Explicit and Implicit Disability Attitudes of Healthcare Providers.

Purpose/Objective: Health care providers' attitudes of marginalized groups can be key factors that contribute to health care access and outcome disparities because of their influence on patient encounters as well as clinical decision-making. Despite a growing body of knowledge linking disparate health outcomes to providers' clinical decision making, less research has focused on providers' attitudes about disability. The aim of this study was to examine providers' explicit and implicit disability attitudes, interactions between their attitudes, and correlates of explicit and implicit bias. Research Method/Design: We analyzed secondary data from 25,006 health care providers about their disability attitudes. In addition to analyzing people's explicit and implicit attitudes (Disability Attitudes Implicit Association Test), we used Son Hing, Chung-Yan, Hamilton, & Zanna's (2008) model of two-dimensional prejudice to compare provider's explicit and implicit attitudes. Finally, we used linear regression models to examine correlates of providers' explicit and implicit attitudes. Results: While on average, provider's explicit attitudes (M = 4.41) indicated little prejudice, their implicit attitudes (M = 0.54) revealed they moderately preferred nondisabled people—they were aversive ableists. Correlates of providers' explicit and implicit attitudes also included age, gender, political orientation, and having relationships with disability (friends, family, and being a person with disability). Conclusions/Implications: This study revealed that despite a majority of providers self-reporting not being biased against people with disabilities, implicitly, the overwhelming majority were biased. This study's findings can be used to better understand how provider disability bias can contribute to inequitable health care access and health outcomes for people with disabilities. Impact and Implications: The findings of this study suggest that health care providers, in many cases, are not cognizant of their own biases related to disability. It is evident that more research is needed to fully understand the impact of bias on people with disabilities in health care contexts, as well as to determine and implement effective means of reducing bias among providers. [ABSTRACT FROM AUTHOR]

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