Implicit and explicit racial prejudice and stereotyping toward Black (vs. White) Americans: The prevalence and variation among genetic counselors in North America.
Implicit and explicit racial prejudice and stereotyping toward Black (vs. White) Americans: The prevalence and variation among genetic counselors in North America.
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DOI：
10.1002/jgc4.1648
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发表时间：
2023-04
影响因子：
1.9
通讯作者：
Quillin, John
中科院分区：
文献类型：
--
作者：
Hagiwara, Nao;Duffy, Conor;Quillin, John
研究表明，患者的经验和遗传咨询的结果是不公平的种族类别，discriminating黑人患者相对于白色患者。造成这种种族差异的一个主要因素可能是遗传咨询师的种族偏见。本研究探讨了北美遗传咨询师对黑人（与白色）美国人的种族偏见的流行和变化。本研究通过区分内隐和外显层面的偏见（负面情绪或态度）和刻板印象（信念），以及通过包括认证的遗传咨询师和遗传咨询学员，扩展了目前文献中遗传咨询经验和结果的种族差异。215名遗传咨询师（107名遗传咨询师，由美国遗传咨询委员会认证，108名遗传咨询培训生，来自遗传咨询认证理事会认证项目）以随机顺序完成四项测量：种族内隐联想测验（IAT，隐含的偏见），感觉温度计（对于显性偏见），医疗合作IAT（对于隐性刻板印象），以及外显刻板印象的自我报告测量（对于外显刻板印象）。平均而言，遗传咨询师（包括认证的遗传咨询师和遗传咨询学员）在内隐水平上对白色美国人的支持略高于黑人。与美国黑人相比，他们更有可能将“医疗合作”刻板印象与美国白色联系起来。相比之下，遗传咨询师，平均而言，没有表现出明确的偏见或明确的负面刻板印象，这可能反映了遗传咨询师的社会期望的关注。然而，遗传咨询师作为一个群体强烈支持与不信任有关的刻板印象（不信任医疗保健系统，怀疑基因检测，不信任遗传咨询师）对黑人（相对于白色）美国人更真实。最后，我们的研究揭示了遗传咨询师之间每种类型的偏见都有相对较大的差异。未来的研究应该检查每种类型的偏见的这种变化是如何与患者的经验和遗传咨询的结果。
Research has shown that patient experiences and outcomes of genetic counseling are not equitable across racial categories, disadvantaging Black patients relative to White patients. One major factor contributing to such racial disparities might be genetic counselor racial bias. The present study examined the prevalence of and variation in racial bias toward Black (vs. White) Americans among genetic counselors in North America. This study extends the current literature of racial disparities in experiences and outcomes of genetic counseling by distinguishing prejudice (negative feelings or attitudes) and stereotyping (beliefs) at the implicit and explicit levels as well as by including both certified genetic counselors and genetic counseling trainees. Two-hundred and fifteen genetic counselors (107 genetic counselors Board-certified by the American Board of Genetic Counseling, 108 genetic counseling trainees from Accreditation Council for Genetic Counseling accredited programs) completed four measures in a random order: the Race Implicit Association Test (IAT, for implicit prejudice), feeling thermometer (for explicit prejudice), the Medical Cooperativeness IAT (for implicit stereotyping), and a self- report measure of explicit stereotypes (for explicit stereotyping). On average, genetic counselors (both certified genetic counselors and genetic counseling trainees) were slightly to moderately in favor of White Americans over Black Americans at the implicit level. They were also slightly more likely to associate “medically cooperative” stereotypes with White Americans more than Black Americans implicitly. In contrast, genetic counselors, on average, did not display either explicit prejudice or explicit negative stereotyping, which may reflect social desirability concerns among genetic counselors. However, genetic counselors as a group strongly endorsed stereotypes related to mistrust (mistrustful of the healthcare system, skeptical of genetic testing, mistrustful of genetic counselors) to be more true for Black (vs. White) Americans. Finally, our study revealed relatively large variability in each type of bias across genetic counselors. Future research should examine how such variability in each type of bias is associated with patient experiences and outcomes of genetic counseling.
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