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A Social Psychological Approach to Improving the Outcomes of Racially Discordant Medical Interactions

Abstract

BACKGROUND

Medical interactions between Black patients and non-Black physicians are less positive and productive than racially concordant ones and contribute to racial disparities in the quality of health care.

OBJECTIVE

To determine whether an intervention based on the common ingroup identity model, previously used in nonmedical settings to reduce intergroup bias, would change physician and patient responses in racially discordant medical interactions and improve patient adherence.

IINTERVENTION

Physicians and patients were randomly assigned to either a common identity treatment (to enhance their sense of commonality) or a control (standard health information) condition, and then engaged in a scheduled appointment.

DESIGN

Intervention occurred just before the interaction. Patient demographic characteristics and relevant attitudes and/or behaviors were measured before and immediately after interactions, and 4 and 16 weeks later. Physicians provided information before and immediately after interactions.

PARTICIPANTS

Fourteen non-Black physicians and 72 low income Black patients at a Family Medicine residency training clinic.

MAIN MEASURES

Sense of being on the same team, patient-centeredness, and patient trust of physician, assessed immediately after the medical interactions, and patient trust and adherence, assessed 4 and 16 weeks later.

KEY RESULTS

Four and 16 weeks after interactions, patient trust of their physician and physicians in general was significantly greater in the treatment condition than control condition. Sixteen weeks after interactions, adherence was also significantly greater.

CONCLUSIONS

An intervention used to reduce intergroup bias successfully produced greater Black patient trust of non-Black physicians and adherence. These findings offer promising evidence for a relatively low-cost and simple intervention that may offer a means to improve medical outcomes of racially discordant medical interactions. However, the sample size of physicians and patients was small, and thus the effectiveness of the intervention should be further tested in different settings, with different populations of physicians and other health outcomes.

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Acknowledgements

This research was supported by a grant to the first author from the National Institute of Child Health and Development (1R21HD050445001A1) and a SAGES Award from the Society for the Psychological Study of Social issues, grants to the last author from the National Cancer Institute (U01CA114583, 1U54CA154606-01), a grant from the National Science Foundation (BCS-0613218) to Samuel L. Gaertner and John F. Dovidio, and a NIH Grant RO1HL 0856331-0182 and a NIDA Grant 1R01DA029888-01 to John F. Dovidio. Prior Presentation: Society for Personality and Social Psychology, January 27, 2010, Tampa, Florida.

Conflict of Interest

The authors declare that they do not have a conflict of interest.

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Correspondence to Louis A. Penner PhD.

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Penner, L.A., Gaertner, S., Dovidio, J.F. et al. A Social Psychological Approach to Improving the Outcomes of Racially Discordant Medical Interactions. J GEN INTERN MED 28, 1143–1149 (2013). https://doi.org/10.1007/s11606-013-2339-y

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KEY WORDS

  • common ingroup identity model
  • intergroup bias
  • racially discordant medical interactions