Uncovering social structures and informational prejudices to reduce inequity in delivery and uptake of new molecular technologies

Abstract

Advances in molecular technologies have the potential to help remedy health inequities through earlier detection and prevention; if, however, their delivery and uptake (and therefore any benefits associated with such testing) are not more carefully considered, there is a very real risk that existing inequities in access and use will be further exacerbated. We argue this risk relates to the way that information and knowledge about the technology is both acquired and shared, or not, between health practitioners and their patients.A healthcare system can be viewed as a complex social network comprising individuals with different worldviews, hierarchies, professional cultures and subcultures and personal beliefs, both for those giving and receiving care. When healthcare practitioners are not perceived as knowledge equals, they would experience informational prejudices, and the result is that knowledge dissemination across and between them would be impeded. The uptake and delivery of a new technology may be inequitable as a result. Patients would also experience informational prejudice when they are viewed as not being able to understand the information that is presented to them, and information may be withheld.Informational prejudices driven by social relations and structures have thus far been underexplored in considering (in)equitable implementation and uptake of new molecular technologies. Every healthcare interaction represents an opportunity for experiencing informational prejudice, and with it the risk of being inappropriately informed for undertaking (or offering) such screening or testing. Making knowledge acquisition and information dissemination, and experiences of informational prejudice, explicit through sociologically framed investigations would extend our understandings of (in)equity, and offer ways to affect network relationships and structures that support equity in delivery and uptake.

Understanding communication between patients and healthcare professionals regarding comprehensive biomarker testing in precision oncology: A scoping review

“…Importantly, the number of studies dealing with HCP‐specific barriers to cBT‐related communication was low, clearly indicating that more research is needed and reinforcing the point on suitable and continuing HCPs' education in this area 49,50 . Importantly, disseminating cBT‐related knowledge among HCPs and improving uptake of cBT across institutions must be guided by principles of equity and patient‐focused practice 79 …”

“…49,50 Importantly, disseminating cBT-related knowledge among HCPs and improving uptake of cBT across institutions must be guided by principles of equity and patient-focused practice. 79 This study has several limitations. We cannot exclude the possibility that relevant records were omitted because some search terms were broad and only PubMed was searched.…”

A sociology of precision‐in‐practice: The affective and temporal complexities of everyday clinical care

“…However, these gains have been achieved within a complex social, political and economic context that has received limited sociological attention at least insofar as it inflects clinical practice. This is despite precision therapies drawing an increasing proportion of research and development funding and health system resources (Reed et al, 2017 ; Vokinger et al, 2020 ) while also encountering various challenges in being integrated into routine care (Filoche et al, 2019 ; Olstad & McIntyre, 2019 ; Ramaswami et al, 2018 ). How precision medicine is being implemented—in cancer care and beyond—and with what consequences is thus in need of sustained critical attention.…”