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Brownsyne Tucker Edmonds, MD, MS, MPH

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Brownsyne Tucker Edmonds, MD, MS, MPH
Department of Obstetrics and Gynecology
Division of General Obstetrics and Gynecology
550 N. University Blvd (UH2440)
Indiana University School of Medicine
Indianapolis, IN. 46202
317-944-1661
btuckere@iupui.edu


Degrees:

A.B. Brown University, Providence, RI., 2000

M.P.H. Harvard School of Public Health, Boston, MA., 2005

M.D. Brown University School of Medicine, Providence, RI., 2005

M.S. University of Pennsylvania, Philadelphia, PA., 2011

Formal Reseach Training:

Robert Wood Johnson Foundation Clinical Scholars fellowship in health policy and health services research, University of Pennsylvania School of Medicine 2009-2011.

Research Interests:

Dr. Tucker Edmonds' research interests are in patient-provider communication and decision-making in the setting of uncertainty.  More specifically, she is interested in understanding the impact of race, class and culture on patient preferences and risk perceptions; physician decision-making and counseling; and ultimately, variations in treatment provision and service delivery.

Dr. Tucker Edmonds has utilized multiple methodologies in a variety of projects that explore these interests.  As a fellow, she completed a survey assessing pregnant women's risk perceptions and attitudes toward receiving the H1N1 vaccine and later conducted focus groups with low-income women to understand decision-making regarding prenatal care attendance.  More recently her work has focused on patient-provider dynamics in the management of periviable (extremely premature) deliveries.  She conducted a secondary data analysis of linked maternal and infant vital statistic and hospital discharge records to examine racial/ethnic differences in utilization of cesarean delivery and neonatal resuscitation for periviable neonates and found that periviable neonates born to African American and Hispanic women are more likely to be intubated than those born to White women. Moreover, delivery hospital confounds the relationship between Hispanic ethnicity and intubation status.  Her findings suggest that social and cultural or, perhaps, institutional factors may influence resuscitation decision-making for periviable neonates.  Dr. Tucker Edmonds subsequently conducted a qualitative study, interviewing obstetricians about patient, provider, and institution-level factors that influence decision-making and counseling in their management of periviable deliveries.  She found that obstetricians are primarily influenced by patient preference.  However, patient-related factors such as infertility and education-level also influence how obstetricians counsel patients and, often, how aggressively they manage the deliveries.  These findings give rise to a number of questions about the interplay between sociocultural factors, patient preferences, and provider biases that operate when decisions are made in this setting of uncertainty.  Dr. Tucker Edmonds hopes to utilize a mix of qualitative and quantitative methods to examine these dynamics further in the coming years.

Dr. Tucker Edmonds's long-term goal is to improve the equity and quality of care provided to underserved populations of women by improving the quality of communication they receive in the clinical encounter.  Ultimately, she intends to develop interventions and curricula to support and educate physicians in providing more effective, equitable, and culturally appropriate counseling.

Keywords Describing Research Interests:

Patient-Provider Communication, Shared decision-making, Surrogate decision-making, Health disparities, Periviability, Decisional Psychology

Peer-reviewed Publications

1. Tucker Edmonds, Brownsyne; Fager, Corinne; Srinivas, Sindhu; Lorch, Scott.: Predictors of Cesarean Delivery for Periviable Neonates. Obstetrics and Gynecology July 2011.

2. Tucker Edmonds, Brownsyne; Fager, Corinne; Srinivas, Sindhu; Lorch, Scott.: Racial and Ethnic Differences in Utilization of Intubation for Periviable Neonates. Pediatrics May 2011.

3. Tucker Edmonds, Brownsyne: Moving Beyond the Impasse: Discussing Death and Dying with African American Patients. Obstetrics and Gynecology February 2011.

4. Tucker Edmonds, Brownsyne; Coleman, Jenell; Armstrong, Katrina; Shea, Judy: Risk perceptions, worry, or distrust: What drives pregnant women's decisions to accept the H1N1 vaccine? Maternal and Child Health Journal October 2010.