: Racial disparities are pervasive throughout medicine and there is a desperate need for research into effective ways to counteract these trends. Through the use of the intervention developed herein, inroads can be made that will impact all areas of medicine. This proposal will lead to an R01 application to further study quality improvement in the diagnosis of child abuse. Abusive head trauma is a significant cause of morbidity and mortality for young children. It has been clearly demonstrated that child abuse is diagnosed and reported to child protective services differentially based on race. Further, an extensive body of research shows that physicians use non-malicious, unconscious racial stereotypes in their clinical decision-making. The objective of this proposal is to explore the impact of unconscious racial stereotypes on physicians' recognition and clinical recall in the diagnosis of potential abusive head trauma (AHT). The central hypothesis for this project is that physicians use patient race as a decision-point for evaluation of possible AHT, specifically physicians are more likely to recognize possible indicators of AHT in minority race children ? and less likely to interpret these same signs as AHT in White children resulting in missed cases. The ? research aims of this project are (1) Develop a tool that will demonstrate the influence of unconscious racial stereotypes on physicians' diagnosis and information recall in cases of potential abusive head trauma, (2) Using qualitative research techniques develop and pilot test an educational intervention to decrease the effect of physicians' unconscious stereotypes on the decision to evaluate for abusive head trauma (3) Using the novel intervention developed in Aim 2, pilot test the effectiveness of reducing unconscious racial stereotypes in physicians' diagnosis in cases of possible abusive head trauma.
Specific Aim 1 will be a web-based randomized controlled study of physicians to study the effect of race on diagnosis and recall of clinical information.
Specific Aim 2 will test an intervention designed to raise awareness of unconscious racial stereotypes and use qualitative analysis with clinicians to develop a strategy to ameliorate the effect on future decision-making.
Specific Aim 3 will be refinement and testing of this intervention and its effects on physicians' decision-making behavior in order to gather important data needed to develop a successful R01 application. ? ? ?
| Laskey, Antoinette L; Stump, Timothy E; Perkins, Susan M et al. (2012) Influence of race and socioeconomic status on the diagnosis of child abuse: a randomized study. J Pediatr 160:1003-8.e1 |
