS questions were administered alongside a Brief Resilience Scale (BRS) and demographic questionnaire. The MSSS measures stress with a total score determined as a summation of the responses, where higher scores indicate greater stress. The BRS measures resiliency with a total score determined as a summation of the 6 item responses and can be categorized as being low (1-2.99), normal (3-4.3), or high (4.31-5).

Results
The overall response rate was 61% (107 out of 175) in the fall and 47% (87 out of 175) in the spring. Average student stress score in the fall and spring was 34.3 and 38.8, respectfully. The resiliency score in the fall and spring was 3.6 and 3.5, respectfully. The multivariable generalized linear model showed that student stress decreased by 10 points and 13 points with every 1-point increase on the BRS in the fall and spring, respectfully (p<0.001). Additionally, at both time points, males display a significantly lower estimated stress score than females (p=0.044 and p=0.016). In the spring, compared to students of Christian faith, Jewish students displayed an estimated 10-point increase in stress (p=0.024), and Islamic students displayed an estimated 17- point increase in stress (p=0.005). Additionally, students that reported they were low-income displayed an estimated 8-point increase in stress compared to non-low-income students (p=0.009).

Conclusion
The MSSS and BRS were feasible to implement and identified clear trends in stress based on demographic factors. High levels of stress are reported even early in the academic year suggesting the need for early and ongoing support. The second time point showed compounding effects, emphasizing the importance of longitudinal support. Resiliency emerged as a potential protective factor and a possible target for future interventions.

Reported Levels of Student Stress and Protective Nature of Resiliency Among First Year Medical Students - A Single Institution, Pilot Study

Background: 

In 2023, a tragic cardiac arrest during a high school basketball game in Detroit, where a student-athlete collapsed and later died despite bystander aid and EMS intervention. This event brought national attention to the lack of consistent sideline medical coverage in underserved urban public schools. Despite widespread advocacy for the presence of certified athletic trainers, Detroit’s public schools have faced systemic under-resourcing. To address this inequity, students at Wayne State University School of Medicine developed the Detroit Public School Health Corps (DPSHC), a student-led initiative that provides consistent sideline medical care through strategic partnerships and longitudinal volunteer engagement. 



Methods: 


Our organization formed a partnership between the Detroit Public Schools Community District, Wayne Pediatrics, and the Detroit Medical Center Orthopedics and Sports Medicine. The initiative recruited over 50 medical student volunteers over the 2024-2025 academic year to volunteer as sideline sports first responders at high school athletic events. Students completed several sport specific training courses led by physicians and residents in sports medicine and pediatrics. We utilized a combined didactic and hands-on instruction, adding up to over ten hours of curriculum across an academic year. Trained volunteers were deployed to 16 high schools in the Detroit Public School Community District. Each sporting season, we provide on-site triage and acute care, with escalation protocols involving on-call physicians and EMS for higher-acuity injuries. Our hospital partners also supported logistical coordination and physician oversight. 



Results: 


During the most recent academic year, our volunteers staffed: 156 of 250 home basketball games (boys and girls), 58 of 64 home football games, 50 of 185 home baseball/softball games, 10 of 14 home girls' soccer games, and 10 of 10 track meets. This totaled 598 hours of sideline coverage across all three sports seasons in 16 public high schools. Over 50 trained student volunteers provided consistent, supervised care, directly assisting thousands of student-athletes. The collaboration with on-call physicians through Wayne Pediatrics and the Detroit Medical Center Orthopedics and Sports Medicine enabled real-time consultation and emergency triage as needed. 



Conclusion: 


DPSHC demonstrates a sustainable, scalable model for addressing the absence of sideline medical personnel in under-resourced school systems. By leveraging medical student enthusiasm, structured clinical training, and institutional partnerships, this initiative has delivered meaningful healthcare access to student-athletes in Detroit. Looking ahead, we aim to expand the program’s impact through continued systematic data collection on injuries, hydration access, and volunteer experiences. These insights will guide ongoing improvements in both student-athlete well-being and the educational value for medical students.

Medical Student-Led Model for Sideline Sports Coverage in Underserved Detroit High Schools through the Detroit Public Schools Health Corp ​

Background: Direct acting antivirals (DAAs) are over 95% effective at curing hepatitis C virus (HCV) infection, yet treatment rates remain low among people who inject drugs (PWID), a priority population for HCV treatment. Given the high prevalence of HCV among PWID, this study looks to characterize treatment uptake and completion among PWID in a safety-net healthcare system in a large city.
Methods: We conducted a retrospective study to identify individuals with evidence of HCV (detectable HCV RNA) between 11/01/2021 to 10/31/2023 and evidence of possible or definite injection drug use (IDU) who accessed care within our integrated healthcare system. We then reviewed medical records of individuals we identified with HCV and IDU to determine demographic characteristics and progression through the HCV care continuum. We compared demographic characteristics at different stages of the care continuum to assess for factors associated with completion of each stage.
Results: 1165 individuals had positive HCV RNA results in our medical system during the study period. Of those, 149 individuals had evidence of definite (n=118, 80.3 %) or possible (n=29, 19%) IDU. 34.2% (n=51) of the study population met with a HCV treatment provider, 26.8% (n=40) started treatment, 25.5% (n=38) completed treatment, and 18.1% (n=27) had evidence of SVR12. Proportions of individuals linked to care did not differ significantly by gender, housing status, IDU status (definite vs. possible), or race/ethnicity.
Conclusions: Over a two-year period, only 26.8% of the 149 individuals with IDU and HCV started HCV treatment. The largest barrier in achieving cure was linking to a medical visit for HVC care after a positive HCV RNA test. Almost three quarters (74.5%) of those who met with a treatment provider completed treatment. No statistical difference was observed in linkage to care based on gender, race/ethnicity, age or housing status. Of those who did not complete HCV treatment, most were lost to follow up without a documented reason in the electronic medical record.

Hepatitis C Care Continuum among People Who Inject Drugs in a Safety-Net Healthcare System

Introduction: Food insecurity (FI) is associated with poor health outcomes, including obesity, diabetes, hypertension, and mental illness. While food voucher programs help address FI, their clinical impact is understudied. At Prisma Health, where 1 in 5 patients face barriers to healthy eating, we implemented a voucher program at a Family Medicine clinic to improve food access and assess health outcomes. 

Materials and Methods: Between February 1 and November 1, 2024, nurses and program coordinators recruited patients during routine visits if they met ≥1 of the following criteria: (1) positive screen on a validated FI questionnaire; (2) homelessness; (3) on Medicaid; (4) uncontrolled DM (A1c ≥8.0%), or (5) HTN (≥130/90 mmHg). Participants received one to three $15 vouchers per visit, redeemable for produce at a nearby market. Voucher use was tracked at the individual level, and clinical data were obtained through manual chart review. Analyses included descriptive statistics via SAS, negative binomial regression for redemption rates, and paired t-tests or Wilcoxon tests for clinical outcomes.

Results: We distributed 4,552 vouchers to 943 participants, with a 54.6% redemption rate. After exclusions, 877 were analyzed: 78% female, 85% Black, and 78% extremely low income. Diagnoses included DM (22%), HTN (52%), depression (19%), anxiety (23%), and overweight/obesity (61%; among 710 patients with BMI data). In multivariate analysis, HTN (IRR 1.26, p = 0.0018), age ≥45 (IRR 1.42, p = 0.0002), Black vs. White race (IRR 1.37, p = 0.0009), and Latino vs. Black race (IRR 1.39, p = 0.0339) were independently associated with higher redemption. In a pre-post analysis of 535 overweight/obese patients, BMI significantly decreased (mean difference -0.44, p = 0.0006). Among 136 patients with HTN who had a pre- systolic blood pressure ≥ 140, SBP decreased on average by 11.2 mmHg. In patients with uncontrolled DM, (pre- A1c ≥ 8, n=68) there was a 1.17 decrease in A1c. Patients with a PHQ-9 ≥ 10 experienced an 8.8-point decrease (p<0.0001) in their score. No significant changes were seen in GAD-7.

Conclusion: This study identified patients likely to engage in a food access program, including those with HTN, age ≥45, and Black or Latino race. BMI improved among overweight/obese participants; other clinical outcomes remained stable. As the first study of its kind in SC – one of seven states with FI prevalence above national average – future research is indicated to evaluate whether longer-term or higher-intensity programs improve clinical outcomes.

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