The Impact of an Intervention to Reduce Pharmacists' Racial Bias Towards People of Color at Risk of HIV

Project Summary: Significance: Although disproportionally affected by HIV, people of color experience significant disparities in the pre-exposure prophylaxis (PrEP) care continuum. The accessibility of community pharmacies and patient trust in pharmacists suggest that pharmacists can contribute significantly to increasing

equity in PrEP care. Pharmacist-led PrEP programs are expanding in the United States, with positive outcomes in PrEP initiation and retention in care for those taking PrEP. Despite great potential for pharmacy-based PrEP care, implicit racial bias is common among healthcare providers, including pharmacists, and may reduce the

effectiveness of pharmacist-led PrEP delivery. Candidate: I am a Ph.D.-level pharmacist with a strong foundation in general pharmacy-related research; however, my research interests have pivoted in recent years to HIV and racial disparities in care. My long-term goal is to become an independent NIH-funded clinical

investigator focused on developing and implementing pharmacy-based interventions to reduce healthcare disparities in HIV treatment and prevention. I am therefore pursuing additional mentored training in key areas for this new career path. Training aims: I propose training in (1) designing and conducting qualitative research

using implementation science frameworks; (2) implicit bias intervention adaptation; (3) simulation-based learning in healthcare research; and (4) designing and executing clinical trials. Mentor team: Dr. Jessica Haberer (primary mentor; clinical trials), Dr. Sheree Schwartz (implementation science), Dr. Nao Hagiwara (healthcare

providers’ bias and racial disparities), and Dr. Christina Psaros (qualitative methods. Advisor team: Dr. Musie Ghebremichael (statistical methods), Dr. Aleda Chen (cultural competency), and Dr. Samreen Vora (simulation). Research aims: The primary goal of this proposal is to determine the feasibility, acceptability, and preliminary

impact of an adapted, evidence-based intervention to reduce implicit racial bias among pharmacists who have experience with or are willing to prescribe PrEP. In Aim 1, I will use a qualitative approach with the Health Equity Implementation Framework to elicit the opinions of pharmacy interns, pharmacy managers, and policymakers

on relevant factors for implementing an evidence-based intervention to reduce bias. In Aim 2, I will use Aim 1 data to adapt the intervention to fit community pharmacy settings. In Aim 3, I will conduct a pilot trial with 70 pharmacy interns who will be randomized 1:1 to the adapted intervention vs control (a course on implicit bias) to

test the feasibility, acceptability, and preliminary impact of the adapted intervention in reducing implicit bias. Feedback on the trial findings will also be obtained through interviews of pharmacy managers and policymakers. Impact: Based on my solid foundation in pharmacy practice research, outstanding multidisciplinary mentoring

team, a strong institutional commitment, and this innovative research area, I am well-positioned to complete this project, achieve my training goals, and become an independent clinical investigator to committed to reducing healthcare disparities among disadvantaged people with HIV or those at risk of acquiring the infection.