Polavarapu, Mona

Background: Telemedicine use has expanded rapidly across ambulatory care. Satisfaction with telemedicine services has been associated with social determinants of health (SDOH) such as socioeconomic status, ethnicity, and employment status. However, little is known about gender-specific patterns in patient experience. This study examined how demographic and SDOH are associated with telehealth satisfaction among women. Methods: A cross-sectional analysis was conducted using data from female patients who completed standardized post-telehealth surveys within the Mayo Clinic Health Care System between March 2020 and December 15, 2023. Logistic regression was used to evaluate the association between patient satisfaction and the following demographics and SDOH: age, race, ethnicity, marital status, Elixhauser score, mental health diagnosis, stress risk, financial risk, transportation risk, food insecurity risk, primary language, and physical activity risk. Results: Among 51,512 female patients, higher age was associated with less satisfaction with “ease of scheduling appointment” and “ease of contacting clinic,” but was associated with significantly higher satisfaction for other measures, including “care practitioners’ efforts to include” and “recommending healthcare office.” A high Elixhauser score was associated with lower satisfaction with “how well the audio and video connections worked.” Conclusion and Action Steps: A higher Elixhauser score and older age emerged as key factors associated with telehealth satisfaction among women. Targeted efforts to support patients with complex health needs and those requiring enhanced care coordination may improve satisfaction and equity in ambulatory telemedicine.

ABSTRACT Background As survival following solid organ transplantation (SOT) improves, attention has shifted to survivorship and quality of life (QoL) outcomes. Sexual function is an important component of women's health in transplant recipients. In the general population, sexual distress affects approximately 10%–15% of midlife women. Female SOT recipients may experience additional risk for sexual dysfunction related to surgery, body image, and immunosuppression. However, sexual health in this population remains understudied. This study assessed sexual function and its impact on QoL among female SOT recipients by menopausal status. Methods A cross‐sectional study of female SOT recipients aged ≥ 18 years was conducted at a single tertiary transplant center from 2018 to 2023. Participants were within five years of kidney, liver, or pancreas transplantation. Validated questionnaires included female sexual function index (FSFI), female sexual distress scale (FSDS), menopause rating scale (MRS), linear analog scale assessment (LASA). Respondents were categorized as premenopausal or peri/postmenopausal. Sexual function, distress, and QoL were compared between groups, with exploratory analyses stratified by current sexual activity status. Results The survey response rate was approximately 30%. Among 277 respondents, peri/postmenopausal patients were less likely to be sexually active (48.9% vs 69.4%, p = 0.002). They reported lower desire, arousal, and lubrication scores, and higher sexual distress than premenopausal SOT recipients. While overall QoL was rated highly across both groups, sexual distress negatively correlated with QoL across menopausal groups. Among the entire cohort, most women (≈74%) had not been asked about sexual health by any provider in the past year. Conclusion Sexual dysfunction is common among female SOT recipients and is associated with menopausal status, with higher rates observed than those reported in the general population. These findings highlight the importance of integrating sexual health into posttransplant survivorship care.

Abstract Introduction Sexual and reproductive history taking is a fundamental yet often overlooked aspect of medical education. Most medical schools in North America do not provide adequate sexual health training to students, with 44% of schools lacking a sexual and reproductive health curriculum (1). Moreover, there are currently no national standards across medical schools for training students to take a sexual health history (2). Existing programs vary widely and often consist of limited hours or electives, leaving many medical graduates feeling unprepared (3). Objective To develop a multimodal course and standardized curriculum for first-year medical students. Methods Through a combination of video presentations, live demonstration, interactive lecture, and Group Observed Structured Clinical Experience (GOSCE) sessions with standardized patients, students were guided in learning and practicing sexual history taking skills. Post-course surveys were sent to all 52 students after completion of the course, with 46 students completing the survey (response rate 88%). Students were asked to rank their knowledge of the course topic on a scale from 1 (not at all knowledgeable) to 5 (extremely knowledgeable) both before and after participating. Results On average, there was a significant change in knowledge, regarding navigating sexual health biases and effectively obtaining a sexual history from patients, by 1.2 points after students partook in the course (p < 0.0001). The majority (80%) reported that there was the right amount of lecture and patient interactive learning. Ninety-six percent of students agreed that the course met the learning objectives and indicated they would use what they learned in the course in the future. Conclusions After participating in this multimodal sexual health course, students demonstrated an improvement in knowledge and indicated that the course met the learning objectives. These results suggest that multimodal teaching methods may address the gap in sexual health education. Disclosure No.