Reducing Disparities in Urinary Control Symptoms for Minority Women
University of Chicago
Summary
The study is designed to address the disparity in available conservative/behavioral treatments for UI/LUTS. The program was developed by experts from urogynecology, psychology, and physical therapy then modified based on focus group feedback from racially minoritized women. The study team created a patient-centered, culturally adapted, self-directed, 8-week, home-based module for women with LUTS/UI. The SUPPORT program combines multiple evidence-based conservative treatments for LUTS/UI including cognitive behavioral therapy, behavioral modifications, and home physical therapy exercise. Progression through the home-based program is supported by research staff. This prospective interventional study aims to evaluate the feasibility and acceptability of the SUPPORT program and its impact on patient-centered treatment outcomes, while enabling comparisons across race and ethnicity. This approach will provide a comprehensive understanding of how to effectively deliver self-management strategies for pelvic floor disorders. At the start of the 8 week SUPPORT course participants will also be given access to a custom programmed GPT trained on the SUPPORT workbook and given instructions on empathetic communication techniques and assisting patients in performing the SUPPORT exercises as outlined in the program. At the end of 8 weeks patients will fill out a survey assessing the frequency of use and interactions with the LLM.
Description
Several recent large, population-based studies report that the prevalence of bothersome urinary incontinence (UI) and lower urinary tract symptoms (LUTS) ranges from 55-73%, and a woman's lifetime risk of surgery for pelvic floor disorders is 20%. In other words, one in every five women can expect to undergo surgery for UI or prolapse by age 80, underscoring the public health impact of these conditions. For perspective, a woman's lifetime risk of breast and lung cancer are 15% and 6%, respectively. Although the lifetime risk of UI/LUTS is significantly higher than that of breast cancer or lung…
Eligibility
- Age range
- 18+ years
- Sex
- Female
- Healthy volunteers
- No
Inclusion Criteria: * Age 18 years or older * Able to converse in English * A response of at least "somewhat bothered" by urinary incontinence, urinary frequency or urgency on the UDI * Willing to engage in conservative treatment of their UI/LUTS for 16 weeks Exclusion Criteria: * Anterior or posterior pelvic organ prolapse beyond the hymen or apical prolapse to the hymen * Currently taking medications for their UI/LUTS or history of surgical intervention for UI * Patients with abnormal PVR and positive urine culture at time of study entry * History of recurrent UTIs * History of mobility o…
Interventions
- BehavioralSUPPORT workbook
The SUPPORT workbook contains a template for how pelvic floor physical therapy is delivered in the typical in-person setting with a combination of education, bladder re-training exercises, pelvic floor stretching and core strengthening. To aid in the demonstration of physical therapy exercises, the workbook includes QR-coded links to videos of a physical therapist performing the exercises in an ideal form. The videos include audio instruction to ensure that patients can learn the concepts in either visual, auditory or written form. The cognitive behavioral therapy (CBT) portion of the workbook is adapted from the standardized CBT protocol and includes short introductions and exercises pertaining to cognitive flexibility, behavioral activation and social support. The total time commitment for the program is 2-hours per week. Patients also will be given access to a custom programmed GPT trained on the SUPPORT workbook and given instructions on empathetic communication techniques.
Locations (2)
- Northwestern UniversityChicago, Illinois
- The University of ChicagoChicago, Illinois