Enhancing Provider Knowledge and Attitudes Toward Patients With Sickle Cell Disease

Background: Sickle cell disease (SCD) describes a complex genetic disorder involving hemoglobinopathies with severe disease characterized by painful vaso-occlusive crisis (VOC) episodes requiring acute pain management. Systemic barriers of racism, stigmatization, bias, and lack of application of guidelines have diminished treatment of SCD VOC episodes. Provider-targeted interventions have shown improvement in attitudes and knowledge in treating SCD.

Local Problem: Inpatient advanced practice providers may present bias, stigma, and lack of knowledge regarding SCD care. These negative attitudes represent barriers to care. Providers can improve SCD knowledge and reduce barriers through educational interventions.

Methods: This quality improvement (QI) project assessed 12 advanced practice provider participants in three pre- and post-intervention measures surrounding a four-week educational package within the Hematology-Oncology division in an academic medical center in Pennsylvania. A nonparametric repeated measures ANOVA evaluated changes from pre-assessment to post-assessment of the General Perceptions About Sickle Cell Patients (GPASCP) Scale, APP knowledge questionnaire, and perceived change in practice (PCIP) questions. Interventions: A four-week progressive intervention package containing a video, informational flyers, scannable QR codes, resource binders, and bi-weekly TigerConnect text messaging was deployed for immersion in the material. The package highlighted SCD bias, sigma prevention, VOC syndromes, and relevant treatment guidelines.

Results: Ten out of 12 participants completed the GPASCP scale, knowledge questionnaire, and PCIP questions with significant improvement GPASCP negative attitudes (p < 0.001), positive attitudes (p < 0.001), concern behaviors (p= 0.0098), red flag behaviors (p = 0.015), quiz (p = 0.041), and PCIP questions, (p = 0.006). Self-reported attitudes and knowledge were maintained four-weeks following the intervention.

Conclusions: Extended Hematology Oncology APP-targeted educational interventions on SCD management reduce bias and stigma while increasing APPs’ positive attitudes and VOC pain guidelines knowledge. Participant’s perceived effects persisted beyond the intervention’s end.