(306) The Unique and Interactive Effects of Patient Race, Patient Weight, and Provider Implicit Attitudes on Chronic Pain Treatment Decisions

Abstract

Prior work suggests that providers are influenced by patient race and weight when making pain-related decisions. Providers with stronger implicit (automatic) attitudes about race and weight may be more likely to be influenced by these patient-level characteristics when making treatment decisions. In this multi-part study, we (a) examined the influence of patient race and weight on providers’ pain treatment decisions, (b) measured providers’ implicit attitudes about race and weight with two separate Implicit Association Tests, and (c) explored the extent to which providers’ attitudes predicted their treatment decisions. Ninety medical students (“providers”) viewed four videos of women with chronic low back pain completing a standardized sit-to-stand task who varied by race (Black/White) and weight (overweight/obese). Text vignettes with additional patient information accompanied the videos. For each patient, providers rated their likelihood of recommending opioids, a psychology referral, and disability compensation. Repeated measures ANOVAs indicated no main effects of patient race or weight on providers’ opioid decisions; however, providers were more likely to recommend a psychology referral for patients with obesity versus overweight [F(1,89)=9.79, p