Implicit Bias Toward Cervical Cancer: Provider and Training Differences

Abstract

Implicit prejudice and stereotyping may exist in health care providers automatically without their awareness. These biases often correlate with outcomes that are consequential for the patient. This study examined gynecologic oncology care providers' implicit prejudice and stereotyping toward cervical cancer. Members of professional gynecologic oncology organizations were asked to complete two Implicit Association Tests (IAT) to determine if they implicitly associate cervical cancer with feelings of anger (prejudice) or beliefs about culpability for the disease (stereotypes), compared to ovarian cancer. Linear regression models and Student t-tests examined average levels of implicit bias and moderators of the implicit bias effects. One-hundred seventy-six (132 female, 43 male, 1 nonresponse; mean age = 39.18 years, SD age = 10.58 years) providers were recruited and the final sample included 151 participants (93 physicians and 58 nurses, mean age=38.93, SD age=10.59). Gynecologic oncology providers showed significant levels of implicit prejudice, X = 0.17, SD = 0.47, 95% CI: (0.10, 0.25), toward cervical cancer patients. They also showed significant levels of implicit stereotyping of cervical cancer patients, X=0.15, SD=0.42, 95% CI: (0.08, 0.21). Whereas physicians did not demonstrate significant levels of implicit bias, nurses demonstrated greater levels of implicit prejudice and implicit stereotyping. Providers without cultural competency training or implicit bias training demonstrated greater implicit bias than those who had completed such training (p < .05). This study provides the first evidence that gynecologic oncology providers hold implicit biases related to cervical cancer. Interventions designed to target specific groups in gynecologic oncology may help improve interactions with patients.