• Gabriel S Tajeu, Lucia Juarez, Jessica H Williams, Jewell Halanych, Irena Stepanikova, April A Agne, Jeff Stone, and Andrea L Cherrington.
• Department of Health Services Administration and Policy, College of Public Health, Temple University, Philadelphia, PA, USA. gabriel.tajeu@temple.edu.
• J Gen Intern Med. 2022 Jun 1; 37 (8): 197019791970-1979.

BackgroundReal or perceived discrimination contributes to lower quality of care for Black compared to white patients. Some forms of discrimination come from non-physician and non-nursing (non-MD/RN) staff members (e.g., receptionists).MethodsUtilizing the Burgess Model as a framework for racial bias intervention development, we developed an online intervention with five, 30-min modules: (1) history and effects of discrimination and racial disparities in healthcare, (2) implicit bias and how it may influence interactions with patients, (3) strategies to handle stress at work, (4) strategies to improve communication and interactions with patients, and (5) personal biases. Modules were designed to increase understanding of bias, enhance internal motivation to overcome bias, enhance emotional regulation skills, and increase empathy in patient interactions. Participants were non-MD/RN staff in nine primary care clinics. Effectiveness of the intervention was assessed using Implicit Association Test and Symbolic Racism Scale, to measure implicit and explicit racial bias, respectively, before and after the intervention. Acceptability was assessed through quantitative and qualitative feedback.ResultsFifty-eight non-MD/RN staff enrolled. Out of these, 24 completed pre- and post-intervention assessments and were included. Among participants who reported characteristics, most were Black, with less than college education and average age of 43.2 years. The baseline implicit bias d-score was 0.22, indicating slight pro-white bias. After the intervention, the implicit bias score decreased to -0.06 (p=0.01), a neutral score indicating no pro-white or Black bias. Participant rating of the intervention, scored from 1 (strongly disagree) to 5 (strongly agree), for questions including whether "it was made clear how to apply the presented content in practice" and "this module was worth the time spent" was ≥4.1 for all modules.ConclusionsThere was a decrease in implicit pro-white bias after, compared with before, the intervention. Intervention materials were highly rated.© 2022. The Author(s) under exclusive licence to Society of General Internal Medicine.

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