A Novel Pilot Program to Improve H. pylori Screening and Treatment in the US Immigrant and Refugee Population

The refugee community in the US is an understudied population that presents with the unique challenge of having endemic health morbidities, yet is screened under guidelines for the undifferentiated US population.

This pilot study aims to improve Helicobacter pylori testing and treatment prescribing practice via a curriculum consisting of four interactive core modules presented to clinical trainees/educators.

The case-based workshop curriculum consisted of four interactive core modules delivered through PowerPoint presentation to medical trainees working in the Immigrant and Refugee Health Center (IRHC). Participants were surveyed before and after each session using an internally developed questionnaire. Pre- and post-test data were analyzed using paired T-test analysis. The number of patients who were ordered for and completed H. pylori stool or breath testing and antibiotic therapy was identified before and after the educational intervention, and compared using paired T-test analysis.

A total of 51 participants were observed. Participants were clinical trainees and educators, including 38 internal medicine residents, 6 attendings, and 7 medical students working in the clinic.

A paired T-test analysis comparing pre- vs. post-survey questionnaire accuracy per knowledge category showed a statistically significant increase in knowledge transfer for 5 out of the 6 survey questions. A statistically significant difference in the average percentage of patients appropriately ordered for H. pylori testing when comparing pre- vs. post-intervention period was observed (5.9% vs. 11.0%, p-value = 0.019).

This study demonstrates the feasibility of implementing a novel pilot program to address disparities in H. pylori screening and treatment in the refugee community. This intervention can serve as a pilot for future quality-based programs in refugee clinics in other high-risk hospital systems.