Clinical trial NCT04180956: Addressing Microaggressions in Racially Charged Patient-provider Interactions: A Pilot Randomized Trial
Official title: Reducing Racial Disparities in Healthcare: Developing Social Connections Through Behavioral Science
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Racism
Lead sponsor: University of Washington
Sponsor class: OTHER
Collaborators: name: Bastyr University
First posted: 2019-11-29
Enrollment: 25
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: This is a randomized controlled trial, wherein doctors are prospectively assigned to either an intervention or waitlist control condition.
Primary purpose: SUPPORTIVE_CARE

Brief summary: Racial bias in medical care is a significant public health issue, with increased focus on microaggressions and the quality of patient-provider interactions. Innovations in training interventions are needed to decrease microaggressions and improve provider communication and rapport with patients of color during medical encounters. This paper presents a pilot randomized trial of an innovative clinical workshop that employed a theoretical model from social and contextual behavioral sciences. The intervention was largely informed by research on the importance of mindfulness and interracial contact involving reciprocal exchanges of vulnerability and responsiveness, to target processes centered on the providers' likelihood of expressing biases and negative stereotypes when interacting with patients of color in racially challenging moments. Twenty-five medical student and recent graduate participants were randomized to a workshop intervention or no intervention. Outcomes were measured via provider self-report and observed changes in targeted provider behaviors. Specifically, two independent, blind teams of coders assessed provider emotional rapport and responsiveness during simulated interracial patient encounters with standardized Black patients who presented specific racial challenges to participants. We observed greater improvements in observed emotional rapport and responsiveness (indexing fewer microaggressions), improved self-reported explicit attitudes toward minoritized groups, and improved self-reported working alliance and closeness with the Black standardized patients were observed and reported by intervention participants. Effects largely were driven by improvements by the White participants.


Eligibility criteria: Inclusion Criteria:

* Medical students or recent graduates of Bastyr University.

Exclusion Criteria:

* None

Primary outcomes:
measure: Change in Emotional Rapport Building from Pre- to Post-Intervention
timeFrame: Pre-test occurred on Day 1, the Intervention occurred Day 2, and then post-test occurred Day 4ater after the intervention
measure: Change in responsiveness to racial challenges from Pre- to Post-Intervention
timeFrame: Pre-test occurred on Day 1, the Intervention occurred Day 2, and then post-test occurred Day 4ater after the intervention
Secondary outcomes:
measure: Change in offensiveness from Pre- to Post-Intervention
timeFrame: Pre-test occurred on Day 1, the Intervention occurred Day 2, and then post-test occurred Day 4
measure: Change in Bias from Pre- to Post-Intervention
timeFrame: Pre-test occurred on Day 1, the Intervention occurred Day 2, and then post-test occurred Day 4
measure: Change in Recommendations from Pre- to Post-Intervention
timeFrame: Pre-test occurred on Day 1, the Intervention occurred Day 2, and then post-test occurred Day 4
measure: Change in Patient experience from Pre- to Post-Intervention
timeFrame: Pre-test occurred on Day 1, the Intervention occurred Day 2, and then post-test occurred Day 4
measure: Change in Ethnocultural empathy from Pre- to Post-Intervention
timeFrame: Pre-test occurred on Day 1, the Intervention occurred Day 2, and then post-test occurred Day 4
measure: Change in attitudes toward various ethnic/racial groups from Pre- to Post-Intervention
timeFrame: Pre-test occurred during screening, between 5 days and 4 months prior to Intervention; post-test occurred two days after intervention.
measure: Change in Working alliance from Pre- to Post-Intervention
timeFrame: Pre-test occurred on Day 1, the Intervention occurred Day 2, and then post-test occurred Day 4
measure: Change in Interaction closeness from Pre- to Post-Intervention
timeFrame: Pre-test occurred on Day 1, the Intervention occurred Day 2, and then post-test occurred Day 4
Other outcomes:
Locations:
city: Seattle
country: United States
facility: Bastyr University Seattle Clinic
state: Washington
Study officials:
affiliation: University of Washington
name: Jonathan Kanter, Ph.D.
role: PRINCIPAL_INVESTIGATOR
References: