Urinalysis and Prenatal Health: Evaluation of a Simple Experiment That Connects Organic Functional Groups to Health Equity

Abstract

Knowledge of functional groups provides students with a language for organic chemistry. However, students in a health science chemistry course do not plan to be synthetic organic chemists and, therefore, need examples of how functional group chemistry is relevant to their vocational goals. We have developed a lab to demonstrate how simple functional group chemistry is used in laboratory testing, namely, the “pee test”, or dipstick urinalysis. Dipstick urinalysis is frequently used to screen for various conditions and is used weekly in the last month of pregnancy. Our lab models the prenatal clinical environment. The laboratory allows for testing of chemical species that support a medical diagnosis: albumin testing for preeclampsia; leukocytes, nitrites, and pH for urinary tract infection; glucose, ketones, and pH to test for gestational diabetes, alcoholism, or other serious metabolic diseases. The related lessons are designed to support students in understanding the reactions involved in testing, biochemistry related to diagnosis, and general understandings of how tests are interpreted. In developing this experiment, we were confronted with disparities in prenatal care, namely, the absence of culturally competent care, inequitable access to care, and toxic stress due to racism that contribute to dramatically increased maternal death rates for women of color in the US. We identified resources to educate students on culturally competent care. These resources include reference to the way in which the “pee test” is administered. We have incorporated this resource into our lab with appropriate reflection questions, based on our newly devised cultural competence and social justice framework for chemistry students. Our findings indicated that student understandings of the chemistry and testing methods were adequate; on average, 77% of samples were properly diagnosed. With respect to social justice and cultural competence, we found that students predominantly discussed two elements of the cultural competence and social justice framework: reflection on privilege in society and agency to promote equity in healthcare.