Development and Pilot Testing of an Implicit Bias Training Intervention for Providers to Advance Equity in Healthcare
Objective: Development and feasibility testing of an implicit bias training intervention for providers
Despite substantial improvements in the overall health of our nation, racial and ethnic disparities in health and healthcare remain ubiquitous. Disparities are apparent after controlling for access to care, insurance, income, patient preferences, and clinical need, suggesting that providers and health systems are important contributors to racial disparities in healthcare.
In its landmark report, “Unequal Treatment,” the Institute of Medicine concluded that providers contribute to disparities through the effects of implicit bias. Implicit bias occurs when thoughts and feelings outside of conscious awareness and control affect judgment and/or behavior.
Implicit racial bias in providers is associated with Blacks (compared to Whites) experiencing lower patient-centered communication, worse doctor-patient relationships, lower confidence in the doctor, and poorer health outcomes. Therefore, to address health disparities, there is an urgent need for interventions that address implicit bias in healthcare.
Implicit bias training is increasingly used in public service, business and healthcare settings to raise self-awareness and provide self-management tools for avoiding actions based on implicit bias. While such interventions are well-conceived and intuitively attractive, they have not been rigorously tested. Our overall objective is to test the hypothesis that implicit bias training for healthcare providers will reduce racial and ethnic disparities in patient-centered care.
The aims of this project are to:
- Refine an existing implicit bias training intervention based on input from patients, providers, health system stakeholders, and other experts
- Determine the feasibility of delivering the training to clinicians assessing patient-centered outcomes.
At the conclusion of this study, we will be prepared to test the impact of implicit bias training on racial/ethnic disparities in the clinical encounter, and thus move us toward the delivery of equitable, evidence-based, patient-centered clinical care.
- Focus groups to identify elements and behaviors associated with patient perceptions of implicit bias
- Interviews with providers, health system stakeholders, experts to refine existing IB training
- Determine feasibility of delivering the refined IB training and assessing patient-centered outcomes
- Provide preliminary data for RCT of IB training