P9: Teaching Health Disparities as Regards Cardiopulmonary Support Technologies for Underepresented/ Underserved Patients

Abstract

Background: There is a growing interest in addressing health care disparities faced by underrepresented/ underserved (U/U) populations across all fields of medicine. To that end, my goal was to introduce to the undergraduate (UG) and graduate (G) bioengineering classes that I teach the challenges faced by U/U patients as regards state-of-the art cardiopulonary support technologies (CPST) for treatment of end-stage cardiac or pulmonary failure. Methods: At the University of Pittsburgh (UoP) I teach two separate UG artificial organs (AO) classes; one class focuses on cardiac assist devices and the other on pulmonary assist devices. I also teach the cardiac assist module for a G cardiovasuclar organ replacement class. Through a long-standing NSF-funded collaboration with North Carolina Agricultural and Technical State University (Greensboro, NC), a Historically Black College and University (HBCU), I also teach my AO classes to NCAT students. The NCAT courses are taught remotely (via ZOOM). For the past several years, the term projects for my UG and G artificial organs classes at UoP and NCAT have focused on i) investigating health inequities/ disparities in CPST as applied to U/U patients; and, ii) proposing innovative improvements to current CPST that benefit, particularly, U/U patients. Students are asked to address the following in their term papers and class PPT presentations: 1) current state-of-the art in CPST; 2) limitations of current CPST as applied to U/U patients; 3) unmet clinical needs for U/U patients; 4) the feasibility of the proposed innovative improvements from a product specification, regulatory and societal viewpoint. Results: Students identified numerous reference materials that highlight the inequities/ disparities that U/U patients face. The American Heart Association, the CDC and NHLBI all maintain detailed epidemiological information related to the term project topic. There also exists a plethora of peer-reviewed published articles in this regard; a few examples being, Frech et al, “Ventricular Assist Device Technology and Black-White Disparities on the Heart Transplant Wait List.” Progress in Transplantation 2021; 31(1): 80-87; Nyak et al, “Understanding the Complexity of Heart Failure Risk and Treatment in Black Patients.” Circulation Heart Failure 2020; 13: 301-314. Among the student term project topics were, “Improving VAD Technology for the African American Community;” “Blood Pressure Measurement and Management in Black Ventricular Assist Device Users;” “A Multi-Factor Approach to Improve African American Heart Health;” “Innovative Design for Cystic Fibrosis in Women of Color.” Conclusions: Student response to the term project assignment was positive. Meetings with the students demonstrated the students’ interest in the topic. The ultimate success of this assignment will be achieved, if these students are sensitive to the special needs of U/U patients and incorporate these needs in their design of biomedical devices.