The Efficacy of an Antioppression Curriculum for Health Professionals

Abstract

Background and Objectives: Health professionals increasingly recognize the role that social determinants play in health disparities. However, little focus is placed on how health care professionals themselves contribute to disparities through biased care. We have developed a curriculum based on an antioppression framework which encourages health professionals to evaluate their biases and combat health care disparities through an active process of allyship. Methods: Teaching methods emphasize skill building and include lectures, guided reflections, and facilitated discussions. Pre- and postsurveys were administered to assess participants’ confidence level to recognize unconscious bias and to be an ally to colleagues, patients, and staff. In total, we conducted 20 workshops with a total of 468 participants across multiple disciplines. Results: The survey response rate was 80%. Using a paired t-test, the mean difference in the pre- and postsurveys revealed a statistically significant improvement across all measures. Participants showed the greatest improvements (large effect size d>0.8) in their understanding of the process of allyship, their ability to describe strategies to address, assess, and recognize unconscious bias, and their knowledge of managing situations in which prejudice, power, and privilege are involved. Conclusions: Results show that an antioppression curriculum can enhance health professionals’ confidence in addressing bias in health care through allyship. For those who value social justice and equity, moving from the role of bystander to a place of awareness and solidarity allows for one’s behaviors to mirror these values. Allyship is an accessible tool that all health professionals can use in order to facilitate this process.

Part I: A Quantitative Study of Social Risk Screening Acceptability in Patients and Caregivers

“…When feasible, clinical practices engaging in social risk screening activities should develop strategies to ensure screening is conducted by team members with empathy 62 and implicit bias training. 63,64 Future work will need to explore whether social risk−related activities in healthcare settings reduce or exacerbate perceptions of unfair treatment generally and in specific subgroups.…”

Advancing health equity through CTSA programs: Opportunities for interaction between health equity, dissemination and implementation, and translational science

“…Over the years, several personal-, inter-personal-, and structural-level interventions have been developed and tested to address health disparities, and there is a widespread call for innovative EBIs. Examples of interventions at personal and inter-personal levels include exposure to counter-stereotypical exemplars to overcome implicit biases in health professionals [29], and stigma reduction and management [30,31], which have shown some evidence of effectiveness. Structural interventions that aim to change the physical and built environments (such as housing mobility interventions [32]), sociocultural determinants, and multiple levels of influences [33] are complex and more difficult to assess [34] but still show promise in addressing health inequities.…”

Racism Is Real. Racism Is Complicated. Racism Is Real Complicated.

“…8 Intervening more insistently and assertively through an "antioppression curriculum," Diana Wu, MD, and colleagues found that a workshop with multiple teaching approaches successfully taught participants to engage in allyship-"an active, consistent, and arduous practice of unlearning and reevaluating, in which a person of privilege seeks to operate in solidarity with a marginalized group or people." 9 Their paired pre-and postassessments allowed each person's experiences to be compared individually instead of through simple group mean comparisons. Workshop participants gained knowledge, confidence, and skills in allyship.…”