The association between patient–provider racial/ethnic concordance, working alliance, and length of treatment in behavioral health settings.

Cheng, A.; Nakash, Ora; Cruz-Gonzalez, Mario; Fillbrunn, Mirko; Alegrı́a, Margarita

doi:10.1037/ser0000582

Cited by 22 publications

(14 citation statements)

References 68 publications

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“…suggests limited evidence on the effectiveness of race-matching as a preventative health care measure, 40 there is evidence that it may be important in behavioral health settings. 41 Results from the current study move beyond the patient-provider level, highlighting several interpersonal, organizational, and policy level recommendations for an antiracist approach to integrated primary care. As noted by Hassen and colleagues, 18 many antiracist approaches to health care utilize a multilevel approach.…”

Section: Discussionmentioning

confidence: 78%

“…The current study also highlights that patient‐provider race‐matching may be an important patient preference to consider when implementing antiracist approaches in care. Although research suggests limited evidence on the effectiveness of race‐matching as a preventative health care measure, 40 there is evidence that it may be important in behavioral health settings 41 . Results from the current study move beyond the patient‐provider level, highlighting several interpersonal, organizational, and policy level recommendations for an antiracist approach to integrated primary care.…”

Section: Discussionmentioning

confidence: 78%

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Consideration of racism experiences in the implementation of trauma‐focused therapy in primary care

McCuistian

Kimball

Vega

et al. 2022

Health Services Research

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Objective To understand providers' perceptions of how a patient's experience of racism may impact the successful implementation of a brief posttraumatic stress disorder (PTSD) treatment in the safety net integrated primary care setting. To conduct a developmental formative evaluation prior to a hybrid type I effectiveness‐implementation trial. Data Sources and Study Setting From October 2020 to January 2021, in‐depth qualitative interviews were conducted with integrated primary care stakeholders (N = 27) at the largest safety net hospital in New England, where 82% of patients identify as racial or ethnic minorities. Study Design Interviews with clinical stakeholders were used to (a) contextualize current patient and provider experiences and responses to racism, (b) consider how racism may impact PTSD treatment implementation, (c) gather recommendations for potential augmentation to the proposed PTSD treatment (e.g., culturally responsive delivery, cultural adaptation), and (d) gather recommendations for how to shift the integrated primary care practice to an antiracist framework. Data Collection/Extraction Methods Interview data were gathered using remote data collection methods (video conferencing). Participants were hospital employees, including psychologists, social workers, primary care physicians, community health workers, administrators, and operations managers. We used conventional content analysis. Principal Findings Clinical stakeholders acknowledged the impact of racism, including racial stress and trauma, on patient engagement and noted the potential need to adapt PTSD treatments to enhance engagement. Clinical stakeholders also characterized the harms of racism on patients and providers and provided recommendations such as changes to staff training and hiring practices, examination of racist policies, and increases in support for providers of color. Conclusions This study contextualizes providers' perceptions of racism in the integrated primary care practice and provides some suggestions for shifting to an antiracist framework. Our findings also highlight how racism in health care may be a PTSD treatment implementation barrier.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 78%

Consideration of racism experiences in the implementation of trauma‐focused therapy in primary care

McCuistian

Kimball

Vega

et al. 2022

Health Services Research

View full text Add to dashboard Cite

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“…First, PNCC sites should prioritize the recruitment of community concordant PNCC providers, whether they are nurses as in both of our research sites, or community health workers. Although we did not specifically seek to document clients’ thoughts on racial concordance with their PNCC provider (see Limitations below), the benefits of concordance with healthcare providers have been documented in other settings (Cheng, Nakash, Cruz-Gonzalez, Fillbrunn, & Alegría, 2021; Shen et al, 2018). Second, given the centrality of the nurse-client relationship, PNCC provider training should be established to further develop a nurse or community health worker’s communication, client engagement, and compassionate care abilities.…”

Section: Discussionmentioning

confidence: 99%

“…Although we did not specifically seek to document clients' thoughts on racial concordance with their PNCC provider (see Limitations below), the benefits of concordance with healthcare providers have been documented in other settings (Cheng, Nakash, Cruz-Gonzalez, Fillbrunn, & Alegría, 2021;Shen et al, 2018) overall-that contributed to mistrust and unwillingness to participate, and c) our participant payment was not enough to motivate or enable the time and effort required to participate.…”

Section: Discussionmentioning

confidence: 99%

Beyond Common Outcomes: Client’s Perspectives on the Benefits of Prenatal Care Coordination

Greene

Tran-Smith

Moua

2022

Preprint

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Prenatal Care Coordination (PNCC) is a fee-for-service Medicaid benefit available in Wisconsin and several other states. It provides for home visiting, health education, care coordination and other supportive services to high-risk mothers. However, PNCC is not supported by an evidence-based model, its impact is not systematically evaluated, and the benefit is not currently reaching all eligible mothers. The purpose of this qualitative descriptive study was to describe PNCC clients' perspectives on the experience of receiving the benefit and the value and impact of PNCC in the context of their own lives. We interviewed recent clients of PNCC programs in two PNCC sites that varied by racial/ethnic community makeup, rural/urban geography, and health department size. PNCC clients identified two major benefits of PNCC: 1) social and emotional support from the PNCC nurse; and 2) assistance with obtaining or getting connected to other resources they needed. These two program benefits were especially meaningful to PNCC clients in the context of difficult life events and circumstances. Findings from this study highlight the impact of PNCC services on social and emotional health through trusting and supportive nurse-client relationships. Our findings also suggest that a longer program period and the development of standards to assess program effectiveness would improve PNCC client outcomes and reduce disparities in maternal health.

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“…For example, the proposed revisions of the CPA’s accreditation standards (Canadian Psychological Association [CPA], 2021, p. 48) state clearly that in order to repair and build meaningful relationships with the Indigenous Peoples, psychology needs to be derived from both Indigenous and Eurocentric knowledge, known as the “two-eyed seeing” approach (Blume, 2020; Marshall et al, 2015; Truth and Reconciliation Commission of Canada, 2015a). Congruent with these principles, fostering the representation of BIPOC graduate students within psychology is vital for the psychological health within BIPOC communities because members from these groups are more likely to seek treatment from providers with whom they share ethnicity, race, and lived experiences (Cheng et al, 2021; Tram et al, 2020). Furthermore, Cénat, Kogan, et al (2021) found that Black individuals in the top quartile of those experiencing “everyday racial discrimination” were 36.4 times more likely to report symptoms of depression relative to those in the lowest category (Cénat, Kogan, et al, 2021).…”

Section: The Rationale For Focusing On Bipocmentioning

confidence: 99%

Increasing the representation of Black, Indigenous, and People of Colour as students in psychology doctoral programmes.

Sarr¹,

Knight²,

Strauss³

et al. 2022

Canadian Psychology / Psychologie canadienne

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There have been persistent calls for increased representation of Black, Indigenous, and People of Colour (BIPOC) in all aspects of the psychology workforce. For equity to occur in the profession and delivery of services, there must be equity in access to graduate-level training in psychology. In this article, we discuss systemic racial inequity in access to Canadian psychology graduate programmes. We reviewed literature to investigate admissions evaluation criteria for racial bias using the University of Ottawa, School of Psychology's publicly available ranking grid as an example. This scoring grid provides a transparent evaluation process that includes elements common to many Canadian programmes. We reviewed literature relevant to predictive validity and racial bias in the grid elements. Our review was guided by two questions: (a) What evidence is there that ranking grid items and other commonly used admissions criteria predict psychology graduate student success? (b) Do the criteria maintain systemic racial bias in the selection of graduate students? We found that all items on the admissions ranking grid were biased, suggesting that racial bias in admissions criteria maintains systemic racism against BIPOC applicants. We propose both concrete and policy/advocacy recommendations to improve access to psychology graduate education for BIPOC groups; these recommendations may benefit other underrepresented groups as well. Public Significance StatementBIPOC are disproportionately underrepresented in Canadian graduate psychology programmes, resulting in few BIPOC working in psychology professions in Canada. This lack of representation has devastating impacts on the profession of psychology as a whole (e.g., lack of diverse thought), and importantly, the health of racialized communities (e.g., lack of culturally appropriate practices and services). The recommendations provided herein can inform changes in policy and procedures to promote racial equity, diversity, and inclusion in the field of psychology.

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The association between patient–provider racial/ethnic concordance, working alliance, and length of treatment in behavioral health settings.

Cited by 22 publications

References 68 publications

Consideration of racism experiences in the implementation of trauma‐focused therapy in primary care

Consideration of racism experiences in the implementation of trauma‐focused therapy in primary care

Beyond Common Outcomes: Client’s Perspectives on the Benefits of Prenatal Care Coordination

Increasing the representation of Black, Indigenous, and People of Colour as students in psychology doctoral programmes.

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