The current proposal seeks support for research on the role of implicit or unconscious stereotyping in the unequal treatment of Hispanics who seek healthcare. Research in social psychology on prejudice, stereotyping and discrimination shows that while many biases are conscious and deliberate, the expression of bias is often unintentional because people hold negative attitudes and stereotypes at an implicit or unconscious level. Thus, implicit biases may leak into the way health professionals acquire information, diagnose, and treat Hispanic patients, but the impact of implicit bias can also be mitigated by training health care providers to control their implicit biases, and by empowering Hispanic patients to use strategies that will deactivate the implicit biases held by their health care providers. The proposed research translates basic theory and methodology from the social psychological study of implicit stereotyping to achieve two broad goals for reducing bias against Hispanic patients: First, two experiments will examine the degree to which medical and nursing students hold the conscious and unconscious negative stereotype that Hispanic patients do not comply with diagnosis and treatment recommendations. Two experiments will examine how factors like fatigue and cognitive load moderate the implicit activation of the negative stereotype about Hispanic patients, and how the implicit activation of the stereotype mediates the acquisition of information, diagnosis and treatment of a Hispanic patient. Secondly, the research will develop and test new approaches to cultural competency and health literacy that can reduce implicit stereotyping of Hispanic patients. One project will test the effectiveness of a workshop to teach medical and nursing students about the psychology of implicit stereotyping and provide them strategies, like perspective taking, egalitarian goal activation, and collecting counter-stereotypic information that reduce the activation of implicit stereotypes. Another project will test the impact of patient-delivered strategies for inducing perspective taking, priming egalitarian goals, and providing counter-stereotypic information that reduce the activation of implicit stereotypes in a health care provider. The results of these studies will take significant steps toward understanding and reducing the role of unconscious stereotyping in the care provided to Hispanic patients. Involving both health care providers and Hispanic patients in the bias reduction process has the potential to enhance the health care provider's use of cultural competency and improve the Hispanic patient's participation in their care. Both of these outcomes, in turn, can improve communication between provider and patient, which will lead to better diagnosis and treatment recommendations for patients, and enhanced health literacy efficacy in Hispanic patients.

Public Health Relevance

This R01 award will support research on the role that unconscious stereotyping plays in creating health disparities for Hispanics who seek health care in a border state like Arizona. The award will support six studies over three years to examine how unconscious stereotypes leak into the way health professionals acquire information, diagnose, and treat Hispanic patients, and on how unconscious stereotyping can be reduced by training health care providers to control their implicit biases, and by empowering Hispanic patients to use strategies that deactivate the unconscious stereotypes held by health care providers. ) )

Agency
National Institute of Health (NIH)
Institute
National Institute on Minority Health and Health Disparities (NIMHD)
Type
Research Project (R01)
Project #
5R01MD005902-02
Application #
8241641
Study Section
Special Emphasis Panel (ZMD1-MLS (01))
Program Officer
Alvidrez, Jennifer L
Project Start
2011-06-01
Project End
2014-05-31
Budget Start
2012-06-01
Budget End
2013-05-31
Support Year
2
Fiscal Year
2012
Total Cost
$377,486
Indirect Cost
$73,715
Name
University of Arizona
Department
Psychology
Type
Schools of Arts and Sciences
DUNS #
806345617
City
Tucson
State
AZ
Country
United States
Zip Code
85721
Bean, Meghan G; Covarrubias, Rebecca; Stone, Jeff (2014) How Hispanic Patients Address Ambiguous versus Unambiguous Bias in the Doctor's Office. J Appl Soc Psychol 44:693-707
Bean, Meghan G; Stone, Jeff; Moskowitz, Gordon B et al. (2013) Evidence of nonconscious stereotyping of Hispanic patients by nursing and medical students. Nurs Res 62:362-7
Moskowitz, Gordon B; Stone, Jeff; Childs, Amanda (2012) Implicit stereotyping and medical decisions: unconscious stereotype activation in practitioners' thoughts about African Americans. Am J Public Health 102:996-1001