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How is physicians’ implicit prejudice against the obese and mentally ill moderated by specialty and experience?
BACKGROUND: Implicit prejudice can lead to disparities in treatment. The effects of specialty and experience on implicit obesity and mental illness prejudice had not been explored. The main objective was to examine how specializing in psychiatry/general medicine and years of experience moderated imp...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9400557/ https://www.ncbi.nlm.nih.gov/pubmed/36002822 http://dx.doi.org/10.1186/s12910-022-00815-7 |
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author | FitzGerald, Chloë Mumenthaler, Christian Berner, Delphine Schindler, Mélinée Brosch, Tobias Hurst, Samia |
author_facet | FitzGerald, Chloë Mumenthaler, Christian Berner, Delphine Schindler, Mélinée Brosch, Tobias Hurst, Samia |
author_sort | FitzGerald, Chloë |
collection | PubMed |
description | BACKGROUND: Implicit prejudice can lead to disparities in treatment. The effects of specialty and experience on implicit obesity and mental illness prejudice had not been explored. The main objective was to examine how specializing in psychiatry/general medicine and years of experience moderated implicit obesity and mental illness prejudice among Swiss physicians. Secondary outcomes included examining the malleability of implicit bias via two video interventions and a condition of cognitive load, correlations of implicit bias with responses to a clinical vignette, and correlations with explicit prejudice. METHODS: In stage 1, participants completed an online questionnaire including a clinical vignette. In stage 2, implicit prejudice pre- and post- intervention was tested using a 4 × 4 between-subject design including a control group. In stage 3, explicit prejudice was tested with feeling thermometers and participants were debriefed. Participants were 133 psychiatrists and internists working in Geneva, hospital-based and private practice. Implicit prejudice was assessed using a Weight IAT (Implicit Association Test) and a Mental Illness IAT. Explicit feelings towards the obese and the mentally ill were measured using Feeling Thermometers. A clinical vignette assessed the level of concern felt for a fictional patient under four conditions: control, obese, depression, obese and depression. Linear regression was conducted to test for association of gender, experience, and specialty with responses to vignettes, pre-intervention IATs and explicit attitudes, and to test for association of interventions (or control) with post-intervention IATs and explicit attitudes. Reported effect sizes were computed using Cohen’s d. Two-tailed p < 0.05 was selected as the significance threshold. RESULTS: Compared to internists, psychiatrists showed significantly less implicit bias against mentally vs. physically ill people than internists and warmer explicit feelings towards the mentally ill. More experienced physicians displayed warmer explicit feelings towards the mentally ill and a greater level of concern for the fictional patients in the vignette than the less experienced, except when the patient was described as obese. CONCLUSIONS: Specialty moderates both implicit and explicit mental illness prejudice. Experience moderates explicit mental illness bias and concern for patients. The effect of specialty on implicit prejudice seems to be based principally on self-selection. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12910-022-00815-7. |
format | Online Article Text |
id | pubmed-9400557 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-94005572022-08-25 How is physicians’ implicit prejudice against the obese and mentally ill moderated by specialty and experience? FitzGerald, Chloë Mumenthaler, Christian Berner, Delphine Schindler, Mélinée Brosch, Tobias Hurst, Samia BMC Med Ethics Research BACKGROUND: Implicit prejudice can lead to disparities in treatment. The effects of specialty and experience on implicit obesity and mental illness prejudice had not been explored. The main objective was to examine how specializing in psychiatry/general medicine and years of experience moderated implicit obesity and mental illness prejudice among Swiss physicians. Secondary outcomes included examining the malleability of implicit bias via two video interventions and a condition of cognitive load, correlations of implicit bias with responses to a clinical vignette, and correlations with explicit prejudice. METHODS: In stage 1, participants completed an online questionnaire including a clinical vignette. In stage 2, implicit prejudice pre- and post- intervention was tested using a 4 × 4 between-subject design including a control group. In stage 3, explicit prejudice was tested with feeling thermometers and participants were debriefed. Participants were 133 psychiatrists and internists working in Geneva, hospital-based and private practice. Implicit prejudice was assessed using a Weight IAT (Implicit Association Test) and a Mental Illness IAT. Explicit feelings towards the obese and the mentally ill were measured using Feeling Thermometers. A clinical vignette assessed the level of concern felt for a fictional patient under four conditions: control, obese, depression, obese and depression. Linear regression was conducted to test for association of gender, experience, and specialty with responses to vignettes, pre-intervention IATs and explicit attitudes, and to test for association of interventions (or control) with post-intervention IATs and explicit attitudes. Reported effect sizes were computed using Cohen’s d. Two-tailed p < 0.05 was selected as the significance threshold. RESULTS: Compared to internists, psychiatrists showed significantly less implicit bias against mentally vs. physically ill people than internists and warmer explicit feelings towards the mentally ill. More experienced physicians displayed warmer explicit feelings towards the mentally ill and a greater level of concern for the fictional patients in the vignette than the less experienced, except when the patient was described as obese. CONCLUSIONS: Specialty moderates both implicit and explicit mental illness prejudice. Experience moderates explicit mental illness bias and concern for patients. The effect of specialty on implicit prejudice seems to be based principally on self-selection. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12910-022-00815-7. BioMed Central 2022-08-24 /pmc/articles/PMC9400557/ /pubmed/36002822 http://dx.doi.org/10.1186/s12910-022-00815-7 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research FitzGerald, Chloë Mumenthaler, Christian Berner, Delphine Schindler, Mélinée Brosch, Tobias Hurst, Samia How is physicians’ implicit prejudice against the obese and mentally ill moderated by specialty and experience? |
title | How is physicians’ implicit prejudice against the obese and mentally ill moderated by specialty and experience? |
title_full | How is physicians’ implicit prejudice against the obese and mentally ill moderated by specialty and experience? |
title_fullStr | How is physicians’ implicit prejudice against the obese and mentally ill moderated by specialty and experience? |
title_full_unstemmed | How is physicians’ implicit prejudice against the obese and mentally ill moderated by specialty and experience? |
title_short | How is physicians’ implicit prejudice against the obese and mentally ill moderated by specialty and experience? |
title_sort | how is physicians’ implicit prejudice against the obese and mentally ill moderated by specialty and experience? |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9400557/ https://www.ncbi.nlm.nih.gov/pubmed/36002822 http://dx.doi.org/10.1186/s12910-022-00815-7 |
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