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Assessing and Addressing Implicit Organizational Bias to Tackle Mental Health Disparities

评估和解决隐性组织偏见以解决心理健康差异

基本信息

批准号：
10192277
负责人：
Miraj U. Desai
金额：
$ 13.03万
依托单位：
YALE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-04-07 至 2026-01-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10192277
关键词：
Address American Assessment tool Attention Belief COVID-19 Caring Characteristics Client Clinic Clinical Collaborations Communities Community Health Conflict (Psychology)Country Data Development Discrimination Elements Empirical Research Environment Epidemic Evidence based practice Future Goals Health system Healthcare Healthcare Systems High Prevalence Individual International Journals K-Series Research Career Programs Knowledge Lead Light Measures Mediating Mental Depression Mental Health Mental Health Services Mental disorders Mentors Methodology Methods Modeling Outcome Pathway interactions Patients Perception Phase Poverty Process Property Provider Psychologist Psychometrics Public Health Publishing Quality of Care Research Research Methodology Research Personnel Science Services Social Environment Source Structure System Testing Training Training Programs United States United States Substance Abuse and Mental Health Services Administration Universities base behavioral health care preference comparative concept mapping design effective intervention ethnic minority population expectation experience global health health disparity health economics health equity health organization help-seeking behavior implementation science implicit bias improved innovation mental health organization minority communities mortality organizational structure pandemic disease population health psychologic psychosocial racial and ethnic disparities service delivery social culture social health determinants social organization suicidal risk theories therapy design tool uptake vision science

项目摘要

PROJECT SUMMARY/ABSTRACT Mental health disparities among ethnic minorities have reached crisis proportions in the United States. Although ethnic minorities are more likely to experience mental illnesses such as depression and associated social determinants of health like poverty and discrimination, they are less likely to seek help from, have access to, or receive quality mental health services. Efforts to redress such disparities and improve engagement have often focused on adding new services or altering provider characteristics, including the implicit biases they may unknowingly hold. However, recent scientific reviews suggest that cultural and structural barriers deeply embedded in the underlying mental health organization itself are a significant factor in the continued persistence of mental health disparities. While implementation science has advanced our knowledge of the relationship between organizational factors and the uptake of evidence-based practices, there has been comparatively little empirical research on organizational issues as they pertain to mental health disparities. This gap in research may be due, in part, to the relative lack of operationalized constructs of disparity at the organizational level. Based on our research, we have conceptualized a key organizational mechanism of disparities—which we term Implicit Organizational Bias (IOB)—or, the unspoken norms, beliefs, and expectations about the way clients should ideally behave and/or interact with the mental health system to gain optimal benefit from available services (e.g., a client should be verbal, openly admit a problem, accept services, be proactive, be individually-oriented). These preferred organizational norms may conflict with the norms of ethnic minority patients, leading to a higher likelihood of incongruent, suboptimal, or compromised care. The proposed career development award seeks to extend the substantial evidence on implicit bias beyond its focus on individuals to the level of the organization through two phases of participatory, mixed methods research that aim: 1) To systematically operationalize, and develop a tool to assess, Implicit Organizational Bias and its congruence with the culture of ethnic minority communities; and 2) To examine the psychometric properties of the IOB measure and test the pathways of association outlined in our conceptual model. While I have extensive experience in mental health disparities research at the patient and community levels, this K is intended to develop my skillset in: 1) implicit bias research, organizational theory, and implementation science; 2) concept mapping and assessment development, and 3) advanced mixed methods and quantitative research. I have established a comprehensive mentoring and training program involving national and international leaders in disparities, implicit bias, and organizational research. My mentors, in combination with a world-class training environment at Yale University, will guide me towards my goal of becoming an independent investigator of multi-level influences on mental health disparities, with expertise in designing and conducting rigorous, pragmatic research aimed at improving engagement, care, and clinical outcomes for ethnic minorities.

项目总结/文摘