Objectives: We aimed to evaluate the association between implicit racial bias and willingness to remove an intrauterine device (IUD) upon patient request.
Methods: We recruited obstetrician-gynecology (Ob-Gyn) and family medicine (FM) residents and attendings via national residency listservs. We collected demographic information and then randomized participants to view a clinical vignette associated with either a picture of a black or white patient who requested IUD removal. After selecting their management, participants completed a validated racial Implicit Associated Test (IAT).
Results: To date, 367 participants completed the study. 278 (76.7%) were Ob-Gyn, 83 (22.9%) were FM, and 262 (71.4%) were residents. We found no statistical differences in participant randomization to the black or white patient based on demographics. Participants who were randomized to the clinical vignette with the black patient were more likely to leave the IUD in place if they had a stronger racial preference for white people, as determined by the IAT. We found no differences in IUD discontinuation rates by racial preference among participants randomized to the white patient or by baseline demographics.
Conclusions: Our preliminary findings suggest that implicit racial bias may have an association with clinician reported intentions for contraceptive counseling and provision, in particular with IUD discontinuation. Given the importance of patient autonomy and shared decision making in reproductive life planning, these findings require further investigation to understand the role of implicit bias in contraceptive discontinuation.
© 2021 Published by Elsevier Inc.