BACKGROUND: Racial bias is associated with suboptimal healthcare treatment for minorities. Research focuses on bias among physicians rather than non-physician healthcare staff (e.g., receptionists). Patients spend considerable amounts of time with non-physician staff. Therefore, we investigate differences in implicit and explicit racial bias by healthcare staff race and occupation using the Implicit Association Test and Modern Racism Scale, respectively. METHODS: Staff (n = 107) were recruited using the Alabama based Primary Care Research Coalition. Occupation was categorized into "medical doctors/registered nurses" (MD/RN) and "non-MD/RN" (e.g., receptionists). RESULTS: Implicit bias scores were higher among whites compared with blacks (0.62, -0.04, respectively; p < 0.01). Among whites, non-MD/RNs demonstrated more pro-white implicit bias compared with MD/RNs (0.67, 0.44, respectively; p < 0.01). Whites had higher explicit bias scores than blacks (17.7, 12.3, respectively; p < 0.01). CONCLUSION: Non-MD/RNs should not be overlooked for cultural competency training, and efforts are needed to reduce racial bias among healthcare workers identified as having higher levels of bias.

Department of Health Services Administration and Policy Temple University Philadelphia PA USA

Department of Internal Medicine Montgomery Campus of the University of Alabama School of Medicine Montgomery AL USA

Department of Psychology University of Arizona Tucson AZ USA

Department of Sociology University of Alabama at Birmingham and Research Centre for Toxic Compounds in the Environment Masaryk University Birmingham AL Czech Republic

Division of Preventive Medicine School of Medicine University of Alabama at Birmingham Birmingham AL USA

The Disparities Solutions Center Massachusetts General Hospital and Harvard Medical School Boston MA USA

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Development of a Multicomponent Intervention to Decrease Racial Bias Among Healthcare Staff