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Racial implicit biases among obstetric care providers and associated differential care

BACKGROUND: The mechanisms of disparities in maternal and perinatal health between migrant and native women are multiple and remain poorly understood. One hypothesis is the existence of implicit biases among caregivers through which the women's ethno-racial belonging can influence medical decis...

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Autores principales: Azria, E, Sauvegrain, P, Anselem, O, Bonnet, M P, Deneux-Tharaux, C, Fischer, C, Rousseau, A, Richetin, J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10595713/
http://dx.doi.org/10.1093/eurpub/ckad160.339
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author Azria, E
Sauvegrain, P
Anselem, O
Bonnet, M P
Deneux-Tharaux, C
Fischer, C
Rousseau, A
Richetin, J
author_facet Azria, E
Sauvegrain, P
Anselem, O
Bonnet, M P
Deneux-Tharaux, C
Fischer, C
Rousseau, A
Richetin, J
author_sort Azria, E
collection PubMed
description BACKGROUND: The mechanisms of disparities in maternal and perinatal health between migrant and native women are multiple and remain poorly understood. One hypothesis is the existence of implicit biases among caregivers through which the women's ethno-racial belonging can influence medical decisions and engender healthcare disparities. Their existence and their role in the generation of non-medically justified differential care is being more and more documented in the United States but remains largely unexplored in Europe. OBJECTIVES: The aims of the BiP research program are to test and quantify the existence of implicit biases toward African migrant women among obstetric care providers and to explore the association between implicit biases and differential care. STUDY DESIGN: This study is a national web-based survey to which French obstetricians, midwives, and anesthetists were invited to take part by eight professional societies and networks. The potential existence of implicit biases toward African versus French was quantified through Implicit Association Tests (IAT) for valence and strength. The association between implicit biases and clinical decisions was then assessed using six clinical vignettes. For each, the patient's origin, African/French, was suggested by using typical surnames. RESULTS: The survey was completed by 887 professionals. The IATs showed that caregivers in the three professional categories had strong implicit biases with a preference for French versus African women in terms of valence, while they implicitly tended to attribute more strength to African women. We did not observe any association between Patient's name (French vs. African), caregiver's biases (implicit valence or strength) and the behavioral intention captured through vignettes responses. CONCLUSIONS: This study shows a high level of implicit racial biases among obstetric care providers, but these biases were not associated with differential clinical decisions. KEY MESSAGES: • This study shows a high level of racial implicit bias among healthcare providers. • No association between implicit bias and clinical behavioral intentions were observed.
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spelling pubmed-105957132023-10-25 Racial implicit biases among obstetric care providers and associated differential care Azria, E Sauvegrain, P Anselem, O Bonnet, M P Deneux-Tharaux, C Fischer, C Rousseau, A Richetin, J Eur J Public Health Parallel Programme BACKGROUND: The mechanisms of disparities in maternal and perinatal health between migrant and native women are multiple and remain poorly understood. One hypothesis is the existence of implicit biases among caregivers through which the women's ethno-racial belonging can influence medical decisions and engender healthcare disparities. Their existence and their role in the generation of non-medically justified differential care is being more and more documented in the United States but remains largely unexplored in Europe. OBJECTIVES: The aims of the BiP research program are to test and quantify the existence of implicit biases toward African migrant women among obstetric care providers and to explore the association between implicit biases and differential care. STUDY DESIGN: This study is a national web-based survey to which French obstetricians, midwives, and anesthetists were invited to take part by eight professional societies and networks. The potential existence of implicit biases toward African versus French was quantified through Implicit Association Tests (IAT) for valence and strength. The association between implicit biases and clinical decisions was then assessed using six clinical vignettes. For each, the patient's origin, African/French, was suggested by using typical surnames. RESULTS: The survey was completed by 887 professionals. The IATs showed that caregivers in the three professional categories had strong implicit biases with a preference for French versus African women in terms of valence, while they implicitly tended to attribute more strength to African women. We did not observe any association between Patient's name (French vs. African), caregiver's biases (implicit valence or strength) and the behavioral intention captured through vignettes responses. CONCLUSIONS: This study shows a high level of implicit racial biases among obstetric care providers, but these biases were not associated with differential clinical decisions. KEY MESSAGES: • This study shows a high level of racial implicit bias among healthcare providers. • No association between implicit bias and clinical behavioral intentions were observed. Oxford University Press 2023-10-24 /pmc/articles/PMC10595713/ http://dx.doi.org/10.1093/eurpub/ckad160.339 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of the European Public Health Association. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Parallel Programme
Azria, E
Sauvegrain, P
Anselem, O
Bonnet, M P
Deneux-Tharaux, C
Fischer, C
Rousseau, A
Richetin, J
Racial implicit biases among obstetric care providers and associated differential care
title Racial implicit biases among obstetric care providers and associated differential care
title_full Racial implicit biases among obstetric care providers and associated differential care
title_fullStr Racial implicit biases among obstetric care providers and associated differential care
title_full_unstemmed Racial implicit biases among obstetric care providers and associated differential care
title_short Racial implicit biases among obstetric care providers and associated differential care
title_sort racial implicit biases among obstetric care providers and associated differential care
topic Parallel Programme
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10595713/
http://dx.doi.org/10.1093/eurpub/ckad160.339
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