UnBIASED: Understanding Biased patient-provider Interaction And Supporting Enhanced Discourse

项目摘要/摘要 女同性恋者、男同性恋者、双性恋者、变性人、同性恋者和其他(LGBTQ+)社区的成员更容易 由于性取向或性别认同而遭受比普通人群更多的歧视。在……里面 医疗保健方面的例子包括关于异性恋、仇视同性恋/变性人的态度或 评论，或忽略LGBTQ+患者的特定需求。这种歧视导致了可怜的病人- 服务提供者沟通、寻求护理的延迟、护理不平等和健康差距。通常这样的歧视 是由于无意的隐性偏见，因此在患者和提供者之间的沟通中是隐藏的，但却是联系在一起的 具有与护理不足和缺乏提供者知识相关的负面医疗经历 LGBTQ+医疗保健需求。由此产生的健康差距表现为LGTBQ+社区 对心理健康问题的易感性更高，药物使用率更高，饮食和锻炼更差 比一般人群的行为更多。正如我们在家长拨款中所争论的那样，迫切需要解决卫生问题 通过理解和缓解患者之间互动中表现出的内隐偏见来实现差异 和提供者。为了扩大我们的父母赠款的重点是低收入，种族多元化的患者，这种多样性 补充内容主要针对LGBTQ+人群。遵循与父母赠款的目标2相同的研究设计， 拟议的项目将邀请LGBTQ+患者和初级保健提供者设计沟通反馈 这传达了隐藏的偏见。拟议的项目将吸引LGBTQ+患者和初级保健提供者参与 三个目标是(1)评估关于内隐偏见的沟通反馈的需求，(2)共同设计原型反馈， 以及(3)通过可用性测试迭代地提炼原型反馈。项目调查结果将扩展父项 通过提供来自第二个已知经历隐性的危重患者群体的设计证据进行授予 导致健康差距的医疗偏向。除了促进我们对隐性偏见作为一种 LGBTQ+人群以患者为中心的沟通障碍，这一证据将有助于更有力地 家长赠款中正在开发评估和反馈的模型和自动化工具。

Project Summary/Abstract Members of the Lesbian, Gay, Bisexual, Transgender, Queer, and other (LGBTQ+) community are more prone to experience discrimination than the general population based on their sexual orientation or gender identity. In healthcare, examples include assumptions about heterosexuality, homophobic/transphobic attitudes or comments, or neglecting the specific needs of LGBTQ+ patients. This discrimination results in poor patient- provider communication, delays in care-seeking, care inequities, and health disparities. Often such discrimination is due to implicit biases that are unintentional, and thus “hidden” in patient-provider communication, yet linked with negative healthcare experiences associated with inadequate care and lack of provider knowledge about LGBTQ+ health care needs. The resulting health disparities are demonstrated by the LGTBQ+ community having greater susceptibility to mental health issues, higher rates of substance use, and poorer diet and exercise behaviors than the general population. As we argue in the parent grant, there is a dire need to address health disparities by understanding and mitigating implicit bias that manifests within the interactions between patients and providers. To expand our parent grant focus on low income, racially diverse patients, this diversity supplement focuses on LGBTQ+ people. Following the same study design as Aim 2 of the parent grant, the proposed project will engage LGBTQ+ patients and primary care providers to design communication feedback that conveys hidden bias. The proposed project will engage LGBTQ+ patients and primary care providers in three aims to (1) assess needs for communication feedback on implicit bias, (2) co-design prototype feedback, and (3) and iteratively refine prototype feedback through usability testing. Project findings will extend the parent grant by providing design evidence from a second critical patient population known to experience implicit healthcare biases that lead to health disparities. In addition to advancing our understanding of implicit bias as a barrier to patient-centered communication for LGBTQ+ people, this evidence will contribute to more robust models and automated tools for assessment and feedback being developed in the parent grant.