# Articulating External Factors that Limit UF Outcomes for All Women and Create Disparities for BAA women

> **NIH NIH P50** · MAYO CLINIC ROCHESTER · 2024 · $364,373

## Abstract

PROJECT SUMMARY – PROJECT 2
External factors including insurance coverage, patient-clinician relationships, and healthcare policies limit
personalized uterine fibroid (UF) care and shared decision-making for women. These factors are magnified for
Black/African American (BAA) women secondary to distrust between medical providers, and specifically
gynecologists and BAA contributing to a situation whereby women generally desire uterine sparing procedures
while nearly 60% of women undergo hysterectomy without prior conservative therapy. This project seeks to
understand the external factors contributing to barriers to wider use of conservative nonsurgical treatment
options that have widespread endorsement of their safety and efficacy. The specific aims are to 1) analyze
predictors of UF treatment adoption and outcomes in BAA and White women in a large commercially insured
population and assess the impact of Medicaid expansion on access to UF treatments and outcomes
specifically focusing on disparities between BAA and White women; 2) assess via focus groups non-
gynecologic and gynecologic providers’ knowledge, standard of treatment, and comfort with approaches when
providing care to patients for the treatment of UF; 3) conduct a discrete choice experiment to understand
provider preferences for treatment options. Since healthcare decisions are primarily influenced by healthcare
providers that vary on context, barriers identified will be utilized to decrease disparities in offering medical and
uterine sparing therapies. Through dissemination of the findings and collaboration with the administrative
corps, pilot projects will be supported to bring diverse early-stage investigators into the fields of policy and
research to empower personalized and evidence-based decision making.
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## Key facts

- **NIH application ID:** 10899981
- **Project number:** 1P50HD115283-01
- **Recipient organization:** MAYO CLINIC ROCHESTER
- **Principal Investigator:** Bijan Borah
- **Activity code:** P50 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $364,373
- **Award type:** 1
- **Project period:** 2024-06-19 → 2029-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10899981

## Citation

> US National Institutes of Health, RePORTER application 10899981, Articulating External Factors that Limit UF Outcomes for All Women and Create Disparities for BAA women (1P50HD115283-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10899981. Licensed CC0.

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