title: Genetic counselors' implicit racial attitudes and their relationship to communication.
abstract: OBJECTIVE
  Implicit racial attitudes are thought to shape interpersonal interactions and may contribute to health-care disparities. This study explored the relationship between genetic counselors' implicit racial attitudes and their communication during simulated genetic counseling sessions.
  
  
  METHODS
  A nationally representative sample of genetic counselors completed a web-based survey that included the Race Implicit Association Test (IAT; Greenwald, McGhee, & Schwartz, 1998; Cooper et al., 2012). A subset of these counselors (n = 67) had participated in an earlier study in which they were video recorded counseling Black, Hispanic, and non-Hispanic White SCs about their prenatal or cancer risks. The counselors' IAT scores were related to their session communications through robust regression modeling.
  
  
  RESULTS
  Genetic counselors showed a moderate to strong pro-White bias on the Race IAT (M = 0.41, SD = 0.35). Counselors with stronger pro-White bias were rated as displaying lower levels of positive affect (p < .05) and tended to use less emotionally responsive communication (p < .10) when counseling minority SCs. When counseling White SCs, pro-White bias was associated with lower levels of verbal dominance during sessions (p < .10). Stronger pro-White bias was also associated with more positive ratings of counselors' nonverbal effectiveness by White SCs.
  
  
  CONCLUSIONS
  Implicit racial bias is associated with negative markers of communication in minority client sessions and may contribute to racial disparities in processes of care related to genetic services.
authors.affiliation: Department of Health, Behavior & Society, The Johns Hopkins Bloomberg School of Public Health.
authors.forename: Kendra L
authors.initials: KL
authors.lastname: Schaa
authors.affiliation: Department of Health, Behavior & Society, The Johns Hopkins Bloomberg School of Public Health.
authors.forename: Debra L
authors.initials: DL
authors.lastname: Roter
authors.affiliation: Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health.
authors.forename: Barbara B
authors.initials: BB
authors.lastname: Biesecker
authors.affiliation: Department of Medicine, The Johns Hopkins University School of Medicine.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Cooper
authors.affiliation: Department of Health, Behavior & Society, The Johns Hopkins Bloomberg School of Public Health.
authors.forename: Lori H
authors.initials: LH
authors.lastname: Erby
mesh_terms: D000328:Adult; D001741:Black or African American; D001291:Attitude of Health Personnel; D003142:Communication; D005260:Female; D005817:Genetic Counseling / Q000523:psychology*; D054625:Healthcare Disparities; D006630:Hispanic or Latino; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D063505:Racism / Q000523:psychology*; D044465:White People