Evidence map›Paper›PMID 31036330›Full record

ArticlePatient education and counseling2019

Detecting implicit racial bias in provider communication behaviors to reduce disparities in healthcare: Challenges, solutions, and future directions for provider communication training.

Nao Hagiwara, Jennifer Elston Lafata, Briana Mezuk, Scott R Vrana, Michael D Fetters

Registry-linked trialAbstract read
In one paragraph

Article in Patient education and counseling, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05211869 (T1DTechCHW), which is not on this map. Cited by 68 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
68citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

NCT05211869 nacompletednot on this mapstarted 2022, after this paper: background citation

T1DTechCHW: Enhancing the Community Health Worker (CHW) Model to Promote Diabetes Technology Use in Young Adults From Underrepresented Minority Groups (YA-URMs) With Type 1 Diabetes (T1D)

TypeinterventionalSponsorAlbert Einstein College of MedicineRan2022 to 2025Enrolled119ConditionsDiabetes, Type 1 Diabetes, Young Adult, Diabetes MellitusArmsT1D-CATCH
3 · Its place in the literature

Who cites it

68 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
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  4. Racial and Ethnic Disparities in Hepatocellular Carcinoma Treatment Receipt in the United States: A Systematic Review and Meta-Analysis.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2024
    Pooled it
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  9. Observational
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  11. The Use of Biased Language in the Care of Seriously Ill Children: A Pilot Study.The American journal of hospice & palliative care · 2026
    Article
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  14. Review
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8 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Nao HagiwaraDepartment of Psychology, Virginia Commonwealth University, Richmond, USA. Electronic address: nhagiwara@vcu.edu.
Jennifer Elston LafataDivision of Pharmaceutical Outcomes and Policy, University of North Carolina, Chapel Hill, Chapel Hill, USA.
Briana MezukDepartment of Epidemiology, University of Michigan, Ann Arbor, USA.
Scott R VranaDepartment of Psychology, Virginia Commonwealth University, Richmond, USA.
Michael D FettersDepartment of Family Medicine, University of Michigan, Ann Arbor, USA.

Funding

Unveiling the role of physician implicit bias and communication behaviors in dissatisfaction, mistrust, and nonadherence in Black patients with Type 2 diabetesR01DK112009 · NIDDK · VIRGINIA COMMONWEALTH UNIVERSITY · PI HAGIWARA, NAO · 2017 to 2020
$1.7M
NIDDK NIH HHS R01 DK112009
6 · The paper itself

Abstract

Since publication of Unequal Treatment by the Institute of Medicine in 2003, there has been a growing recognition of the role of provider implicit racial bias in patient care. Provider implicit racial bias has been consistently negatively associated with both care satisfaction and provider trust among racial/ethnic minority patients. This suggests provider implicit racial bias likely manifests through their communication behaviors, which in turn may offer a means of addressing racial disparities in healthcare and ultimately in health. However, identifying provider communication behaviors that mediate the links between provider implicit racial bias and patient outcomes is challenging. In this paper, we argue that identifying these provider communication behaviors requires (1) taking into account findings from social psychology research of implicit racial bias and (2) incorporating the perspectives of racial/ethnic minority patients into patient-provider communication research. We discuss the utility of mixed methods research designs as a framework for resolving this complex scientific question. Research that draws on social psychology research of implicit racial bias and incorporates the racial/ethnic minority patient perspectives can inform the development of communication skills training programs for students and residents in various healthcare fields. Such programs are one element of a broader effort to reduce racial/ethnic disparities in healthcare.

Indexed as

CommunicationPhysician-Patient RelationsRacismAttitude of Health PersonnelCultural CompetencyEducation, MedicalHealthcare DisparitiesHumansPatient SatisfactionTrustImplicit racial biasMixed methods research designsPatient-provider communicationPatient satisfactionPatient trust

Identifiers

PMID31036330
PMCPMC7269129

What OpenQuestion holds

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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.