Proposal for a Novel Gastrostomy Button for Sensing Overfeeding; Deserted in Delivery: How Profit Motives Limit Rural Maternal Care Access in the US

Healthcare is a fundamental human right, and should be accessible, equitable, and high quality. It should not be limited by geographic location, demographic status, or socioeconomic status. This includes access to specialized care, such as maternal and gastrointestinal care. To this end, my team’s technical project entailed designing a novel gastrostomy button for sensing overfeeding in human enteral nutrition users. Our motivation for completing this project was to reduce the incidence of aspiration pneumonia –a serious condition that occurs when the stomach contents enter the airways. For my individual STS paper, I was motivated to analyze the disparities between rural and urban maternal health outcomes, and how these disparities are shaped by financial incentives in the United States. My personal motivation for completing this work is a result of the closure of my hometown hospital maternity ward in Bradford, Pennsylvania. I aim to identify the disparities created by financial pressures and propose ways they may be addressed.
My team’s technical project was completed with Luminoah, a local medical device company in Charlottesville, Virginia. The goal of this project was to integrate a sensor that measures stomach fullness into a gastrostomy button. A gastrostomy button is a low-profile gastrointestinal device that is accessible at the skin level above the stomach, which it provides direct access too. The gastrostomy button allows users to use enteral nutrition – feeding directly into the stomach. Many patient groups are dependent on enteral nutrition, including ICU patients, children with developmental disabilities, and people suffering from neurological or gastrointestinal conditions that prevent the ability to receive nutrition orally. This project accomplishes three key aims: identifying a physiological proxy for stomach fullness, identifying a commercial sensor capable of detecting the selected proxy, and developing a simulation to verify the theoretical capability of the sensor to be integrated into the standard gastrostomy button design. The original scope of this project was to incorporate a physical sensor into the device. However, the sensor broke during our initial testing phase. Due to time constraints, we shifted to a simulation. We successfully created a model based on prior literature that accomplished our proposed aims, validating the use of our selected sensor and allowing for the continuation of our project by future capstone groups and Luminoah.
My STS research investigated the role that profit prioritization has in shaping the disparities between urban and rural maternal health outcomes. This was achieved by collecting data via a literature review as well as analyzing content from news articles and social media. A Social Construction of Technology (SCOT) analysis was performed using this data, allowing for a sociotechnical framework to understand the factors that shape maternal health. Through this analysis, two competing social groups were identified and examined – a corporate group, consisting of executives, hospital administrators, and other financially incentivized actors, and a public group – including birthing people, healthcare providers, and other health-outcome incentivized actors. My analysis argues that the motivation difference between these groups results in the disparities between urban and rural maternal health outcomes.
Sociotechnical analysis allows for the investigation of both technical and societal factors that influence individuals’ access to specialized healthcare. While my technical and STS projects are not inherently related, they both seek to address adverse outcomes in specialized fields of healthcare. As I move into professional work as a biomedical engineer, it is imperative that I understand not only the technical aspects of my work, but also the disparities impacting both the access and application of my projects. Completing the technical and STS papers allowed me to greatly strengthen both my technical skills and social awareness of disparities impacting diverse patient populations. I hope to bring this understanding with me into the professional landscape as I continue to work on medical devices in the future.

School of Engineering and Applied Science
Bachelor of Science in Biomedical Engineering
Technical Advisor: Jordan Word
STS Advisor: Karina Rider
Technical Team Members: Kyleigh Brown, Olivia Gubbay, Natalie Kester