# Planning grant for clinical trial of implicit bias mitigation training for clinicians

> **NIH NIH R34** · DUKE UNIVERSITY · 2024 · $161,000

## Abstract

Hypertension is a leading cardiovascular disease risk factor in the US and a leading cause of stroke, kidney
disease, and heart failure. Compared to White individuals, it is more prevalent, severe, and uncontrolled in
Black individuals, who have almost two-fold higher age-adjusted mortality for hypertension-related
cardiovascular deaths. Clinician implicit bias (IB) contributes to health disparities, including hypertension
disparities. Because hypertension is most often treated by primary care clinicians, this group is a high priority
for intervention to mitigate IB. Therefore, in order to achieve cardiovascular health equity, it is crucial to
mitigate the impact of primary care clinician IB in hypertension care.
We have developed and pilot-tested an evidence-based curriculum (“Reaching Equity”) designed to teach
practicing clinicians IB mitigation skills. Preliminary data in a group of non-primary care clinicians indicated that
clinicians are motivated to address IB in health care, that Reaching Equity is feasible and acceptable, and that
clinician confidence in providing equitable care increased.
In order to proceed to a definitive clinical trial to test the hypothesis that Reaching Equity will increase use of IB
mitigation skills by primary care clinicians and reduce racial disparities in hypertension outcomes, further work
is needed and will be accomplished in the proposed project. We will refine and standardize the Reaching
Equity curriculum, and additionally develop and standardize protocols for a) clinician enrollment and
engagement; b) patient enrollment and engagement; c) implementation of patient-initiated audio-recording of
clinical encounters; d) analysis of recorded encounters; e) extraction of blood pressure and other data from the
EHR; and f) data management and analysis. We will pilot these protocols in two primary care clinics, enrolling
20 primary care clinicians and 100 patients. Outcomes will include an objective measure of IB mitigation skills
immediately after completing intervention and EHR-generated assessment of hypertension control 3 and 6
months after intervention. In addition, we will obtain qualitative feedback from clinicians on study procedures,
curriculum content/format, and ways to sustain learning.
The proposed work is necessary and sufficient for the conduct of a subsequent full-scale randomized trial to
test the hypothesis that Reaching Equity will increase use of implicit bias mitigation skills by clinicians and
reduce racial disparities in hypertension outcomes.

## Key facts

- **NIH application ID:** 10948275
- **Project number:** 1R34HL174728-01
- **Recipient organization:** DUKE UNIVERSITY
- **Principal Investigator:** Laura P Svetkey
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $161,000
- **Award type:** 1
- **Project period:** 2024-09-05 → 2027-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10948275

## Citation

> US National Institutes of Health, RePORTER application 10948275, Planning grant for clinical trial of implicit bias mitigation training for clinicians (1R34HL174728-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10948275. Licensed CC0.

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