# UnBIASED: Understanding Biased patient-provider Interaction And Supporting Enhanced Discourse

> **NIH NIH R01** · UNIVERSITY OF WASHINGTON · 2020 · $48,024

## Abstract

Project Summary/Abstract
Members of the Lesbian, Gay, Bisexual, Transgender, Queer, and other (LGBTQ+) community are more prone
to experience discrimination than the general population based on their sexual orientation or gender identity. In
healthcare, examples include assumptions about heterosexuality, homophobic/transphobic attitudes or
comments, or neglecting the specific needs of LGBTQ+ patients. This discrimination results in poor patient-
provider communication, delays in care-seeking, care inequities, and health disparities. Often such discrimination
is due to implicit biases that are unintentional, and thus “hidden” in patient-provider communication, yet linked
with negative healthcare experiences associated with inadequate care and lack of provider knowledge about
LGBTQ+ health care needs. The resulting health disparities are demonstrated by the LGTBQ+ community having
greater susceptibility to mental health issues, higher rates of substance use, and poorer diet and exercise
behaviors than the general population. As we argue in the parent grant, there is a dire need to address health
disparities by understanding and mitigating implicit bias that manifests within the interactions between patients
and providers. To expand our parent grant focus on low income, racially diverse patients, this diversity
supplement focuses on LGBTQ+ people. Following the same study design as Aim 2 of the parent grant, the
proposed project will engage LGBTQ+ patients and primary care providers to design communication feedback
that conveys hidden bias. The proposed project will engage LGBTQ+ patients and primary care providers in
three aims to (1) assess needs for communication feedback on implicit bias, (2) co-design prototype feedback,
and (3) and iteratively refine prototype feedback through usability testing. Project findings will extend the parent
grant by providing design evidence from a second critical patient population known to experience implicit
healthcare biases that lead to health disparities. In addition to advancing our understanding of implicit bias as a
barrier to patient-centered communication for LGBTQ+ people, this evidence will contribute to more robust
models and automated tools for assessment and feedback being developed in the parent grant.

## Key facts

- **NIH application ID:** 10204270
- **Project number:** 3R01LM013301-02S1
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** Andrea L. Hartzler
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $48,024
- **Award type:** 3
- **Project period:** 2019-09-20 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10204270

## Citation

> US National Institutes of Health, RePORTER application 10204270, UnBIASED: Understanding Biased patient-provider Interaction And Supporting Enhanced Discourse (3R01LM013301-02S1). Retrieved via AI Analytics 2026-06-01 from https://api.ai-analytics.org/grant/nih/10204270. Licensed CC0.

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