Development of a Multicomponent Intervention to Decrease Racial Bias Among Healthcare Staff
ABSTRACT Background Real or perceived discrimination contributes to lower quality of care for Black compared to white patients. Some forms of discrimination come from non-physician and non-nursing (non-MD/RN) staff members (e.g., receptionists). Methods Utilizing the Burgess Model as a framework for...
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Published in | Journal of general internal medicine : JGIM Vol. 37; no. 8; pp. 1970 - 1979 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Cham
Springer International Publishing
01.06.2022
Springer Nature B.V |
Subjects | |
Online Access | Get full text |
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Abstract | ABSTRACT
Background
Real or perceived discrimination contributes to lower quality of care for Black compared to white patients. Some forms of discrimination come from non-physician and non-nursing (non-MD/RN) staff members (e.g., receptionists).
Methods
Utilizing the Burgess Model as a framework for racial bias intervention development, we developed an online intervention with five, 30-min modules: (1) history and effects of discrimination and racial disparities in healthcare, (2) implicit bias and how it may influence interactions with patients, (3) strategies to handle stress at work, (4) strategies to improve communication and interactions with patients, and (5) personal biases. Modules were designed to increase understanding of bias, enhance internal motivation to overcome bias, enhance emotional regulation skills, and increase empathy in patient interactions. Participants were non-MD/RN staff in nine primary care clinics. Effectiveness of the intervention was assessed using Implicit Association Test and Symbolic Racism Scale, to measure implicit and explicit racial bias, respectively, before and after the intervention. Acceptability was assessed through quantitative and qualitative feedback.
Results
Fifty-eight non-MD/RN staff enrolled. Out of these, 24 completed pre- and post-intervention assessments and were included. Among participants who reported characteristics, most were Black, with less than college education and average age of 43.2 years. The baseline implicit bias
d
-score was 0.22, indicating slight pro-white bias. After the intervention, the implicit bias score decreased to −0.06 (
p
=0.01), a neutral score indicating no pro-white or Black bias. Participant rating of the intervention, scored from 1 (strongly disagree) to 5 (strongly agree), for questions including whether “it was made clear how to apply the presented content in practice” and “this module was worth the time spent” was ≥4.1 for all modules.
Conclusions
There was a decrease in implicit pro-white bias after, compared with before, the intervention. Intervention materials were highly rated. |
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AbstractList | Real or perceived discrimination contributes to lower quality of care for Black compared to white patients. Some forms of discrimination come from non-physician and non-nursing (non-MD/RN) staff members (e.g., receptionists).
Utilizing the Burgess Model as a framework for racial bias intervention development, we developed an online intervention with five, 30-min modules: (1) history and effects of discrimination and racial disparities in healthcare, (2) implicit bias and how it may influence interactions with patients, (3) strategies to handle stress at work, (4) strategies to improve communication and interactions with patients, and (5) personal biases. Modules were designed to increase understanding of bias, enhance internal motivation to overcome bias, enhance emotional regulation skills, and increase empathy in patient interactions. Participants were non-MD/RN staff in nine primary care clinics. Effectiveness of the intervention was assessed using Implicit Association Test and Symbolic Racism Scale, to measure implicit and explicit racial bias, respectively, before and after the intervention. Acceptability was assessed through quantitative and qualitative feedback.
Fifty-eight non-MD/RN staff enrolled. Out of these, 24 completed pre- and post-intervention assessments and were included. Among participants who reported characteristics, most were Black, with less than college education and average age of 43.2 years. The baseline implicit bias d-score was 0.22, indicating slight pro-white bias. After the intervention, the implicit bias score decreased to -0.06 (p=0.01), a neutral score indicating no pro-white or Black bias. Participant rating of the intervention, scored from 1 (strongly disagree) to 5 (strongly agree), for questions including whether "it was made clear how to apply the presented content in practice" and "this module was worth the time spent" was ≥4.1 for all modules.
There was a decrease in implicit pro-white bias after, compared with before, the intervention. Intervention materials were highly rated. ABSTRACT Background Real or perceived discrimination contributes to lower quality of care for Black compared to white patients. Some forms of discrimination come from non-physician and non-nursing (non-MD/RN) staff members (e.g., receptionists). Methods Utilizing the Burgess Model as a framework for racial bias intervention development, we developed an online intervention with five, 30-min modules: (1) history and effects of discrimination and racial disparities in healthcare, (2) implicit bias and how it may influence interactions with patients, (3) strategies to handle stress at work, (4) strategies to improve communication and interactions with patients, and (5) personal biases. Modules were designed to increase understanding of bias, enhance internal motivation to overcome bias, enhance emotional regulation skills, and increase empathy in patient interactions. Participants were non-MD/RN staff in nine primary care clinics. Effectiveness of the intervention was assessed using Implicit Association Test and Symbolic Racism Scale, to measure implicit and explicit racial bias, respectively, before and after the intervention. Acceptability was assessed through quantitative and qualitative feedback. Results Fifty-eight non-MD/RN staff enrolled. Out of these, 24 completed pre- and post-intervention assessments and were included. Among participants who reported characteristics, most were Black, with less than college education and average age of 43.2 years. The baseline implicit bias d -score was 0.22, indicating slight pro-white bias. After the intervention, the implicit bias score decreased to −0.06 ( p =0.01), a neutral score indicating no pro-white or Black bias. Participant rating of the intervention, scored from 1 (strongly disagree) to 5 (strongly agree), for questions including whether “it was made clear how to apply the presented content in practice” and “this module was worth the time spent” was ≥4.1 for all modules. Conclusions There was a decrease in implicit pro-white bias after, compared with before, the intervention. Intervention materials were highly rated. BackgroundReal or perceived discrimination contributes to lower quality of care for Black compared to white patients. Some forms of discrimination come from non-physician and non-nursing (non-MD/RN) staff members (e.g., receptionists).MethodsUtilizing the Burgess Model as a framework for racial bias intervention development, we developed an online intervention with five, 30-min modules: (1) history and effects of discrimination and racial disparities in healthcare, (2) implicit bias and how it may influence interactions with patients, (3) strategies to handle stress at work, (4) strategies to improve communication and interactions with patients, and (5) personal biases. Modules were designed to increase understanding of bias, enhance internal motivation to overcome bias, enhance emotional regulation skills, and increase empathy in patient interactions. Participants were non-MD/RN staff in nine primary care clinics. Effectiveness of the intervention was assessed using Implicit Association Test and Symbolic Racism Scale, to measure implicit and explicit racial bias, respectively, before and after the intervention. Acceptability was assessed through quantitative and qualitative feedback.ResultsFifty-eight non-MD/RN staff enrolled. Out of these, 24 completed pre- and post-intervention assessments and were included. Among participants who reported characteristics, most were Black, with less than college education and average age of 43.2 years. The baseline implicit bias d-score was 0.22, indicating slight pro-white bias. After the intervention, the implicit bias score decreased to −0.06 (p=0.01), a neutral score indicating no pro-white or Black bias. Participant rating of the intervention, scored from 1 (strongly disagree) to 5 (strongly agree), for questions including whether “it was made clear how to apply the presented content in practice” and “this module was worth the time spent” was ≥4.1 for all modules.ConclusionsThere was a decrease in implicit pro-white bias after, compared with before, the intervention. Intervention materials were highly rated. |
Author | Halanych, Jewell Juarez, Lucia Agne, April A. Tajeu, Gabriel S. Stepanikova, Irena Williams, Jessica H. Cherrington, Andrea L. Stone, Jeff |
Author_xml | – sequence: 1 givenname: Gabriel S. orcidid: 0000-0002-9982-5250 surname: Tajeu fullname: Tajeu, Gabriel S. email: gabriel.tajeu@temple.edu organization: Department of Health Services Administration and Policy, College of Public Health, Temple University – sequence: 2 givenname: Lucia surname: Juarez fullname: Juarez, Lucia organization: Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham – sequence: 3 givenname: Jessica H. surname: Williams fullname: Williams, Jessica H. organization: Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham – sequence: 4 givenname: Jewell surname: Halanych fullname: Halanych, Jewell organization: Department of Internal Medicine, Montgomery Campus of the University of Alabama School of Medicine – sequence: 5 givenname: Irena surname: Stepanikova fullname: Stepanikova, Irena organization: Department of Sociology, University of Alabama at Birmingham, Research Centre for Toxic Compounds in the Environment, Masaryk University – sequence: 6 givenname: April A. surname: Agne fullname: Agne, April A. organization: Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham – sequence: 7 givenname: Jeff surname: Stone fullname: Stone, Jeff organization: Department of Psychology, University of Arizona – sequence: 8 givenname: Andrea L. surname: Cherrington fullname: Cherrington, Andrea L. organization: Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/35266123$$D View this record in MEDLINE/PubMed |
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CitedBy_id | crossref_primary_10_1007_s40615_023_01887_w crossref_primary_10_1016_j_nepr_2023_103820 crossref_primary_10_1212_CON_0000000000001416 crossref_primary_10_1016_j_clp_2022_11_004 crossref_primary_10_1055_a_1927_3704 |
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Background
Real or perceived discrimination contributes to lower quality of care for Black compared to white patients. Some forms of discrimination... Real or perceived discrimination contributes to lower quality of care for Black compared to white patients. Some forms of discrimination come from... BackgroundReal or perceived discrimination contributes to lower quality of care for Black compared to white patients. Some forms of discrimination come from... |
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StartPage | 1970 |
SubjectTerms | Adult Attitude of Health Personnel Bias Communication Discrimination Health care Healthcare Disparities Humans Internal Medicine Intervention Medicine Medicine & Public Health Modules Motivation Original Research: Qualitative Research Patients Primary care Race factors Racial Groups Racism Racism - prevention & control Racism - psychology |
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Title | Development of a Multicomponent Intervention to Decrease Racial Bias Among Healthcare Staff |
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