Investigating Unconscious Race Bias and Bias Awareness Among Vascular Surgeons.

Autor:	Howard KA; Department of Public Health Sciences, Clemson University, Clemson, SC.; Center for Public Health Modeling and Response, Clemson University, Clemson, SC., Witrick B; Department of Public Health Sciences, Clemson University, Clemson, SC., Clark A; Center for Survey Research and O'Neill School of Public and Environmental Affairs, Indiana University-Bloomington, Bloomington, IN., Morse A; Department of Public Health Sciences, Clemson University, Clemson, SC., Atkinson K; Department of Public Health Sciences, Clemson University, Clemson, SC., Kapoor P; Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, IN., McGinigle KL; Department of Surgery, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill NC., Minc S; Department of Cardiovascular and Thoracic Surgery, West Virginia School of Medicine, Morgantown, WV., Alabi O; Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Emory University School of Medicine, Atlanta, GA., Hicks CW; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD., Gonzalez A; Department of Surgery, School of Medicine, Indiana University School of Medicine; Indianapolis, IN.; Center for Health Services Research, Regenstrief Institute., Cené CW; Department of Medicine, University of California at San Diego Health, La Jolla, CA., Cykert S; Division of General Medicine and Clinical Epidemiology, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill NC., Kalbaugh CA; Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, IN.
Jazyk:	angličtina
Zdroj:	MedRxiv : the preprint server for health sciences [medRxiv] 2024 Jun 05. Date of Electronic Publication: 2024 Jun 05.
DOI:	10.1101/2024.06.04.24308457
Abstrakt:	Background: Implicit bias can influence behavior and decision-making. In clinical settings, implicit bias may influence treatment decisions and contribute to health disparities. Given documented Black-White disparities in vascular care, the purpose of this study was to examine the prevalence and degree of unconscious bias and awareness of bias among vascular surgeons treating peripheral artery disease (PAD). Methods: The sampling frame included all vascular surgeons who participate in the Vascular Quality Initiative (VQI). Participants completed a survey which included demographic questions, the race implicit association test (IAT) to measure magnitude of unconscious bias, and six bias awareness questions to measure conscious bias. The magnitude of unconscious bias was no preference; or slight, moderate, or strong in the direction of pro-White or pro-Black. Data from participants were weighted to account for nonresponse bias and known differences in the characteristics of surgeons who chose to participate compared to the full registry. We stratified unconscious and conscious findings by physician race/ethnicity, physician sex, and years of experience. Finally, we examined the relationship between unconscious and conscious bias. Results: There were 2,512 surgeons in the VQI registry, 304 of whom completed the survey, including getting IAT results. Most participants (71.6%) showed a pro-White bias with 73.0% of this group in the moderate and strong categories. While 77.5% of respondents showed conscious awareness of bias, of those whose conscious results showed lack of awareness, 67.8% had moderate or strong bias, compared to 55.7% for those with awareness. Bias magnitude varied based on physician race/ethnicity and years of experience. Women were more likely than men to report awareness of biases and potential impact of bias on decision-making. Conclusions: Most people have some level of unconscious bias, developed from early life reinforcements, social stereotypes, and learned experiences. Regarding health disparities, however, these are important findings in a profession that takes care of patients with PAD due to heavy burden of comorbid conditions and high proportion of individuals from structurally vulnerable groups. Given the lack of association between unconscious and conscious awareness of biases, awareness may be an important first step in mitigation to minimize racial disparities in healthcare.
Databáze:	MEDLINE
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