ArticleMedical care2016
The Role of Bias by Emergency Department Providers in Care for American Indian Children.
Article in Medical care, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
41 citing papers in PubMed, 1 synthesis or guideline pooled it, 86 citations in OpenAlex.
- The Perpetual Cycle of Racial Bias in Healthcare and Healthcare Education: A Systematic Review.Journal of racial and ethnic health disparities · 2026Pooled it
- A Brief Online Implicit Bias Intervention for School Mental Health Clinicians.International journal of environmental research and public health · 2022Trial
- Implicit Bias in Health Professionals: A Scoping Review.International journal of environmental research and public health · 2026Article
- Healthcare discrimination, healthcare avoidance, and self-rated health in a sample of American Indians with type 2 diabetes.Journal of behavioral medicine · 2025Article
- Disparities and Barriers to Care in Plastic and Reconstructive Surgery for Native American and First Nations Populations.Plastic and reconstructive surgery. Global open · 2025Article
- Provider Implicit Racial Bias in Pediatric Sickle Cell Disease.Journal of racial and ethnic health disparities · 2025Article
- Racial Differences in Stigmatizing and Positive Language in Emergency Medicine Notes.Journal of racial and ethnic health disparities · 2025Article
- "Understand the Way We Walk Our Life": Indigenous Patients' Experiences and Recommendations for Healthcare in the United States.International journal of environmental research and public health · 2025Article
- Examining the relationships among physician implicit bias, language, and Hispanic patient satisfaction.PloS one · 2025Article
- Interventions to improve equity in emergency departments for Indigenous people: A scoping review.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2025Article
- Healthcare providers' psychological investment in clinical recommendations: Investigating the role of implicit racial attitudes.Social science & medicine (1982) · 2024Article
- Inherent Bias in Electronic Health Records: A Scoping Review of Sources of Bias.medRxiv : the preprint server for health sciences · 2024Article
- A scoping review of research on potential impact of implicit bias in healthcare settings for children with acquired brain injuries.Rehabilitation psychology · 2024Article
- Initial evaluation of an intervention to address provider implicit bias in pediatric sickle cell disease pain care: A mixed methods pilot study.Canadian journal of pain = Revue canadienne de la douleur · 2024Article
- Visioning an Effective Health Encounter: Indigenous Healthcare Experiences and Recommendations for Health Professionals.International journal of environmental research and public health · 2023Article
- Unconscious Bias among Health Professionals: A Scoping Review.International journal of environmental research and public health · 2023Article
- Transmission of negative biases through social commentary included in neonatal intensive care unit progress notes.Journal of perinatology : official journal of the California Perinatal Association · 2023Review
- Implicit and explicit racial prejudice among medical professionals: updated estimates from a population-based study.Lancet regional health. Americas · 2023Article
- Graduate Medical Education Training and the Health of Indigenous Peoples.Journal of graduate medical education · 2023Article
- The negative impact of xenophobia on compassion with suffering out-group members is attenuated by trait empathy.Scientific reports · 2022Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundAmerican Indian children have high rates of emergency department (ED) use and face potential discrimination in health care settings.
objectiveOur goal was to assess both implicit and explicit racial bias and examine their relationship with clinical care. RESEARCH
designWe performed a cross-sectional survey of care providers at 5 hospitals in the Upper Midwest. Questions included American Indian stereotypes (explicit attitudes), clinical vignettes, and the Implicit Association Test. Two Implicit Association Tests were created to assess implicit bias toward the child or the parent/caregiver. Differences were assessed using linear and logistic regression models with a random effect for study site.
resultsA total of 154 care providers completed the survey. Agreement with negative American Indian stereotypes was 22%-32%. Overall, 84% of providers had an implicit preference for non-Hispanic white adults or children. Older providers (50 y and above) had lower implicit bias than those middle aged (30-49 y) (P=0.01). American Indian children were seen as increasingly challenging (P=0.04) and parents/caregivers less compliant (P=0.002) as the proportion of American Indian children seen in the ED increased. Responses to the vignettes were not related to implicit or explicit bias.
conclusionsThe majority of ED care providers had an implicit preference for non-Hispanic white children or adults compared with those who were American Indian. Provider agreement with negative American Indian stereotypes differed by practice and respondents' characteristics. These findings require additional study to determine how these implicit and explicit biases influence health care or outcomes disparities.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.