Williams Amanda, Kajiwara Kasey, Soon Reni, Salcedo Jennifer, Tschann Mary, Elia Jennifer, Pauker Kristin, Kaneshiro Bliss
Graduate School of Education, University of Bristol, United Kingdom (AW).
Hawaii J Med Public Health. 2018 Jan;77(1):7-13.
The literature suggests that women of different races are more or less likely to use certain contraceptive methods and patient race can influence which contraceptive recommendations a provider makes. To explore whether health care providers treat individuals of different races differently, we conducted a preliminary investigation on whether medical students recommended different contraceptive methods for hypothetical patients presenting with the same clinical features who only varied by race. Third- and fourth-year medical students (n=103) at the University of Hawai'i completed an online survey. Students read case studies about a 23-year-old and 36-year-old patient and then made contraceptive recommendations. All students reviewed the same scenarios, with the exception of the patient's name which was randomly assigned to represent one of five racial/ethnic groups (White, Chinese, Filipina, Native Hawaiian, and Micronesian). Recommendations were analyzed using χ tests and bivariate logistic regressions. For the younger patient, students were most likely to recommend intrauterine devices (IUDs), followed by the contraceptive pill and Etonogestrel implant; recommendations did not differ by race/ethnicity (P = .91). For the older patient, students were most likely to recommend IUDs or sterilization, and Micronesian women were more likely to receive sterilization recommendations compared to White women (60% versus 27%, P = .04). In summary, contraceptive recommendations, specifically the frequency of recommending sterilization varied by race. Our findings add to the literature exploring the role of a patient's race/ethnicity on recommendations for contraception and highlights the need for more studies exploring the etiology of health care disparities.
文献表明，不同种族的女性使用某些避孕方法的可能性或多或少存在差异，患者的种族会影响医疗服务提供者给出的避孕建议。为了探究医疗服务提供者是否会区别对待不同种族的个体，我们针对医学生是否会为具有相同临床特征但仅种族不同的假设患者推荐不同的避孕方法进行了初步调查。夏威夷大学的三年级和四年级医学生（n = 103）完成了一项在线调查。学生们阅读了关于一名23岁和一名36岁患者的病例研究，然后给出避孕建议。所有学生查看的都是相同的场景，只是患者姓名被随机分配以代表五个种族/族裔群体之一（白人、华裔、菲律宾裔、夏威夷原住民和密克罗尼西亚人）。使用χ检验和双变量逻辑回归分析建议。对于较年轻的患者，学生最有可能推荐宫内节育器（IUD），其次是避孕药和依托孕烯植入剂；不同种族/族裔的建议没有差异（P = 0.91）。对于年龄较大的患者，学生最有可能推荐IUD或绝育手术，与白人女性相比，密克罗尼西亚女性更有可能收到绝育手术建议（60%对27%，P = 0.04）。总之，避孕建议，特别是推荐绝育手术的频率因种族而异。我们的研究结果补充了探索患者种族/族裔在避孕建议中作用的文献，并强调需要更多研究来探索医疗保健差异的病因。
