NIH Awards $3.4 Million for Study of Situational Bias in Healthcare

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The National Institutes of Health awarded just under $3.4 million to Anastasia Makhanova, an assistant professor of psychology at the University of Arkansas. Makhanova will study how stress, illness or worries about personal health may cause healthcare workers to show more bias toward patients from racial or ethnic minority groups. 

“Most people tend to focus on individual differences when it comes to looking at bias. There’s been a lot less attention to the fact that the same people can make more biased decisions in particular situations,” Makhanova said. 

Research has shown that, on average, patients from racial or ethnic minority groups receive worse care than white patients. By identifying the situation that could cause a medical provider to act with increased bias, Makhanova’s research ccan show healthcare workers the most effective times to use existing anti-bias strategies. The results could also lead to systematic changes that reduce burnout and encourage healthcare providers to not work when they are sick. 

In collaboration with five other universities and hospitals, including the University of Arkansas Medical Sciences, Makhanova will track how healthcare workers treat patients with abdominal pain, a complaint without a standardized treatment plan. Past research has found inequities in abdominal pain treatment. For example, Black and Latino patients receive less pain treatment than white patients even when they report the same level of abdominal discomfort. Makhanova and her team will then examine whether being stressed, sick or worried about illness affected the treatment the healthcare workers delivered. 

Preliminary research by Makhanova has shown that inflammation can also increase bias. In fact, people who are most aware of their own biases, and try to limit them, can be more susceptible to them when they are sick. 

“When people are experiencing those inflammatory processes, they have less energy for thinking. So motivation and self-regulation both take a dive, and those are both necessary to engage in those planned, careful and attentive behavior,” Makhanova said. 

In the study, healthcare workers will take a psychological test to measure bias before receiving a flu vaccine. They will re-take the test 24 hours later when the vaccine causes a rise in cytokines, the proteins that increase inflammation in the body. 

“I think we’re bringing something novel that also has potential to build on existing interventions,” Makhanova said about the study. 

The five-year grant will be administered by the NIH’s National Institute on Minority Health and Health Disparities. The U of A’s Ana Julia Bridges of the Department of Psychology and Michelle Gray of the  Exercise Science Program are co-investigators on the project. The grant also includes funding for a U of A graduate student.