Share My World: Illuminating The Experience of Black Uterine Fibroids Patients and the Need for Implicit Bias Awareness and Cultural Competence in Their Reproductive Care Open Access

Grayson, Kierra (Spring 2021)

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Background/Intro: Black women are disproportionately burdened by uterine fibroids. The benign tumors impact their lives physically, mentally, emotionally, and financially. 

Project Goal: This special study project aimed to identify opportunities to address implicit bias as a barrier to care for Black uterine fibroid patients and improve patient outcomes impacted by the implicit bias. 

Methods: An extensive literature review was conducted on four databases. Thirty relevant sources were identified. Outreach via email and LinkedIn to stakeholders in uterine fibroid care took place. One thirty five minute stakeholder was interviewed via phone. Existing implicit bias frameworks were discovered and modified for project use. 

Results: There are five domains that recommendations to improve Black uterine fibroid patient outcomes using implicit bias frameworks should operate from: (1) increasing knowledge about the science of fibroids, (2) acknowledging the impact of implicit bias of Black fibroid patient outcomes, (3) creating a safe, non-threatening context & environment to deliver fibroid care, (4) addressing the unique attributes of the Black fibroid patient experience, and (5) implementing sustainable efforts to provide bias-free care.

Conclusions/Recommendations: Public health practitioners should seek to improve diagnosis, management, and treatment of Black uterine fibroid patients by addressing the barriers to care perpetuated by racial biases. Physicians should strive to provide culturally competent quality reproductive care to enhance early detection and expand treatment options for Black patients with fibroids.

Table of Contents

Table of Contents 

Chapter 1: Introduction 1

Background & Significance 1

Problem Statement 2

Purpose 2

Objectives 3

Chapter 2: Literature Review 4

What Are Uterine Fibroids? 4

Treatment Options 4

Their Invisible Burden On Quality of Life 6

Racial Biases Against Black Women 9

How Racism Manifests Around the Black Female Body 10

How Racism Manifests In The Black Female Body 12

Racial Disparities in Uterine Fibroid Management & Reproductive Healthcare 15

Cultural Competence and Humility in Reproductive Health Care 17

Summary 22

Chapter 3: Methods 23

IRB Approval 25

Limitations 25

Chapter 4: Results 26

Increasing knowledge about the science of fibroids 27

Acknowledging the impact of implicit bias on Black fibroid patient outcomes 27

Creating a safe non threatening environment to provide fibroid care 27

Addressing the unique attributes of the Black fibroid patient experience 28

Implementing sustainable efforts to provide bias free care 28

Chapter 5: Discussion, Implications, and Recommendations for Practice 29

Bibliography 32

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