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Cited by 525Racial and Ethnic Identity ResearchDiversity and Career in MedicineCultural Competency in Health Care

The Influence of Implicit Bias on Treatment Recommendations for 4 Common Pediatric Conditions: Pain, Urinary Tract Infection, Attention Deficit Hyperactivity Disorder, and Asthma

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Sabin, Janice A., Greenwald, Anthony G.·2012·American Journal of Public Health
DOI 10.2105/ajph.2011.300621PMC PMC3483921
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Abstract

Objectives. We examined the association between pediatricians’ attitudes about race and treatment recommendations by patients’ race. Methods. We conducted an online survey of academic pediatricians (n = 86). We used 3 Implicit Association Tests to measure implicit attitudes and stereotypes about race. Dependent variables were recommendations for pain management, urinary tract infections, attention deficit hyperactivity disorder, and asthma, measured by case vignettes. We used correlational analysis to assess associations among measures and hierarchical multiple regression to measure the interactive effect of the attitude measures and patients’ race on treatment recommendations. Results. Pediatricians’ implicit (unconscious) attitudes and stereotypes were associated with treatment recommendations. The association between unconscious bias and patient’s race was statistically significant for prescribing a narcotic medication for pain following surgery. As pediatricians’ implicit pro-White bias increased, prescribing narcotic medication decreased for African American patients but not for the White patients. Self-reported attitudes about race were associated with some treatment recommendations. Conclusions. Pediatricians’ implicit attitudes about race affect pain management. There is a need to better understand the influence of physicians’ unconscious beliefs about race on pain and other areas of care.

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  • Eight articles appeared to refer to the same data collected in a single cross-country comparison study, and a further two articles analysed the same data.

    “eight articles appeared to refer to the same data collected in a single cross-country comparison study [27–32, 34, 35] and a further two articles analysed the same data [45, 47].”

    From Implicit bias in healthcare professionals: a systematic review (2017) · cites this paper as [45]

    The Methods (page unavailable) say this paper collected its own survey data from pediatricians in one department at an urban research university, rather than from a cross-country comparison study. The paper also does not identify eight articles referring to that dataset or two further articles analysing it. (LLM, conf=0.85)

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  • Four studies examining the correlation between IAT scores and responses to clinical vignettes found a significant correlation between high levels of pro-white implicit bias and treatment responses that favoured patients specified as white.

    “Four studies examining the correlation between IAT scores and responses to clinical vignettes found a significant correlation between high levels of pro-white implicit bias and treatment responses that favoured patients specified as white [42, 45–47].”

    From Implicit bias in healthcare professionals: a systematic review (2017) · cites this paper as [45]

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Authors
Sabin, J. A., & Greenwald, A. G.
Affiliations
University of Washington (US)
ORCID
Venue
American Journal of Public Health
Publisher
American Public Health Association
Published
2012-05
Volume
102
Issue
5
Pages
988-995
ISSN
  • 0090-0036 (ISSN-L)
  • 1541-0048
DOI
10.2105/ajph.2011.300621
PMC
PMC3483921
OpenAlex
W2078029714
Cited by
525
References
0
Citations by year
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FWCI
61.18
Type
journal article
Language
en
Open access
Locations
  • American Journal of Public Health (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • American Journal of Public Health
Funders
  • University of Washington
  • Agency for Healthcare Research and Quality (R36 HS015676, 1-R36HS1576-01)
  • National Institute of Mental Health (T32MH20010, T32MH020010)
Topics
  • Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
  • Social Sciences › Gender Studies › Diversity and Career in Medicine
  • Social Sciences › Sociology and Political Science › Cultural Competency in Health Care
Keywords
implicit bias, racial bias in medicine, pediatricians, treatment guidelines, pain management, urinary tract infection, attention deficit hyperactivity disorder, asthma, racial disparities, African American patients, opioid prescribing, Implicit Association Test, racial stereotypes
MeSH terms
Central Nervous System Stimulants, Analgesics, Opioid, Asthma, Attention Deficit Disorder with Hyperactivity, Attitude of Health Personnel, Black or African American, Counseling, Female, Health Services Research, Humans, Male, Pediatrics, Prejudice, Referral and Consultation, Stereotyping, Urinary Tract Infections, White People, Healthcare Disparities, Pain Management

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