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Objective Disparities in pregnancy outcomes among women with SLE remain understudied, with few available racially diverse datasets. We sought to identify disparities between Black and White women in pregnancy outcomes within academic institutions in the United States. Methods Using the Common Data Model electronic medical record (EMR)-based datasets within the Carolinas Collaborative, we identified women with pregnancy delivery data (2014–2019) and ≥1 SLE International Classification of Diseases 9 or 10 code (ICD9/10) code. From this dataset, we identified four cohorts of SLE pregnancies, three based on EMR-based algorithms and one confirmed with chart review. We compared the pregnancy outcomes identified in each of these cohorts for Black and White women. Results Of 172 pregnancies in women with ≥1 SLE ICD9/10 code, 49% had confirmed SLE. Adverse pregnancy outcomes occurred in 40% of pregnancies in women with ≥1 ICD9/10 SLE code and 52% of pregnancies with confirmed SLE. SLE was frequently over-diagnosed in women who were White, resulting in 40–75% lower rates of adverse pregnancy outcomes in EMR-derived vs confirmed SLE cohorts. Over-diagnosis was less common for Black women with pregnancy outcomes 12–20% lower in EMR-derived vs confirmed SLE cohorts. Black women had higher rates of adverse pregnancy outcomes than White women in the EMR-derived, but not the confirmed cohorts. Conclusion EMR-derived cohorts of pregnancies in women who are Black, but not White, provided accurate estimations of pregnancy outcomes. The data from the confirmed SLE pregnancies suggest that all women with SLE, regardless of race, referred to academic centres remain at very high risk for adverse pregnancy outcome. [ABSTRACT FROM AUTHOR]

Objective: This study evaluates the effectiveness of the Training to Increase Minority Enrollment in Lupus Clinical Trials with CommunitY Engagement (TIMELY) program on enhancing referrals of underrepresented patients to lupus clinical trials. TIMELY leverages two existing American College of Rheumatology online educational initiatives: Materials to Increase Minority Involvement in Clinical Trials (MIMICT), a continuing medical education (CME) activity for healthcare providers, and the Community Health Worker (CHW) Lupus Clinical Trials Training (LuCTT). TIMELY introduced a unique roundtable meeting format to build upon the existing online educational programs and facilitate discussions between local clinical trial sites and provider and CHW participants., Methods: This study used an online pre-test/post-test design to assess changes in theory-based behavioral predictors of lupus clinical trial referrals/engagement (i.e. knowledge, attitudes, self-efficacy, and intentions) among providers and CHWs. Participants completed MIMICT/LuCTT and then were eligible to participate in roundtable meetings. Paired t-tests were used to assess changes in composite scores pre-post intervention for each of the outcomes., Results: The final sample included 40 providers and 18 CHWs. Knowledge scores increased significantly for both providers (<0.01) and CHWs (p<0.001) on completion of MIMICT/LuCTT. After participating in the TIMELY roundtable, providers' composite scores for self-efficacy and intentions significantly increased (p<0.001). Provider self-efficacy gains were sustained at 3-month follow up (p<0.001)., Conclusion: These promising findings highlight the potential and opportunities for the TIMELY program to improve behavioral predictors of trial referrals, including CHW knowledge and providers' knowledge, self-efficacy, and intentions to refer underrepresented patients to lupus clinical trials., (This article is protected by copyright. All rights reserved.)