Reducing implicit verbal and nonverbal bias toward Hispanic patients

减少对西班牙裔患者的隐性言语和非言语偏见

• 批准号: 8773897
• 负责人: JEFFREY A STONE
• 金额: $ 39.87万
• 依托单位: UNIVERSITY OF ARIZONA
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-25 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8773897
• 关键词: Address; African American; Arizona; Attitude; Award; Belief; Caring; Client satisfaction; Clinical; Code; Communication; Complex; Conscious; Discrimination; Educational Curriculum; Effectiveness; Ethnic Origin; Exposure to; Health Personnel; Health Sciences; Healthcare; Hispanics; Hybrids; Knowledge; Language; Lead; Learning Module; Linguistics; Measures; Medial; Mediating; Mediator of activation protein; Medical; Minority; Modeling; Nonverbal Communication; Patient Education; Patients; Perception; Play; Prejudice; Process; Provider; Psychology; Publishing; Reporting; Research; Research Support; Role; Socioeconomic Status; Stereotyping; Testing; Training; Training Programs; Trust; Unconscious State; Universities; Withdrawal; Work; design; effective intervention; impression; improved; insight; meetings; novel; public health relevance; satisfaction

DESCRIPTION (provided by applicant): The current proposal seeks support for research to document and reduce the expression of implicit verbal and nonverbal bias by medical residents when they interact with Hispanic patients. Research shows that while stereotyping, prejudice and acts of discrimination can be conscious and deliberate, the expression of bias among healthcare providers is often unintentional because many hold negative attitudes and stereotypes at an implicit or unconscious level. Thus, implicit verbal and nonverbal biases may leak into the way residents interact with Hispanic patients, but training residents to control thei verbal and nonverbal implicit biases can mitigate the negative effect on patients during a clinical encounter. Whereas previous research shows that healthcare providers hold implicit negative attitudes and stereotypes about stigmatized patients, and that these biases can negatively impact both the way providers interact with minority patients, and the satisfaction that minority patients report after a clinical encounter, no research to date has documented the mediators of the relationship between implicit bias and patient satisfaction. The current proposal addresses this void by developing and testing a new model of Implicit Linguistic Bias. The Implicit Linguisti Bias model proposes that interactions between Hispanic patients and residents, who hold implicit biases toward them and their group are characterized by lower linguistic matching, higher use of demand-withdrawal language, and higher intergroup linguistic bias language. The presence of these implicit linguistic biases, in turn, make the patient feel less involved in the conversation, feel less confidence and trust in the provider, and feel less desire to see the provider again. Reducing the expression of implicit verbal and nonverbal biases, including implicit linguistic biases, during a clinical encounter, however, can be achieved by training residents in the psychology of implicit bias, how it is communicated during a clinical encounter, and how they can control their verbal and nonverbal expressions of implicit bias when they interact with Hispanic patients. In three large-scale studies over five years, the proposed research will examine the presence and reduction of verbal and nonverbal forms of implicit bias, including the effects of implicit linguistic bias, during clinical encounters between medical residents and Hispanic patients. Study 1 will develop and test the proposed model of Implicit Linguistic Bias by recording and coding interactions between medical residents and Hispanic patients. Study 2 will develop and test the effectiveness of a new hybrid-learning module for training medical residents in the psychology of implicit bias. Study 3 will then examine if completing the implicit bias training module reduces the expression of implicit verbal and nonverbal bias, including the expression of implicit linguistic bias, and improves patient satisfaction ratings when medial residents interact with Hispanic patients.

描述（由申请人提供）：当前的提案寻求支持研究，以记录和减少医疗居民与西班牙裔患者互动时的隐性口头和非语言偏见的表达。研究表明，尽管刻板印象，偏见和歧视行为可能是有意识和故意的，但医疗保健提供者之间偏见的表达通常是无意的，因为许多人在隐式或无意识的水平上持有负面态度和刻板印象。因此，隐式言语和非语言偏见可能会泄漏到居民与西班牙裔患者互动的方式中，但是培训居民控制言语和非语言隐式偏见可以减轻对临床期间患者的负面影响 遇到。尽管先前的研究表明，医疗保健提供者对受污名的患者的隐性负面态度和刻板印象，并且这些偏见可能会对提供者与少数族裔患者互动的方式产生负面影响，以及少数患者在临床遭遇后报告的满意度，迄今为止，没有研究记录了隐式偏见和患者满意度之间的中介者。当前的建议通过开发和测试一种隐性语言偏见的新模型来解决这一空白。隐式语言偏见模型提出，西班牙裔患者与居民之间的相互作用（对他们及其群体都具有隐性偏见，其特征在于语言匹配较低，对需求 - 引人入胜的语言以及较高的群体间语言偏见的特征。这些隐性语言偏见的存在反过来，使患者的参与程度较小，对提供者的信心和信任较少，并且对再次见到提供商的渴望减少了。然而，在临床遭遇期间，可以通过培训居民对隐性偏见的心理学，临床遭遇期间的传播方式以及他们如何控制其与史上的患者的言语和非语言表达方式来实现隐式言语和非语言偏见的表达，包括隐式语言偏见，包括隐式语言偏见。在五年的三个大规模研究中，拟议的研究将研究医学居民与西班牙裔患者之间的临床相遇期间，在言语和非语言形式的隐性偏见的存在和降低，包括隐式语言偏见的影响。研究1将通过记录和编码医疗居民与西班牙裔患者之间的相互作用来开发和测试所提出的隐式语言偏差模型。研究2将开发和测试新的混合学习模块，以培训医学居民的隐性偏见心理学。然后，研究3将检查是否完成隐式偏见训练模块是否会降低隐式言语和非语言偏见的表达，包括隐性语言偏见的表达，并在内侧居民与西班牙裔患者相互作用时提高患者满意度。