School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
Cecil B. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, United States.
Soc Sci Med. 2018 Feb;199:202-208. doi: 10.1016/j.socscimed.2017.05.013. Epub 2017 May 5.
Negative attitudes and discrimination against Latinos exist in the dominant U.S. culture and in healthcare systems, contributing to ongoing health disparities. This article provides findings of a pilot test of Yo Veo Salud (I See Health), an intervention designed to positively modify attitudes toward Latinos among medical trainees. The research question was: Compared to the comparison group, did the intervention group show lower levels of implicit bias against Latinos versus Whites, and higher levels of ethnocultural empathy, healthcare empathy, and patient-centeredness? We used a sequential cohort, post-test design to evaluate Yo Veo Salud with a sample of 69 medical trainees. The intervention setting was an academic medical institution in a Southeastern U.S. state with a fast-growing Latino population. The intervention was delivered, and data were collected online, between July and December of 2014. Participants in the intervention group showed greater ethnocultural empathy, healthcare empathy, and patient-centeredness, compared to the comparison group. The implicit measure assessed four attitudinal dimensions (pleasantness, responsibility, compliance, and safety). Comparisons between our intervention and comparison groups did not find any average differences in implicit anti-Latino bias between the groups. However, in a subset analysis of White participants, White participants in the intervention group demonstrated a significantly decreased level of implicit bias in terms of pleasantness. A dose response was also founded indicating that participants involved in more parts of the intervention showed more change on all measures. Our findings, while modest in size, provide proof of concept for Yo Veo Salud as a means for increasing ethno-cultural and physician empathy, and patient-centeredness among medical residents and decreasing implicit provider bias toward Latinos.
美国主流文化和医疗体系中存在对拉丁裔的负面态度和歧视，这导致了持续存在的健康差距。本文提供了一项试点测试的结果，该测试针对的是 Yo Veo Salud（我看见健康），这是一种旨在积极改变医学受训者对拉丁裔态度的干预措施。研究问题是：与对照组相比，干预组对拉丁裔与白人的隐性偏见是否更低，而对拉丁裔的种族文化同理心、医疗同理心和以患者为中心的程度是否更高？我们使用了顺序队列、后测设计，在一个快速增长的拉丁裔人口的美国东南部州的一所学术医疗机构中，对 69 名医学受训者进行了 Yo Veo Salud 的评估。该干预措施是在线提供的，数据是在 2014 年 7 月至 12 月期间收集的。与对照组相比，干预组的种族文化同理心、医疗同理心和以患者为中心的程度更高。隐性测量评估了四个态度维度（愉悦感、责任感、顺从性和安全性）。我们的干预组和对照组之间的比较没有发现两组之间隐性反拉丁裔偏见的平均差异。然而，在对白人参与者的子组分析中，干预组的白人参与者在愉悦感方面表现出隐性偏见显著降低。还发现了剂量反应，表明参与更多干预部分的参与者在所有测量指标上的变化更大。我们的发现虽然规模较小，但为 Yo Veo Salud 提供了概念验证，证明它是一种增加医学住院医师的种族文化和医生同理心以及以患者为中心的方法，并减少对拉丁裔的隐性提供者偏见。
