Minding the gap: The importance of active facilitation in moving boundary objects from in-theory to in-use as a tool for knowledge mobilisation

Hassan, Shaima; Melville-Richards, Lucy; Ring, Adele; Cloke, Jane; Smith, Sandra; Saini, Pooja; Goodall, M. C.; Porroche-Escudero, Ana; Popay, Jennie; Gabbay, Mark

doi:10.1016/j.ssmqr.2023.100235

Cited by 1 publication

(2 citation statements)

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“…It is increasingly recognised any such improvement efforts that seek to address health inequalities, such as those caused by HPs implicit SES bias, must involve meaningful coproduction and dialogue about health inequalities that enables and empowers people to have agency and to take action. 115 …”

Section: Resultsmentioning

confidence: 99%

“…Health inequalities only endure because of a lack of insight or willingness to address social injustice, social indifference, an ideological stance or a vacuum of leadership. 115 Given what this scoping review has surfaced about the potential impact of implicit SES-related HP bias greater consideration is needed about how the results can inform efforts to reduce health inequalities. It is also important to concede that HPs implicit biases often mirror those of wider society at any given point in time because their values, beliefs, attitude, outlook and world view will be tempered and influenced by the communities that they belong to and the wider culture that they inhabit.…”

Section: Resultsmentioning

confidence: 99%

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Health professionals implicit bias of patients with low socioeconomic status (SES) and its effects on clinical decision-making: a scoping review

Job,

Adenipekun,

Cleves

et al. 2024

BMJ Open

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ObjectivesResearch indicates that people with lower socioeconomic status (SES) receive inferior healthcare and experience poorer health outcomes compared with those with higher SES, in part due to health professional (HP) bias. We conducted a scoping review of the impact of HP bias about SES on clinical decision-making and its effect on the care of adults with lower SES.DesignJBI scoping review methods were used to perform a systematic comprehensive search for literature. The scoping review protocol has been published inBMJ Open.Data sourcesMedline, Embase, ASSIA, Scopus and CINAHL were searched, from the first available start date of the individual database to March 2023. Two independent reviewers filtered and screened papers.Eligibility criteriaStudies of all designs were included in this review to provide a comprehensive map of the existing evidence of the impact of HP bias of SES on clinical decision-making and its effect on the care for people with lower SES.Data extraction and synthesisData were gathered using an adapted JBI data extraction tool for systematic scoping reviews.ResultsSixty-seven papers were included from 1975 to 2023. 35 (73%) of the included primary research studies reported an association between HP SES bias and decision-making. Thirteen (27%) of the included primary research studies did not find an association between HP SES bias and decision-making. Stereotyping and bias can adversely affect decision-making when the HP is fatigued or has a high cognitive load. There is evidence of intersectionality which can have a powerful cumulative effect on HP assessment and subsequent decision-making. HP implicit bias may be mitigated through the assertiveness of the patient with low SES.ConclusionHP decision-making is at times influenced by non-medical factors for people of low SES, and assumptions are made based on implicit bias and stereotyping, which compound or exacerbate health inequalities. Research that focuses on decision-making when the HP has a high cognitive load, would help the health community to better understand this potential influence.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%