TY - JOUR
T1 - Development of a Multicomponent Intervention to Decrease Racial Bias Among Healthcare Staff
AU - Tajeu, Gabriel S.
AU - Juarez, Lucia
AU - Williams, Jessica H.
AU - Halanych, Jewell
AU - Stepanikova, Irena
AU - Agne, April A.
AU - Stone, Jeff
AU - Cherrington, Andrea L.
N1 - Publisher Copyright:
© 2022, The Author(s) under exclusive licence to Society of General Internal Medicine.
PY - 2022/6
Y1 - 2022/6
N2 - 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.
AB - 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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U2 - 10.1007/s11606-022-07464-x
DO - 10.1007/s11606-022-07464-x
M3 - Article
C2 - 35266123
AN - SCOPUS:85126013604
SN - 0884-8734
VL - 37
SP - 1970
EP - 1979
JO - Journal of General Internal Medicine
JF - Journal of General Internal Medicine
IS - 8
ER -