Pain Treatment Decisions: Influence of Sex, Race, and Age

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DESCRIPTION (provided by applicant): The proposed project is designed to investigate the relative contributions of gender, race and ethnicity, and age to health care providers decisions about pain treatment. Considerable anecdotal and correlational data suggest that men and women receive different treatment for a variety of pain conditions. Similarly, there are disparities in the treatment of different racial groups with respect to pain treatment. Published data and our pilot research have shown that older pain sufferers may be less likely to receive pain medication compared to younger patients. The application represents a competing renewal of our "Sex vs. Gender in Pain Perception" grant which demonstrated that social learning, particularly gender-related stereotypes and expectations about pain were powerful determinants of sex differences in pain responding. We also demonstrated that these gender-related expectations influenced the perception of others' pain. We propose to employ an innovative LENS model approach, delivered via the internet, to capture the decision policies of dentists, nurses, and physicians who will make decisions about multimedia case vignettes of "Virtual Humans" with different presentations of pain. The LENS model methodology will allow for the determination of an individual's or group's statistically reliable predictors of the decisions about pain treatment. The innovative, "Virtual Human", Web-based delivery system will allow for the recruitment of larger sample sizes with sufficient representation of sexes, and racial groups for statistical analyses of differences between them. By employing a facial expression coding system we will be able to standardize the degree of pain expression across gender, age, and race. Systematic variability in decisions about pain treatment will therefore be a function of the health care provider's predisposition to use sex, race, and age cues in making decisions about pain. This methodology will allow for an examination of the contribution of these key variables and tests of specific hypotheses about social learning influences on provider's treatment decisions. The research addresses the public health need to understand, recognize and change gender, race, and age disparities in the assessment and treatment of pain. The results will have direct implications for treatment and the training of health care professionals, particularly in the assessment of gender, race, and age in their decisions about pain treatment. PUBLIC HEALTH RELEVANCE: The research addresses the public health need to understand, recognize and change gender, race, and age biases in the assessment and treatment of pain. The results will have direct implications for treatment and the training of health care professionals, particularly in the assessment of gender, race, and age biases in their decisions about pain treatment.