Patient Perceptions of Physician Education and Quality by Race

NCT ID: NCT04940234

Last Updated: 2021-12-13

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 1500 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2021-08-19
• Study Completion Date: 2021-10-01

Brief Summary

Research has documented positive effects of doctor-patient race concordance, suggesting that increasing diversity among healthcare professionals may play an important role in addressing well-documented racial health disparities in the US. It also remains critical to improve the quality of interactions in race discordant doctor-patient relationships. However, as health systems consider policies to increase the number of minority healthcare professionals, especially among doctors, questions about the equilibrium effects of such initiatives naturally emerge. In this project, the investigators examine whether and how patients vary their perceptions of healthcare professionals by race.

Detailed Description

Research has documented positive effects of doctor-patient race concordance. Given the low representation of minorities among doctors in the US, this evidence suggests that the path to addressing well-documented racial health disparities involves both increasing diversity among healthcare professionals and improving the quality of interactions in race-discordant doctor-patient relationships. Increased focus on improving minority representation among healthcare professionals, and especially among doctors, naturally raises questions about the equilibrium effects of such initiatives. In this study, the investigators aim to explore one potential avenue for equilibrium effects. A growing literature examines how doctors' behavior and beliefs change with patient race and potentially affect the quality of healthcare interactions. This project examines whether and how patients vary their perceptions of the quality of doctors based on race. Significant variation in the perceived quality of minority healthcare professionals could adversely affect the quality and effectiveness of healthcare interactions involving these professionals. Moreover, the range of potential negative patient attitudes that could be encountered in day-to-day clinical practice may also be considered an anticipatory tax and another barrier for prospective minority trainees.

This projects aim to test the following hypotheses: (1) whether subjects believe Black experts are less educated compared with White experts; (2) whether subject believe Black experts are lower quality compared with White experts; (3) whether there is any variation in these two outcomes based on respondent race. The investigators also explore a potential mechanism by examining the extent to which differences in patients' beliefs about the likely occupation of individuals explains differences in patients' beliefs about educational attainment and quality. In this case, the investigators hypothesize that the race of the individual in the photo may be affecting the weight that individuals put on the "expert attire" treatment.

Conditions

Racism; Bias, Racial

Keywords

healthcare

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: HEALTH_SERVICES_RESEARCH
• Blinding Strategy: SINGLE

Study Groups

Black Expert

Survey respondents are exposed to a Black person wearing expert attire.

Group Type: EXPERIMENTAL

Exposure to a Photo

Intervention Type: BEHAVIORAL

We plan to recruit subjects and randomly assign them to one of four treatments. In each treatment arm, the subject will view a photo of a man. We experimentally vary treatment along two dimensions: whether the man is wearing expert vs. layperson attire and whether the man is white vs. black. We will survey participants' beliefs about the actors' educational attainment and perceived quality as measured by subjects' willingness to accept medical advice for non-urgent health issues or participate in a clinical trial being led by the individual in the photo.

Black Layperson

Survey respondents are exposed to a Black person wearing layperson's attire.

Group Type: EXPERIMENTAL

Exposure to a Photo

Intervention Type: BEHAVIORAL

We plan to recruit subjects and randomly assign them to one of four treatments. In each treatment arm, the subject will view a photo of a man. We experimentally vary treatment along two dimensions: whether the man is wearing expert vs. layperson attire and whether the man is white vs. black. We will survey participants' beliefs about the actors' educational attainment and perceived quality as measured by subjects' willingness to accept medical advice for non-urgent health issues or participate in a clinical trial being led by the individual in the photo.

White Expert

Survey respondents are exposed to a white person wearing expert attire.

Group Type: EXPERIMENTAL

Exposure to a Photo

Intervention Type: BEHAVIORAL

We plan to recruit subjects and randomly assign them to one of four treatments. In each treatment arm, the subject will view a photo of a man. We experimentally vary treatment along two dimensions: whether the man is wearing expert vs. layperson attire and whether the man is white vs. black. We will survey participants' beliefs about the actors' educational attainment and perceived quality as measured by subjects' willingness to accept medical advice for non-urgent health issues or participate in a clinical trial being led by the individual in the photo.

White Layperson

Survey respondents are exposed to a white person wearing layperson's attire.

Group Type: EXPERIMENTAL

Exposure to a Photo

Intervention Type: BEHAVIORAL

We plan to recruit subjects and randomly assign them to one of four treatments. In each treatment arm, the subject will view a photo of a man. We experimentally vary treatment along two dimensions: whether the man is wearing expert vs. layperson attire and whether the man is white vs. black. We will survey participants' beliefs about the actors' educational attainment and perceived quality as measured by subjects' willingness to accept medical advice for non-urgent health issues or participate in a clinical trial being led by the individual in the photo.

Interventions

Exposure to a Photo

We plan to recruit subjects and randomly assign them to one of four treatments. In each treatment arm, the subject will view a photo of a man. We experimentally vary treatment along two dimensions: whether the man is wearing expert vs. layperson attire and whether the man is white vs. black. We will survey participants' beliefs about the actors' educational attainment and perceived quality as measured by subjects' willingness to accept medical advice for non-urgent health issues or participate in a clinical trial being led by the individual in the photo.

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• participant identifies as Black or White

Exclusion Criteria

• participant doesn't identify as Black or White
• younger than 25 years old

• Minimum Eligible Age: 25 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Harvard University

OTHER

Sponsor Role: lead

Responsible Party

Marcella Alsan

Principal Investigator

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Harvard University

Cambridge, Massachusetts, United States

Countries

United States

Other Identifiers

IRB21-0682

Identifier Type: -

Identifier Source: org_study_id