TABLE 3—
Implicit General Race Bias and Race and Medical Compliance Stereotyping as Predictors of Patient–Clinician Communication by Patient Race: The Race and Relationship-Centered Care Study, Baltimore, MD, January 2002–August 2006
| Implicit General Race Bias, Black Patients (n = 131)a |
Implicit General Race Bias, White Patients (n = 48) |
Implicit Race and Medical Compliance Stereotyping, Black Patients (n = 135)a |
Implicit Race and Medical Compliance Stereotyping, White Patients (n = 48) |
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| Communication Behavior | Mean Estimateb (95% CI) | P | Mean Estimateb (95% CI) | P | Mean Estimateb (95% CI) | P | Mean Estimateb (95% CI) | P |
| Verbal dominance ratio | .05 | .01 | .14 | .02 | ||||
| No implicit bias | 1.47 (1.29, 1.66) | 1.27 (1.09, 1.49) | 1.48 (1.28, 1.71) | 1.56 (1.26, 1.94) | ||||
| Implicit bias | 9% (0, 19) | 11% (2, 21) | 10% (−3, 24) | −25% (−42, −4) | ||||
| Visit length, minutes | .36 | .14 | .02 | .001 | ||||
| No implicit bias | 14.0 (11.7, 16.7) | 17.1 (14.6, 19.9) | 13.3 (11.2, 15.7) | 19.5 (16.0, 23.8) | ||||
| Implicit bias | 7% (−7, 22) | 8% (−17, 3) | 20% (3, 40) | −21% (−31, –9) | ||||
| Speech speed, statements per minute | .23 | .83 | .02 | .001 | ||||
| No implicit bias | 25.5 (24.1, 26.9) | 23.7 (21.6, 25.8) | 25.8 (24.6, 27.0) | 21.6 (19.4, 23.8) | ||||
| Implicit bias | –0.76 (−2.02, 0.50) | 0.25 (−2.05, 2.55) | –1.75 (−3.25, −0.25) | 3.9 (1.6, 6.3) | ||||
| Patient centeredness ratio | .63 | .37 | .06 | .02 | ||||
| No implicit bias | 1.66 (0.95, 2.37) | 0.70 (0.58, 0.82) | 1.97 (1.00, 2.94) | 0.60 (0.45, 0.74) | ||||
| Implicit bias | –0.10 (−0.51, 0.31) | –0.05 (−0.17, 0.07) | –0.93 (−1.91, 0.04) | 0.15 (0.02, 0.28) | ||||
| Clinician positive affect | .14 | .78 | .35 | .02 | ||||
| No implicit bias | 3.63 (3.51, 3.75) | 3.38 (3.31, 3.45) | 3.60 (3.49, 3.72) | 3.30 (3.20, 3.40) | ||||
| Implicit bias | –0.10 (−0.23, 0.03) | –0.01 (−0.07, 0.05) | –0.06 (−0.19, 0.07) | 0.12 (0.02, 0.21) | ||||
| Patient positive affect | .04 | .87 | .53 | .09 | ||||
| No implicit bias | 3.39 (3.30, 3.49) | 3.31 (3.19, 3.43) | 3.36 (3.26, 3.45) | 3.24 (3.10, 3.38) | ||||
| Implicit bias | –0.10 (−0.19, –0.00) | 0.01 (−0.09, 0.10) | –0.04 (−0.16, 0.08) | 0.11 (−0.02, 0.24) | ||||
Note. CI = confidence interval. Adjusted for clinician gender and patient age, gender, education, and the mental component of the Medical Outcomes Short Form 12.
We excluded 1 observation from speech speed and 1 from patient centeredness because they were extreme outliers.
We estimated the means while holding all other covariates at their means. The estimate for “no pro-White bias” for verbal dominance and visit length is the geometric mean from the generalized estimating equations (GEE) model for a bias score of zero; the estimate for “implicit bias” is the percentage change in verbal dominance and visit length associated with a 0.5-point increase in the bias score. For all other variables, the estimate for “no implicit bias” is the mean outcome score from the GEE model for a bias score of zero; the estimate for “implicit bias” is the change in the outcome associated with a change in bias score of 0.5 (considered a moderate level of bias).