14Objective 15 Implicit prejudice and stereotyping may exist in health care providers automatically without their 16 awareness. These biases can correlate with outcomes that are consequential for the patient. This 17 study examined gynecologic oncology care providers' implicit prejudice and stereotyping toward 18 cervical cancer. 19Methods 20Members of professional gynecologic oncology organizations were asked to complete two 21 Implicit Association Tests to determine if they implicitly associate cervical cancer with feelings 22 of anger (prejudice) and beliefs about culpability for the disease (stereotypes), compared to 23 ovarian cancer. Linear models and student t-tests examined average levels of implicit bias and 24 moderators of the implicit bias effects. 25
Results 26One-hundred seventy-six (132 female, 43 male, 1 nonresponse; � age = 39.18 years, SDage = 10.58 27 years) providers were recruited and the final sample included 151 participants (93 physicians and 28 58 nurses, � age = 38.93, SDage= 10.59). Gynecologic oncology providers showed significant 29 levels of implicit prejudice, � = 0.17, SD = 0.47, 95% CI: (0.10, 0.25), towards cervical cancer 30 patients. They also showed significant levels of implicit stereotyping of cervical cancer patients, 31 � = 0.15, SD = 0.42, 95% CI: (0.08, 0.21). Whereas physicians did not demonstrate significant 32 levels of implicit bias, nurses demonstrated greater levels of implicit prejudice and implicit 33 stereotyping. Providers without cultural competency/implicit bias training demonstrated greater 34 bias than those who had completed such training (p < 0.05). 35Conclusions 36 3This study provides the first evidence that gynecologic oncology providers hold implicit biases 37 related to cervical cancer. Interventions may be designed to target specific groups in gynecologic 38 oncology to improve interactions with patients. 39 4
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