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Implicit racial bias in pediatric emergency medicine: A foundational investigation of physician behaviors

儿科急诊医学中的隐性种族偏见：对医生行为的基础调查

基本信息

批准号：
10722681
负责人：
Colleen Kays Gutman
金额：
$ 15.56万
依托单位：
UNIVERSITY OF FLORIDA
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-08-11 至 2028-02-29
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10722681
关键词：
Accident and Emergency department Address Affect Analgesics Antibiotics Area Asthma Attitude Award Awareness Behavior Caring Characteristics Child Child Care Child Health Child Rearing Code Communication Complement Complex Consensus Craniocerebral Trauma Data Decision Making Delphi Technique Development Development Plans Educational Intervention Elements Emergency Care Emergency Department Physician Emergency Medicine Emergency Situation Emergency department visit Environment Equity Ethnic Origin Family Florida Foundations Funding Future Goals Head Health Disparities Research Heart Arrest Image Individual Inequity Intervention Intervention Studies Interview Investigation Judgment Knowledge Language Leadership Linear Models Measurement Mediating Mediation Mediator Medical Mentored Patient-Oriented Research Career Development Award Mentors Mentorship Methods Minority Minority Groups National Center for Advancing Translational Sciences National Institute on Minority Health and Health Disparities Not Hispanic or Latino Outcome Parents Patient-Focused Outcomes Patients Perception Physicians Prejudice Questionnaires Race Research Resources Risk Science Scientist Sepsis Severity of illness Stereotyping Stress Uncertainty Unconscious State United States Universities Video Recording Writing behavior change career development cognitive load communication behavior design disorder control disparity reduction effective intervention experience health communication health disparity health literacy high risk implicit bias marginalization minority children multidisciplinary outcome disparities patient oriented pediatric emergency professor prospective provider behavior racial bias racism response self-reported anxiety shared decision making skills social factors unconscious bias

项目摘要

PROJECT SUMMARY/ABSTRACT In the pediatric emergency department, children who belong to racial, ethnic, and language minority groups are less likely to receive interventions such as antibiotics and pain medication. Importantly, minority children are more likely to die of emergency conditions, including sepsis and cardiac arrest. Eliminating inequity requires strategic and rigorous approaches across multiple levels. Dr. Colleen Gutman is an Assistant Professor of Pediatric Emergency Medicine at the University of Florida. Her long-term goal is to become an independently funded physician-scientist with a focus on investigating and implementing strategies to promote equitable, patient-centered pediatric emergency care. Through the support of a KL2 award, Dr. Gutman gained introductory skills in multi-center health disparities research, qualitative analysis, and health communication science. To achieve a successful transition to research independence, Dr. Gutman and her multidisciplinary mentorship team devised a career development plan that builds from that foundation. With this K23 award, Dr. Gutman will develop advanced skills in 1) the identification and measurement of implicit bias, 2) the science of patient-centered communication, 3) advanced mixed methods, 4) academic leadership, and 5) scientific writing. The career development plan will be complemented by mentored research experiences. Using the NIMHD Research Framework, the proposed research seeks to define elements of the physician-parent interaction that contribute to child health disparities. The objective is to define how implicit bias affects physician behavior in the pediatric emergency department. This is a necessary first step that will inform targeted interventions aimed at reducing child health disparities. In Aim 1, Dr. Gutman will use a parent- engaged modified Delphi approach to establish physician behaviors (e.g., assumptions about parent characteristics and access to resources; communication with parents) that may mediate the relationship between physician implicit bias and child health disparities. In Aim 2, she will collect paired questionnaires from pediatric emergency physicians and parents. She will analyze physician-parent response concordance on items evaluating parent characteristics and access to resources. Through this analysis, she will assess for systematic differences in the accuracy of physician assumptions based on parent race, ethnicity, and language. In Aim 3, she will video-record pediatric emergency department encounters to analyze the relationship between physician communication and parent race, ethnicity, and language. Physician behaviors that differ for minority parents may mediate the relationship between physician implicit bias and child health disparities. The findings will inform a multicenter R01 proposal that is fully powered to conduct a mediation analysis assessing the relative importance of the defined behaviors on patient-centered disparities outcomes. Long term, this research will inform targeted interventions to reduce disparities in child health.

项目总结/文摘