Detecting implicit racial bias in provider communication behaviors to reduce disparities in healthcare: Challenges, solutions, and future directions for provider communication training
Detecting implicit racial bias in provider communication behaviors to reduce disparities in healthcare: Challenges, solutions, and future directions for provider communication training
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DOI：
10.1016/j.pec.2019.04.023
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发表时间：
2019-09-01
影响因子：
3.5
通讯作者：
Fetters, Michael D.
中科院分区：
文献类型：
--
作者：
Hagiwara, Nao;Lafata, Jennifer Elston;Fetters, Michael D.
自2003年医学研究所出版《不平等待遇》以来，越来越多的人认识到提供者在病人护理中隐含的种族偏见的作用。在种族/少数民族患者中，提供者隐性种族偏见一直与护理满意度和提供者信任呈负相关。这表明提供者隐性种族偏见可能通过他们的沟通行为表现出来，这反过来可能提供一种解决医疗保健和最终健康方面的种族差异的方法。然而，识别提供者沟通行为调解之间的联系提供者隐性种族偏见和病人的结果是具有挑战性的。在本文中，我们认为识别这些提供者沟通行为需要(1)考虑内隐种族偏见的社会心理学研究结果；(2)将种族/少数民族患者的视角纳入患者-提供者沟通研究。我们将讨论混合方法研究设计作为解决这一复杂科学问题的框架的效用。利用社会心理学对内隐种族偏见的研究，并结合种族/少数民族患者的观点，可以为各种医疗保健领域的学生和住院医生的沟通技巧培训计划的发展提供信息。这些项目是减少医疗保健中种族/民族差异的更广泛努力的一个组成部分。(C) 2019 Elsevier B.V.版权所有
Since publication of Unequal Treatment by the Institute of Medicine in 2003, there has been a growing recognition of the role of provider implicit racial bias in patient care. Provider implicit racial bias has been consistently negatively associated with both care satisfaction and provider trust among racial/ethnic minority patients. This suggests provider implicit racial bias likely manifests through their communication behaviors, which in turn may offer a means of addressing racial disparities in healthcare and ultimately in health. However, identifying provider communication behaviors that mediate the links between provider implicit racial bias and patient outcomes is challenging. In this paper, we argue that identifying these provider communication behaviors requires (1) taking into account findings from social psychology research of implicit racial bias and (2) incorporating the perspectives of racial/ethnic minority patients into patient-provider communication research. We discuss the utility of mixed methods research designs as a framework for resolving this complex scientific question. Research that draws on social psychology research of implicit racial bias and incorporates the racial/ethnic minority patient perspectives can inform the development of communication skills training programs for students and residents in various healthcare fields. Such programs are one element of a broader effort to reduce racial/ethnic disparities in healthcare. (C) 2019 Elsevier B.V. All rights reserved.