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.

Cultivating connection in the classroom

“…We recently reported on a chemistry urinalysis lab that discussed the role of racism in maternal health 6 . Two keys to success in this project were developing a robust framework for culturally relevant education and engaging with social partners who supported us in developing relevant connections.…”

“…This project emerged from a more general effort to make chemistry relevant. Through this project, we were confronted with the ways racism impacts healthcare; real-life applications inevitably reflect our society and have connections to discrimination, but also to people who address disparity through improved patient care 6 or other means (such as scientific research or activism).…”

Inquiry-Based Labs Using Paper Microfluidic Devices: The MICRO Project

“…33,34 At present, published articles with these contexts are quite limited. [35][36][37] Each experiment in the MICRO project includes background information linking the scientific concepts to a relevant social justice concern such as food insecurity, medical research disparities, and access to clean water (see Table 1). Background information about the issue and its differential impact on different communities is provided along with resources for students who would like to learn more or get involved.…”

Engaging Social Science and Humanities Students in Community-Based Research on Nitrogen Oxide Pollution

“…For example, local environmental issues have been included in several analytical chemistry courses , and in work to use publicly available information on brownfield sites to map pollutant locations in a course in environmental engineering . Environmental concerns are also at the center of service learning activities in chemistry courses, such as a comprehensive survey of metals in well water. , Providing socioscientific links to chemistry content has also been done in curricula that address cultural and demographic diversity as a component of the learning experience …”

“…13,14 Providing socioscientific links to chemistry content has also been done in curricula that address cultural and demographic diversity as a component of the learning experience. 15 To "re-engage the disengaged", activities used in chemistry courses could be adapted to courses in the social sciences and humanities that include the environment as part of understanding communities. An example is a report of a collaboration of chemistry and political science faculty to support interdisciplinary research teams in the examination of airborne polycyclic aromatic hydrocarbons in different communities.…”