Assessing Impact of Implicit Bias/Anti-Racism Programs for Obstetrical Providers in a Statewide Quality Improvement Initiative

Abstract

Racial disparities in hypertensive disorders of pregnancy (HDP) are known, with Black individuals having increased rates of severe maternal morbidity and mortality. Implicit Bias and Anti-Racism Training Programs (IBAR-TP) represent a strategy to reduce health disparities, but limited data have measured its impact. Our objective was to evaluate the impact of IBAR-TP as part of a statewide quality improvement (QI) project on HDP. From 11/2020 to 1/2021, a survey assessing hospital obstetric care teams’ participation in IBAR-TP was administered at 30 hospitals involved in a statewide QI project on HDP. Surveys were de-identified and administered electronically through Qualtrics. Questions addressed participant awareness of health disparities for Black individuals related to HDP and comfort engaging in conversations regarding health disparities with patients. Univariate and bivariate statistical analyses were performed. In total, 366 surveys were completed (demographics in Table 1). 165 respondents (45.1%) participated in an IBAR-TP and 109 (66.1%) received training within the past 12 months. Any previous IBAR-TP exposure significantly increased acknowledgement of differences in peripartum health outcomes for Black vs White patients (93.2% vs 78.6%, p< 0.01); discussion increased risks of adverse outcomes based on socioeconomic/racial disparities (45.9% vs 33.3%, p=0.03); and comfort discussing the impacts of racial disparities on care (73.8% vs 60.3%, p=0.01). Exposure to IBAR-TP in the preceding 12 months vs having ever received training, did not significantly impact participant responses (Table 2). IBAR-TP improve obstetric healthcare professionals’ awareness, understanding, and comfort in discussing the impact of racial disparities in HDP for Black individuals with a durable impact beyond 1 year after participation. Our findings suggest a role for IBAR-TP as part of broader efforts to reduce and eliminate racial and health disparities in obstetric care and outcomes.View Large Image Figure ViewerDownload Hi-res image Download (PPT)