PDF(Pubmed)
Abstract：
UNASSIGNED: Clinician implicit racial bias (IB) may lead to lower quality care and adverse health outcomes for Black patients. Educational efforts to train clinicians to mitigate IB vary widely and have insufficient evidence of impact. We developed and pilot-tested an evidence-based clinician IB curriculum, \"REACHing Equity.\"
UNASSIGNED: To assess acceptability and feasibility, we conducted an uncontrolled one-arm pilot trial with post-intervention assessments. REACHing Equity is designed for clinicians to: (1) acquire knowledge about IB and its impact on healthcare, (2) increase awareness of one\'s own capacity for IB, and (3) develop skills to mitigate IB in the clinical encounter. We delivered REACHing Equity virtually in three facilitated, interactive sessions over 7-9 weeks. Participants were health care providers who completed baseline and end-of-study evaluation surveys.
UNASSIGNED: Of approximately 1,592 clinicians invited, 37 participated, of whom 29 self-identified as women and 24 as non-Hispanic White. Attendance averaged 90% per session; 78% attended all 3 sessions. Response rate for evaluation surveys was 67%. Most respondents agreed or strongly agreed that the curriculum objectives were met, and that REACHing Equity equipped them to mitigate the impact of implicit bias in clinical care. Participants consistently reported higher self-efficacy for mitigating IB after compared to before completing the curriculum.
UNASSIGNED: Despite apparent barriers to clinician participation, we demonstrated feasibility and acceptability of the REACHing Equity intervention. Further research is needed to develop objective measures of uptake and clinician skill, test the impact of REACHing Equity on clinically relevant outcomes, and refine the curriculum for uptake and dissemination.ClinicalTrials.gov ID: NCT03415308.
UNASSIGNED: To assess acceptability and feasibility, we conducted an uncontrolled one-arm pilot trial with post-intervention assessments. REACHing Equity is designed for clinicians to: (1) acquire knowledge about IB and its impact on healthcare, (2) increase awareness of one\'s own capacity for IB, and (3) develop skills to mitigate IB in the clinical encounter. We delivered REACHing Equity virtually in three facilitated, interactive sessions over 7-9 weeks. Participants were health care providers who completed baseline and end-of-study evaluation surveys.
UNASSIGNED: Of approximately 1,592 clinicians invited, 37 participated, of whom 29 self-identified as women and 24 as non-Hispanic White. Attendance averaged 90% per session; 78% attended all 3 sessions. Response rate for evaluation surveys was 67%. Most respondents agreed or strongly agreed that the curriculum objectives were met, and that REACHing Equity equipped them to mitigate the impact of implicit bias in clinical care. Participants consistently reported higher self-efficacy for mitigating IB after compared to before completing the curriculum.
UNASSIGNED: Despite apparent barriers to clinician participation, we demonstrated feasibility and acceptability of the REACHing Equity intervention. Further research is needed to develop objective measures of uptake and clinician skill, test the impact of REACHing Equity on clinically relevant outcomes, and refine the curriculum for uptake and dissemination.ClinicalTrials.gov ID: NCT03415308.
摘要：
■临床医生内隐种族偏见（IB）可能会导致黑人患者的低质量护理和不良健康结果。培训临床医生减轻IB的教育工作差异很大，影响证据不足。我们开发并试点测试了基于证据的临床医生IB课程，“实现公平。\"
■为了评估可接受性和可行性，我们进行了一项不受控制的单臂试点试验,并进行了干预后评估.实现公平是为临床医生设计的：（1）获得关于IB及其对医疗保健的影响的知识，(2)提高对自己能力的认识，(3)在临床接触中发展减轻IB的技能。我们几乎在三个促进中交付了实现股权，互动会议超过7-9周。参与者是完成基线和研究结束评估调查的医疗保健提供者。
■邀请了大约1,592名临床医生，37人参加,其中29人自称是女性，24人是非西班牙裔白人。平均每节出席率为90％；78％参加了所有3次会议。评估调查的反应率为67%。大多数受访者同意或强烈同意达到课程目标，并且达到公平使他们能够减轻隐性偏见在临床护理中的影响。与完成课程之前相比，参与者一致报告在减轻IB方面的自我效能感更高。
■尽管临床医生参与存在明显障碍，我们证明了实现公平干预的可行性和可接受性。需要进一步的研究来制定摄取和临床医师技能的客观指标，测试达到公平性对临床相关结果的影响，并完善课程以进行吸收和传播。ClinicalTrials.govID：NCT03415308。
■为了评估可接受性和可行性，我们进行了一项不受控制的单臂试点试验,并进行了干预后评估.实现公平是为临床医生设计的：（1）获得关于IB及其对医疗保健的影响的知识，(2)提高对自己能力的认识，(3)在临床接触中发展减轻IB的技能。我们几乎在三个促进中交付了实现股权，互动会议超过7-9周。参与者是完成基线和研究结束评估调查的医疗保健提供者。
■邀请了大约1,592名临床医生，37人参加,其中29人自称是女性，24人是非西班牙裔白人。平均每节出席率为90％；78％参加了所有3次会议。评估调查的反应率为67%。大多数受访者同意或强烈同意达到课程目标，并且达到公平使他们能够减轻隐性偏见在临床护理中的影响。与完成课程之前相比，参与者一致报告在减轻IB方面的自我效能感更高。
■尽管临床医生参与存在明显障碍，我们证明了实现公平干预的可行性和可接受性。需要进一步的研究来制定摄取和临床医师技能的客观指标，测试达到公平性对临床相关结果的影响，并完善课程以进行吸收和传播。ClinicalTrials.govID：NCT03415308。
