Cromeens to Study Pathways to Endometriosis Diagnosis with American Nurses Foundation Grant

Hillman Scholar Martha Grace Cromeens has been awarded a $9,999 American Nurses Foundation (ANF) grant from the Virginia Kelley Fund to map pathways to diagnosis of endometriosis among a diverse group of women

Endometriosis is estimated to affect 5-10% of reproductive-aged women. Despite the profound negative effects of this chronic condition on individual functioning and quality of life, diagnosis can take years or even decades. During this time of delayed diagnosis, women suffer from chronic pelvic pain, menstrual irregularity, pain with intercourse and infertility among other physical symptoms. They also report psychological suffering in the form of social isolation, anxiety and depression. These overwhelming symptoms affect their work productivity and result in high medical costs and substantially diminished quality of life.

In her abstract, Cromeens explains that the high bar for definitive diagnosis, surgical assessment with histological confirmation, leaves women without access to care with longer delays in diagnosis. Women of lower socioeconomic status (SES) and minority races have been underrepresented in endometriosis research, and although there have been studies to examine the experiences of women with endometriosis and delay in diagnosis, there is a large gap in the literature regarding the diagnostic pathways women travel and the pre-diagnostic period especially among lower SES and non-white women.

Cromeens and her team will pursue two main research aims with this study. The first is to map pathways to diagnosis of endometriosis using qualitative interviews and analysis informed by a life course perspective, which they will achieve by (1) describing pathways and experiences of the women’s symptom recognition, appraisal and management and (2) identifying differences in pathways and experiences among a socio-economically and racially diverse group of women. The second aim of the project will be to determine the factors and symptoms shared among women who perceived the time to diagnosis as timely and to those who perceived the time as delayed.

The year-long study will run through August 31, 2020, and will include the team members listed below.

Suzanne Thoyre, PhD, RN, FAAN | Academic Advisor (UNC School of Nursing)
Kathleen Knafl, PhD, FAAN | Key Investigator (UNC School of Nursing)
Erin Carey, MD, MSCR | Key Investigator (UNC Department of Obstetrics and Gynecology)
Whitney Robinson, PhD, MSPH | Key Investigator (UNC School of Public Health, Department of Epidemiology)

Well done, Martha!


American Nurses Foundation, Virginia Kelley Fund, Cromeens (PI) 09/01/19-08/31/20, Funding: $9,999, “Qualitative Inquiry into the Pathways to Diagnosis of Endometriosis Across a Diverse Sample of Women.”