title: 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.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  METHODS
  Fourteen non-Black physicians and 72 low income Black patients at a Family Medicine residency training clinic.
  
  
  METHODS
  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.
  
  
  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.
authors: Population Studies and Disparities Research Program, Karmanos Cancer Institute, Detroit, MI 485201, USA. pennerl@karmanos.org
authors: Louis A
authors: LA
authors: Penner
authors: Samuel
authors: S
authors: Gaertner
authors: John F
authors: JF
authors: Dovidio
authors: Nao
authors: N
authors: Hagiwara
authors: John
authors: J
authors: Porcerelli
authors: Tsveti
authors: T
authors: Markova
authors: Terrance L
authors: TL
authors: Albrecht
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology; D001291:Attitude of Health Personnel / Q000208:ethnology*; D001294:Attitude to Health / Q000208:ethnology*; D004502:Education, Medical, Continuing / Q000379:methods; D005260:Female; D054625:Healthcare Disparities / Q000208:ethnology; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D008297:Male; D008824:Michigan; D008875:Middle Aged; D008960:Models, Psychological; D010349:Patient Compliance / Q000208:ethnology; D010817:Physician-Patient Relations; D012933:Social Identification; D011795:Surveys and Questionnaires; D035502:Trust
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