1. Challenges and Opportunities for Clinician Implicit Bias Training: Insights from Perinatal Care Stakeholders
- Author
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Garrett, Sarah B, Jones, Linda, Montague, Alexandra, Fa-Yusuf, Haleemat, Harris-Taylor, Julie, Powell, Breezy, Chan, Erica, Zamarripa, Stephen, Hooper, Sarah, and Butcher, Brittany D Chambers
- Subjects
Health Services and Systems ,Midwifery ,Public Health ,Health Sciences ,Clinical Research ,Health Services ,Pediatric ,Prevention ,8.1 Organisation and delivery of services ,Health and social care services research ,Reproductive health and childbirth ,Good Health and Well Being ,stakeholder engagement ,implicit bias training ,maternal health ,health equity intervention ,community-based participatory research ,qualitative research ,Public health - Abstract
IntroductionIn an attempt to address health inequities, many U.S. states have considered or enacted legislation requiring antibias or implicit bias training (IBT) for health care providers. California's "Dignity in Pregnancy and Childbirth Act" requires that hospitals and alternative birthing centers provide IBT to perinatal clinicians with the goal of improving clinical outcomes for Black women and birthing people. However, there is as yet insufficient evidence to identify what IBT approaches, if any, achieve this goal. Engaging the experiences and insights of IBT stakeholders is a foundational step in informing nascent IBT policy, curricula, and implementation.MethodsWe conducted a multimethod community-based participatory research study with key stakeholders of California's IBT policy to identify key challenges and recommendations for effective clinician IBT. We used focus groups, in-depth interviews, combined inductive/deductive thematic analysis, and multiple techniques to promote rigor and validity. Participants were San Francisco Bay Area-based individuals who identified as Black or African American women with a recent hospital birth (n=20), and hospital-based perinatal clinicians (n=20).ResultsWe identified numerous actionable challenges and recommendations regarding aspects of (1) state law; (2) IBT content and format; (3) health care facility IBT implementation; (4) health care facility environment; and (5) provider commitment and behaviors. Patient and clinician insights overlapped substantially. Many respondents felt IBT would improve outcomes only in combination with other antiracism interventions.Health equity implicationsThese stakeholder insights offer policy-makers, health system leaders, and curriculum developers crucial guidance for the future development and implementation of clinician antibias interventions.
- Published
- 2023