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Role of implicit bias in pediatric cancer clinical trials and enrollment recommendations among pediatric oncology providers
Author(s) -
Graetz Dylan E.,
Madni Arshia,
Gossett Jeffrey,
Kang Guolian,
Sabin Janice A.,
Santana Victor M.,
Russo Carolyn L.
Publication year - 2021
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.33268
Subject(s) - vignette , medicine , implicit association test , socioeconomic status , medline , association (psychology) , clinical psychology , family medicine , psychology , population , social psychology , environmental health , political science , law , psychotherapist
Background Provider implicit bias can negatively affect clinician‐patient communication. In the current study, the authors measured implicit bias training among pediatric oncology providers and exposure to implicit association tests (IATs). They then assessed associations between IATs for race and socioeconomic status (SES) and recommendations for clinical trial enrollment. Methods A prospective multisite study was performed to measure implicit bias among oncology providers at St. Jude Children's Research Hospital and affiliate clinics. An IAT was used to assess bias in the domains of race and SES. Case vignettes were used to determine an association between bias and provider recommendation for trial enrollment. Data were analyzed using Student t tests or Wilcoxon tests for comparisons and Jonckheere‐Terpstra tests were used for association. Results Of the 105 total participants, 95 (90%) had not taken an IAT and 97 (92%) had no prior implicit bias training. A large effect was found for (bias toward) high SES (Cohen d , 1.93) and European American race (Cohen d , 0.96). The majority of participants (90%) had a vignette score of 3 or 4, indicating recommendation for trial enrollment for most or all vignettes. IAT and vignette scores did not significantly differ between providers at St. Jude Children's Research Hospital or affiliate clinics. No association was found between IAT and vignette scores for race ( P = .58) or SES ( P = .82). Conclusions The authors noted a paucity of prior exposure to implicit bias self‐assessments and training. Although these providers demonstrated preferences for high SES and European American race, this did not appear to affect recommendations for clinical trial enrollment as assessed by vignettes.