Rationale for the Study: Public health officials, academics, and social activists agree health disparities between African Americans and Whites is a serious, pervasive, and persistent health problem. Stereotype threat in clinical encounters is postulated to be one contributor to healthcare disparities, as evidenced by patients avoiding healthcare, communication challenges, and patient non-adherence to treatment plans. Authors postulate compared to Whites, African Americans encounter more situations where they are stereotyped and subsequently are at higher risk for stereotype threat. Purpose: The purpose of this mixed methods study was to address healthcare encounters triggering stereotype threat amongst African Americans with hypertension or diabetes. Method: A basic qualitative mixed methods study, using a convergent design was conducted. The Multidimensional Inventory of Black Identity (MIBI) Centrality Scale and semi-structured interviews provided quantitative and qualitative data. Data was analyzed separately and then integrated to determine areas of convergence and divergence. Results: The MIBI Centrality Scale mean score across the sample was 5.46. Individuals of Caribbean ethnicity scored lower on the MIBI Centrality Scale (i.e., M = 4.5). Fifty-five percent of participants (i.e., 12 of 22) described differential treatment. Race emerged as the common denominator during suboptimal healthcare encounters. Caribbean participants described fewer encounters of differential treatment in comparison to their African American counterparts. Only one participant’s healthcare encounter contained elements associated with stereotype threat. Provider behaviors associated with positive healthcare encounters were the exact opposite of behaviors participants associated with differential treatment. Conclusion: Human beings are sociocultural individuals. Culture and other social identities intersect to shape racial saliency during healthcare encounters. In most cases, ineffective communication (i.e., not listening to patients) was the vehicle for actual or potential healthcare disparities.
Leslie Wright-Brown (Thu,) studied this question.