Racial Biases in Pain Treatment: Tests of pain-care recommendations, treatment biases, and race perception mechanisms

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PROJECT SUMMARY/ABSTRACT E. Paige Lloyd, PhD is a social psychologist whose ultimate career goal is to use her expertise in intergroup relations to investigate the social psychological underpinnings of health disparities and create interventions that reduce treatment disparities and promote equitable care. The research she proposes titled, “Racial biases in pain treatment: Tests of pain-care recommendations, treatment biases, and the malleability of race perception processes” addresses gaps in the literature, offers practical insights, and provides a platform for development. Research: Pain is a prevalent and consequential health concern. However, pain care is not equally distributed; for example, White Americans receive more aggressive and guideline-directed pain care than Black Americans. Although there is consistent evidence of pain care disparities, there is no work integrating models of race perception or experimentally examining the contribution of these processes to pain care decisions. The overall objective of this research is to identify and attenuate problematic race-perception processes contributing to racial biases in pain treatment. To test this objective, Dr. Lloyd will pursue the following Specific Aims: Aim #1: To investigate the presence and pattern of clinician biases in pain care for White, Black, and multiracial Black/White hypothetical patients, Aim #2: To examine the extent to which person perception processes are associated with treatment recommendations for hypothetical Black, White, and Black/White patients, Aim #3: To empirically test a novel intervention designed to attenuate race perception biases. Three complementary studies employing vignette, standardized patient, and intervention designs will 1) examine pain care biases across Black, White, and Black/White multiracial hypothetical patients, 2) the race perception mechanisms that inform treatment recommendations, and 3) potential solutions to biases in race perception. Training: The proposed career development plan will build upon Dr. Lloyd’s previous training with three training goals: 1) expand measurement and statistical expertise to encompass assessment of race categorization and nonverbal biases, 2) gain expertise in the ethics, theory, and methodologies of health services research relevant to disparities 3) learn about developing and implementing translational interventions. Dr. Lloyd and her mentorship team propose specific training activities, didactic and experiential, that will enable her to gain the skills necessary to complete the proposed research and develop as an independent scientist. This training will be supported by an experienced and successful multidisciplinary team. Dr. Lloyd’s institution and department, the University of Denver and the Department of Psychology, are committed to her success and have provided extensive resources to promote her productivity and training. This award will provide Dr. Lloyd with the training and pilot data required to seek R01 funding, become a nationally-recognized independent investigator, and make scientific contributions that promote equitable care.