Examining Provider Comfortability to Improve Healthcare Outcomes Among Black Indigenous People of Color: A Comprehensive Project

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Background: Disparities in healthcare exist because of discord between provider bias, beliefs, cultural humility, and attitudes regarding physician-patient communication interaction. This paper seeks to promote closing the health gap and eradicating racism, two of the 12 Grand Challenges endorsed by the American Academy of Social Work and Social Welfare, by meeting the community's social, physical, and economic health needs by enhancing provider- BIPOC client communication to reduce health inequity. Community Engagement: A community-based task force, JEDIS HEAL (Justice, Equity, Diversity, Inclusion, and Systems, Humility, Engagement, Advocacy, and Liberation ), consisting of researcher/scholars, mental and physical healthcare students, providers, multiple discipline educators was created to promote implicit bias awareness, critical thought, and discussion to build on culturally competent education influenced by cross-cultural experiential learning to produce the Comfortability, Awareness, Reflexivity for Equity Tool (CARET). The task force employed the Community-Based Participatory Research approach by fostering a partnership with the task force as key stakeholders in improving the quality of the proposed care intervention through development, feedback, and future dissemination. Conceptual Model: The researcher designed the framework Cultural Humility and Critical Race-Centered Design (CH-CRCD), informed the development of the Comfortability, Awareness, Reflexivity for Equity Tool (CARET) assessment tool by extrapolating tenets of critical race theory and cultural humility with the conceptualization, creativity, and implementation of human-centered design to inform the research delivery. Social Innovation: The Comfortability, Awareness, Reflexivity for Equity Tool (CARET) addresses implicit bias in provider interaction. CARET is a paper-based, web-based online screening tool that identifies provider communication biases while interacting with BIPOC customers. A comfortability and reflexivity score will identify areas for quality improvement. This innovation fills a significant gap in literature exploring the impact of provider comfortability and reflexivity with Black Indigenous People of Color clients for future diversity education. Evaluation Plan: The projected evaluation plan will address the questions: (1)Does the social innovation show a relationship between clinician comfortability, cultural reflexivity, and Black Indigenous People of Color engagement attempts? (a) To what extent do the quantitative findings generalize the qualitative results? (2) How do clinician comfortability and cultural reflexivity compare across the education levels and healthcare disciplines? (3) Did the intervention lead to an increase in clinician comfortability and reflexivity when engaging BIPOC clients? Through exploratory factor analysis, this projected cross-sectional mixed methods study will examine baseline data collected related to clinician comfortability and cultural reflexivity of provider engagement with Black Indigenous People of Color clients. The projected outcome of this study is to guide the quality improvement of cultural competency programs. Future Directions: Additional research is crucial to improving cultural competency curricula for improved provider-BIPOC client communication to impact BIPOC health disparity outcomes directly.
A capstone project submitted in partial fulfillment of the requirements for the degree Doctor of Social Work
Social Work, African American Studies, Counseling Psychology