EleVATE-Clinicians: a tool to mitigate implicit bias by increasing clinicians' empathy

EleVATE-Clinicians：通过增加临床医生的同理心来减轻隐性偏见的工具

基本信息

批准号：
10538910
负责人：
Ebony Boyce Carter
金额：
$ 21.73万
依托单位：
WASHINGTON UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-23 至 2024-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10538910
关键词：
Address Adult Advocacy Advocate Attitude Behavior Biological Birth Rate Black race Caring Client satisfaction Data Discipline of obstetrics Dose Education Empathy Enrollment Ethnic group Funding Gestational Age Health Healthcare Hour Individual Intervention Learning Life Low Birth Weight Infant Measures Mental Depression Midwife Missouri Modeling Morbidity - disease rate Mothers Observational Study Outcome Participant Patient Self-Report Patient-Focused Outcomes Patients Physicians Pilot Projects Postpartum Depression Pregnancy Pregnancy Outcome Pregnant Women Prejudice Premature Birth Prenatal care Quality of Care Race Randomized Randomized Controlled Trials Reduce health disparities Reporting Site Stress Structural Racism System Testing Training Trauma Unconscious State United States Voice Woman adverse pregnancy outcome anti-racism black patient black women disparity reduction experience forging high risk implicit bias improved improved outcome individual patient innovation insight meetings mortality multi-site trial neonate patient-clinician communication peripartum depression pregnant prevent racial disparity racism response social socioeconomics tool traditional care

项目摘要

Abstract Group prenatal care is one of few interventions proven to improve pregnancy outcomes for Black women, but the mechanism is unknown. We propose to leverage an R01-funded trial of 330 pregnant patients randomized to individual prenatal care or Elevating Voices, Addressing Depression, Toxic Stress and Equity in Group Prenatal Care, called EleVATE-Patients. The focus of EleVATE-Patients is whether the intervention improves perinatal depression and pregnancy outcomes. The EleVATE-Clinicians study, proposed here, moves the focal point from patients to their clinicians. Clinicians facilitating EleVATE groups receive training in trauma- informed care, anti-oppressive principles, dismantling racism, and group dynamics. We will measure whether patients seeing clinicians with high empathy scores (by validated self- and patient-report) will be less likely to experience perinatal depression, preterm birth, low birthweight (Aim 1), and whether participating in EleVATE GC training and facilitating group prenatal care is associated with increased clinician empathy (Aim 2). We hypothesize that the 20+ hours that clinicians spend providing group care allows them to longitudinally apply lessons learned from anti-racism training, develop closer patient relationships, respect patients' intersectional identities, and strengthens their ability to provide high-quality care for socially dissimilar patients. We hypothesize that increasing empathy in this way mitigates the impact of implicit bias and contributes to improved patient outcomes. The data from this R21 will be used to plan a multi-site trial powered to further test this hypothesis and determine whether participation in EleVATE facilitates greater clinician advocacy for changes to dismantle structural racism in healthcare.

抽象的团体产前护理是少数被证明可以改善黑人女性妊娠结局的干预措施之一，但是其机制尚不清楚。我们建议利用 R01 资助的一项试验，该试验对 330 名怀孕患者进行了随机分组个人产前护理或提高声音、解决抑郁症、有毒压力和群体公平产前护理，称为 EleVATE-Patients。 EleVATE-Patients 关注的焦点是干预措施是否有所改善围产期抑郁症和妊娠结局。此处提出的 EleVATE-Clinicians 研究推动了从患者到临床医生的焦点。促进 EleVATE 小组的临床医生接受创伤培训知情护理、反压迫原则、消除种族主义和群体动力。我们将衡量是否看到具有高同理心得分（通过经过验证的自我报告和患者报告）的临床医生的患者不太可能经历过围产期抑郁症、早产、低出生体重（目标 1）以及是否参加 EleVATE GC 培训和促进团体产前护理与临床医生同理心的增强相关（目标 2）。我们假设临床医生花费 20 多个小时提供团体护理使他们能够纵向应用从反种族主义培训中汲取的经验教训，发展更密切的患者关系，尊重患者的交叉身份，并增强他们为社会不同的患者提供高质量护理的能力。我们假设以这种方式增加同理心可以减轻隐性偏见的影响，并有助于改善患者治疗效果。 R21 的数据将用于计划多站点试验，以进行进一步测试这一假设并确定参与 EleVATE 是否有利于临床医生更好地倡导消除医疗保健中结构性种族主义的变革。