Date Presented 04/13/21
Racial bias is defined as the negative evaluation of a group and its members relative to another and can exist on explicit and implicit levels. This is an exploratory study to examine the presence of implicit and explicit racial bias among OT professionals across the United States. The results (N = 201) highlight the presence of implicit and explicit racial biases among OT professionals in the United States and the need for further education on racial bias.
Primary Author and Speaker: Alaa Abou-Arab
Additional Authors and Speakers: Alee Leteria, Kristina Zanayed, and Susanne Higgins
PURPOSE: Racial bias can be defined as the negative evaluation of group and its members relative to another. Bias can exist on both explicit and implicit levels, making its measurement difficult (Maina et al., 2017). Explicit racial bias can be measured by self-reporting and implicit racial bias can be activated by the mere presence of another’s race, without a person’s full awareness or control (Dovido, Gaertner, & Kawakami, 2002). Occupational therapy personnel have a vested interest in addressing inequities, including biases, that limit opportunities for participation in society (Braveman & Bass-Haugen, 2009). Over 30 studies that assessed implicit and explicit racial and ethnic bias among healthcare providers showed that most healthcare providers, across multiple levels of training and disciplines have implicit bias against Black, Latino, American Indian, and dark-skinned individuals (Blair et al., 2013; Maina et al., 2017), however evidence of assessment of racial biases in occupational therapy professionals was limited.
DESIGN: Exploratory study design
METHODS: This exploratory study examines the presence of implicit and explicit racial bias among occupational therapy professionals across the United States using the feeling thermometer ratings (FT) to study explicit racial bias and the racial argument scale (RAS) to study implicit racial bias. The RAS is a valid and reliable measure of subtle and implicit racial attitudes and has a poor correlation with measures of social desirability (Saucier & Miller, 2003). FT is a widely used ranking system to measure the general population's attitudes and feelings towards a particular group or organization. Research indicates that the FT is reliable and valid measure of self-reported feelings about a particular group or organization (Lie and Wang, 2015). Participants (n = 201, 133 = OTR, 15 = OTA, 53 = OTS) consisted of occupational therapists and occupational therapy assistants as well as students enrolled in occupational therapy programs across the United States. Demographics such as participants’ gender identity, geographical location, race, sexual orientation, religion, age, and area of practice, were also collected. Descriptive statistics, regression, and correlation analysis were used to analyze the data.
RESULTS: Participants were obtained from all four quadrants of the United States (Northeast – 37.5%, Midwest – 20.5%, South – 28%, West- 14%). The results showed a positive correlation between a participant’s self-identified race and favorable explicit racial biases or feelings towards that same race. Additionally, participants who identified as not White had a less favorable explicit racial bias towards White people. Regression analysis highlighted that 1) Race (p = .035) and religion (p = .000) statistically predicted implicit racial bias towards African American, 2) Religion (p = .002) and gender identity (p = .032) statistically predicted explicit racial bias towards Arabs and/or Muslims, 3) Race (p = .047) and religion (p = .001) statistically predicted explicit racial bias towards White people.
CONCLUSION: The study is one of the first to nationally sample occupational therapy professionals and indicate the presence of implicit and explicit racial bias among them. This highlights that without addressing the issue of race and racial bias, occupational therapist and occupational therapy researchers are not fully committing to improve and fit the needs of their client(s). There is not only a need for further research, but education and training on racial bias for occupational therapy professionals, not to eliminate, but to create awareness of biases and provide therapists with strategies to prevent these biases from interfering with providing the best quality care.
References
Blair, I. V., Steiner, J. F., Fairclough, D. L., Hanratty, R., Price, D.W., Hirsh, H.K (2013). Clinicians’ implicit ethnic/racial bias and perceptions of care among Black and Latino patients. Ann.Fam.Med. 11(1), 43e52. http://dx.doi.org/ 10.1370/afm.1442.
Liu, M., & Wang, Y. (2015). Data Collection mode effect on feeling thermometer questions: A comparison of face-to-face and Web surveys. Computers in Human Behavior, 48, 212-218.
Maina, I.V., Belton, T.D., Ginzberg, S., Singh, A., & Johnson, T.J. (2018). A decade of studying implicit racial/ethnic bias in healthcare providers using the implicit association test. Social Science and Medicine 199 (2018) 219-229.
Suacier, D. A. & Miller, C.T. (2003). The Persuasiveness of Racial Arguments as a Subtle Measure of Racism. Personality and Social Psychology Bulletin 29 (10) 1303-1315.
