Neonatology Fellow Children's National Health System Washington, District of Columbia, United States
Background: Systemic racism, historical racial trauma, and health disparities can affect the care provided to NICU patients and families. Tools and frameworks, such as implicit bias training and trauma-informed care (TIC) respectively, have been implemented to assist with mitigating bias and reducing trauma exposure. Application of these practices continues to fall short, especially in the area of communication. Communication skills are an integral part of these ideals, yet gaps exist in the delivery of these practices. Although concordance studies outlining differences in communication based on race of clinician and family exist, very few detail the attitudes and perceptions of race and communication from both family and provider perspectives. This qualitative study seeks to explore family and provider perspectives on the intersections of family-clinician communication, trust, bias, and racial health disparities in the NICU setting. Objective: This study seeks to determine the perception, confidence, and experience of NICU clinical staff on family communication related to trauma-informed care, racism, and racial health disparities. Additionally, it seeks to determine the perception and experience of NICU parents with family-clinician communication related to strengths and weaknesses in building a therapeutic alliance, in the context of their personal racial and ethnic identities. Design/Methods: Study participants (staff=18, parent=4) completed a demographic survey, followed by a qualitative interview on the topics of communication and race in the NICU, and racism in medicine. Each interview was recorded, and transcribed. They will be analyzed using Atlas.Ti. A codebook will be developed. Themes that evolve will guide understanding of perceptions of racism as a potential barrier to effective communication with NICU clinical staff. An additional 6 parents will potentially need to be enrolled to achieve thematic saturation. Demographic data will be analyzed using simple descriptive analysis. We have IRB approval and results will be available by February 2024 or before.
