REACH Implicit Bias Training Project

NCT03415308 | Completed Results

• 1 other identifier: Pro00088354
• Study Type: observational
• Target: 114
• Locations: 1 country
• Sites: 1

Brief Summary

The overall goal and theme of the Duke Center for Research to Advance Equity in Healthcare is to reduce racial and ethnic disparities in health through interventions that affect the clinical encounter. To achieve this goal, there is an urgent need for interventions that address implicit bias in healthcare. Implicit bias training is widely used to raise self-awareness and provide self-management tools. The overall objective is to test the hypothesis that implicit bias training for healthcare providers will reduce racial and ethnic disparities in patient- centered care. The proposed project will lay the groundwork for testing that hypothesis by using patient focus groups to garner a deeper understanding of perceptions of implicit bias in the clinical encounter; provider and health system stakeholder semi-structured interviews to inform refinement of the existing implicit bias training at Duke; and perform a pilot study of implicit bias training for providers. At the conclusion of this study, the investigators will have the necessary preliminary data to propose a definitive trial to determine the impact of an implicit bias training intervention for providers on racial and ethnic disparities in patient-centered care. This research will ultimately lead to the delivery of equitable, evidence-based, patient-centered care for all.

Conditions

Communication; Bias, Racial; Relation, Doctor Patient

Keywords

Implicit Bias; Healthcare Equity

Outcome Measures

Primary Outcomes (2)

• Feasibility of Training Measured by Participation

  Investigators will judge the trial as feasible if at least 50% of eligible providers agree to participate.

  4 hours (post-training)

• Acceptability

  At least 80% of those enrolled complete the trial (attend both sessions); and achieve at least 75% adherence to all intervention activities and exercises.

  4 hours (post-training)

Secondary Outcomes (2)

• Variability in Any Trial Outcomes by Provider-related Characteristics

  4 hours (post-training)

• Change in IAT Outcomes From Baseline to Immediately Post-intervention

  baseline, 4 hours (post-training)

Study Arms (3)

Patient Focus Groups

Identify patient preferences for constructs, and related outcomes, that reflect the expression of implicit bias in clinical encounters. I

Other: Focus Groups

Stakeholders Cognitive Interviews

Investigators will conduct a series of semi-structured interviews.

Other: Cognitive Interviews

Pilot Testing of Implicit Bias Training

Refined intervention emerging from Aim 2. T

Other: Pilot Testing of Implicit Bias Training

Interventions

Focus Groups OTHER

Investigators will use qualitative methods to gather data on the elements associated with the patient perception of implicit bias (e.g. communication, respect, patient-centeredness) to ensure that our selected outcomes reflect the breadth of patients' concerns.

Patient Focus Groups

Cognitive Interviews OTHER

To gather insights from stakeholders regarding how to best refine the design of our existing implicit bias intervention to ensure that we have addressed potential facilitators and barriers to uptake, use, and sustainability

Stakeholders Cognitive Interviews

Pilot Testing of Implicit Bias Training OTHER

Determine the feasibility of delivering the refined implicit bias reduction intervention and assessing patient centered outcomes by giving providers a refined implicit bias training.

Pilot Testing of Implicit Bias Training

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

For Aim 1, investigators will use the community population. Aims 2 and 3 focus specifically on providers and stakeholders at Duke medical center.

You may qualify if:

• Aim 1:
• Had at least 2 non-urgent ambulatory care visits any Healthcare facility in the past year (via self-report)
• Proficient in English
• Aim 2:
• Providers from Durham-based ambulatory clinics in the Duke Health System or Stakeholder
• Aim 3:
• Providers from the Duke Health System providing care to a continuity patient panel.

You may not qualify if:

• Aim 1:
• Less than 2 non-urgent visits
• Patient not identifying as black, white or Hispanic
• Non-English speaking
• Aim 2:
• Not a Duke provider or stakeholder
• Aim 3:
• Not a Duke Health system provider/affiliated provider
• Does not provide clinical care at a Duke affiliated facility

Sponsors & Collaborators

• Duke University: lead

Study Sites (1)

Duke University

Durham, North Carolina, 27710, United States

Location

Related Publications (1)

• Svetkey LP, Bennett GG, Reese B, Corsino L, Pinheiro SO, Fischer JE, Seidenstein J, Olsen MK, Brown T, Ezem N, Liu E, Majors A, Steinhauser KE, Sullivan BH, van Ryn M, Wilson SM, Yang H, Johnson KS. Design and pilot test of an implicit bias mitigation curriculum for clinicians. Front Med (Lausanne). 2024 Jun 6;11:1316475. doi: 10.3389/fmed.2024.1316475. eCollection 2024.

  PMID: 38903809 DERIVED

MeSH Terms

Conditions

Communication; Racism; Bias, Implicit

Interventions

Focus Groups

Condition Hierarchy (Ancestors)

Behavior; Prejudice; Social Behavior; Social Discrimination

Intervention Hierarchy (Ancestors)

Data Collection; Epidemiologic Methods; Investigative Techniques; Health Care Evaluation Mechanisms; Quality of Health Care; Health Care Quality, Access, and Evaluation; Public Health; Environment and Public Health

Results Point of Contact

• Title: Alesha Majors
• Organization: Duke Center for Research to Advance Healthcare Equity

alesha.majors@duke.edu

919-660-7545

Study Officials

• Gary G Bennett, Ph.D

  Duke University

  PRINCIPAL INVESTIGATOR

• Kimberly S Johnson, MD

  Duke University

  STUDY DIRECTOR

• Laura P Svetkey, MD

  Duke University

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: OTHER
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: January 23, 2018
• First Posted: January 30, 2018
• Study Start: April 18, 2018
• Primary Completion: June 1, 2022
• Study Completion: June 1, 2022
• Last Updated: March 18, 2024
• Results First Posted: March 18, 2024

Record last verified: 2024-03

Locations

US (1)