A Systematic Review of Microaggression-Focused Interventions and Training Programs in Healthcare
Rui Fu1, Jonathan Varghese1, Nathalie H Duroseau2
1Center for Violence Prevention at Children's Hospital of Philadelphia, PA, USA.
Abstract:
Microaggressions in healthcare are prevalent in clinical encounters, training, and collegial interactions, impacting the physical and psychological well-being of patients and healthcare professionals with marginalized backgrounds. To address healthcare-based microaggressions, there has been an increasing number of interventions and training programs over the past few decades. Based upon the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist, a systematic literature search, screening, and review of microaggression-focused interventions and programs in healthcare settings was conducted and yielded 44 interventions. The interventions and training programs included were reviewed on a range of program characteristics and quality indicators, such as theoretical framework, targeted interpersonal interaction, targeted behavioral strategies, delivery platform and teaching modality, and evaluation design. The reviewed interventions and programs have shown promising potential in enhancing awareness of and/or behavioral skills in addressing microaggressions. Further, this review identified critical areas in the field for improvement, such as a lack of interventions designed for or implemented among preceptors and patients and for equipping perpetrators with strategies when involved in microaggressions, insufficient use of randomized controlled trials and other rigorous methods for intervention and program evaluation, and a lack of an intersectionality lens and placing microaggressions in the historical and structural context.
Insights
Healthcare microaggressions harm patients and professionals. While interventions show promise, more rigorous research and inclusive approaches are needed to effectively address these pervasive issues.
Area of Science:
- Healthcare Disparities
- Medical Education
- Health Equity
Background:
- Microaggressions in healthcare settings negatively impact patient and professional well-being, particularly for marginalized groups.
- Numerous interventions and training programs have been developed to combat healthcare microaggressions over recent decades.
Purpose of the Study:
- To systematically review and analyze existing interventions and training programs designed to address microaggressions in healthcare.
- To evaluate the characteristics and quality of these interventions and identify areas for improvement.
Main Methods:
- A systematic literature search, screening, and review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
- Forty-four microaggression-focused interventions and programs in healthcare were analyzed based on program characteristics and quality indicators.
Main Results:
- Reviewed interventions demonstrate potential in improving awareness and behavioral skills for addressing microaggressions.
- Key areas for enhancement include developing interventions for preceptors and patients, equipping perpetrators with strategies, and increasing the use of rigorous evaluation methods like randomized controlled trials.
Conclusions:
- Current interventions show promise but require further development to address critical gaps.
- Future efforts should incorporate an intersectionality lens and acknowledge the historical and structural context of microaggressions for more effective solutions.
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