Understanding the Relationship Between Pharmacists’ Implicit and Explicit Bias and Perceptions of Pharmacist Services Among Arab and Black Individuals
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Date
2019-11-27
Authors
Alzahrani, Fahad
Journal Title
Journal ISSN
Volume Title
Publisher
University of Waterloo
Abstract
Background. Recent studies suggest that Health Care Professionals’ (HCPs) unconscious bias about race contributes to health care disparities. The objective of this research was to estimate unconscious racial bias among pharmacists in order to understand its relationship with Black and Arab individuals’ perceptions and experience of pharmacist services and their interaction with pharmacists in Ontario.
Methods. Multi-method research combining both quantitative and qualitative methods was employed. A secure, web-based survey was administered to Ontario community pharmacists. The survey included two Implicit Association Tests (IATs) to assess unconscious preferences and direct questions regarding community pharmacists’ explicit attitude to race. In a qualitative study using purposive sampling, face-to-face semi-structured interviews with 27 Black and Arab individuals were conducted to explore their interactions with pharmacists and their opinions, perceptions, attitudes, and experiences about community pharmacist services.
Results. A total of 407 community pharmacists (40% male, mean age 47, 57% white) completed the survey. Evidence of race/ethnicity bias toward Black and Arab individuals was evident, as determined by both explicit and implicit measures. Moderate to high levels of implicit pro-white bias were found among Ontario community pharmacists on average. Explicit pro-white bias was less evident, but apparent for measures of racial/ethnic preference and, relative warmth (amount of warmth felt toward Black/Arab individuals subtracted from the amount of warmth felt toward whites). In addition, implicit bias appeared to be associated with pharmacist characteristics such as age, racial/ethnic background, years as a pharmacist, years as a licensed pharmacist in Canada practice location, and place of birth, and explicit preferences had a weak positive correlation. The qualitative data revealed that most Black and Arab individuals felt comfortable interacting
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and seeking advice from their pharmacists. However, some Black and Arab participants experienced discrimination from community pharmacists. The data also provided information about some personal and systemic issues encountered by Black and Arab individuals when they interacted with community pharmacist.
Conclusions. Race and ethnicity bias exists among most Ontario community pharmacists and may be associated with Black and Arab individuals’ perceptions of pharmacist services and their interaction with pharmacists. Future work needs to employ more rigorous approaches to explore whether, and under what conditions, community pharmacists’ implicit bias about race/ethnicity affect the quality of their services toward visible minority individuals, including Black and Arab people. Interventions to reduce bias may need to be comprehensive so that they can ultimately influence an individual’s implicit and explicit biases in all measured areas.
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Keywords
community pharmacy, bias, black and Arab individuals, multi-method research