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

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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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Authors: Sabin, J. A., & Greenwald, A. G.
Affiliations: University of Washington (US)
ORCID: Sabin, Janice A.
Greenwald, Anthony G.
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: 2026: 21 · 2025: 32 · 2024: 46 · 2023: 48 · 2022: 78 · 2021: 54 · 2020: 53 · 2019: 37 · 2018: 37 · 2017: 34 · 2016: 25 · 2015: 26 · 2014: 19 · 2013: 11 · 2012: 2
FWCI: 61.18
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
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
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › 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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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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