The primary aim of the proposed study is to use an experimental design to test the degree to which a self-affirmation intervention protects and improves the mental health of Black medical students. This study is part of a larger program of research intended to reduce racial disparities in health care by reducing bias in White medical students, and is driven by a sizeable gap in the evidence base regarding ways to improve the recruitment and increase the success and retention of Black medical professionals. Minority patients benefit from a diverse pool of medical professionals, and The Institute on Medicine's report on Unequal Treatment recommended increasing the number of Black physicians as one way to reduce disparities. Yet, preliminary evidence suggests that, from the start of medical school, Black medical students are more likely than their White counterparts to experience a number of vulnerabilities including discrimination and stereotype threat (a psychological state with proven deleterious effects that is created by awareness that one's group may be judged negatively because of a stereotype). The unique stressors experienced by Black medical students may contribute to disparities on medical student health outcomes. Furthermore, stress is among the contributors to documented negative changes over the course of medical school including increased cynicism, reduced empathy, reduced idealism, and less importance placed in forming interpersonal relationships with patients and on providing care for the medically underserved. There have been very few methodologically rigorous tests of strategies for protecting and promoting the well-being of Black medical students. This study will determine whether a self-affirmation intervention is effective at reducing stereotype threat and improving the psychological well- being of Black medical students. The intervention being tested here would provide a low-cost and easy-to-implement strategy for improving Black students'well-being. Findings from this study will help with future intervention strategies to increase underrepresented medical students'psychological well-being and quality of care for the underserved.

Public Health Relevance

We will use an experimental design to examine the impact of a self-affirmation intervention, a low-cost and easy-to-implement strategy with proven benefits for Black high school and college students ,on the well-being of two distinct groups of Black medical students-students attending 1) predominately White medical schools (PWS), and 2) historically Black medical colleges (HBMC). Findings from this study will guide future intervention strategies to increase underrepresented medical students'psychological well-being.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Exploratory/Developmental Grants (R21)
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Health Disparities and Equity Promotion Study Section (HDEP)
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Haverkos, Lynne
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Yale University
Schools of Arts and Sciences
New Haven
United States
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Khosla, Natalia N; Perry, Sylvia P; Moss-Racusin, Corinne A et al. (2018) A comparison of clinicians' racial biases in the United States and France. Soc Sci Med 206:31-37
Perry, Sylvia P; Hardeman, Rachel; Burke, Sara E et al. (2016) The Impact of Everyday Discrimination and Racial Identity Centrality on African American Medical Student Well-Being: a Report from the Medical Student CHANGE Study. J Racial Ethn Health Disparities 3:519-26