Implicit Bias in Healthcare Professionals Caring for Children with Acquired Brain Injuries: A Scoping Review

Objective(s): To investigate the incidence of implicit bias in healthcare professionals caring for children with acquired brain injury (ABI). Unacknowledged bias, particularly of healthcare providers can result in healthcare disparities (FitzGerald & Hurst, 2017).

Data Sources: Five databases (CINAHL Plus, Cochrane CENTRAL, PsycARTICLES, PsycINFO, and PubMed) were searched using a pre-determined set of keyword strings. All articles published before 2/23/2022 were included, except for non-empirical or non-English articles that couldn’t be translated.

Study Selection: PRISMA guidelines were followed for screening (Moher et al., 2011). After duplicate removal, 143 studies entered title/abstract screening, resulting in 37 studies for full-text screening. Three studies were found eligible for inclusion in this review. The risk of bias was assessed by two independent raters following the Cochrane guidelines.

Data Extraction: Characteristics of the included studies were qualitatively synthesized to create descriptive summaries of the study design and findings. PRISMA guidelines were followed where independent extraction was performed by two co-authors using a pre-schemed template.

Data Synthesis: All articles evaluated the racial and ethnic implicit bias and the evaluation of abusive head trauma (AHT). Ages ranged from birth to three years of age. Rangel et al. (2009) used a pre/post-policy-based intervention to decrease the disparity in care. Hymel et al. (2018) found minority race/ethnicity patients to be more frequently evaluated (p <.001) for suspected AHT than white/non-Hispanic patients. Site-specific analysis showed two of eighteen sites with significant race-based disparities in AHT evaluation and reporting. Jenny et al. (1999) found AHT to be more likely unrecognized in young white children.

Conclusions: This review is among the first in synthesizing implicit bias of healthcare professionals amid the pediatric ABI population. The dearth studies available indicate a need for additional research on the potential bias of healthcare providers and the association on pediatric ABI outcomes.

Author(s) Disclosures: None