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Bennett"},{"_key":"a6a756b987cd2","_type":"span","marks":[],"text":" shared her wisdom and expertise in conversation with Dr. Stephanie McClellan, Chief Medical Officer of Tia. They spoke about the need for patient advocacy for BIPOC, what patient advocates do, and how to weave them through the clinical experience from institutional change to providers to the layperson. Here is some of what we learned."}],"markDefs":[{"_key":"462761f45d02","_type":"externalLink","url":"https://www.instagram.com/drbennettmfm/?hl=en"}],"style":"large"},{"_key":"5cc2d857b25a","_type":"sectionHeader","title":"The basics"},{"_key":"18872cfaaa12","_type":"block","children":[{"_key":"18872cfaaa120","_type":"span","marks":[],"text":"The American healthcare system has a long legacy of racism and discrimination, fuel for the disparity that is pervasive in this system. Navigating the healthcare system is daunting for most, but especially for BIPOC. Due to an array of access barriers, BIPOC not only receive less care than white people but also receive worse care. BIPOC are disproportionately misdiagnosed, under-diagnosed, and mistreated, quality of care directly correlates to worse health outcomes."}],"markDefs":[],"style":"normal"},{"_key":"69c3a1a3bba9","_type":"block","children":[{"_key":"69c3a1a3bba90","_type":"span","marks":[],"text":"Emotional expressions and experience of pain by Black individuals are more likely to be misperceived. Pain is under-diagnosed and under-treated as a result of racial bias. Stereotyping is ever-present in clinical situations, leading certain populations to emphasize specific class and cultural resources such as cultural health capital (cultural skills, attitudes, behaviors, and interaction styles) to leverage and mitigate discrimination."}],"markDefs":[],"style":"normal"},{"_key":"f7a587f59750","_type":"block","children":[{"_key":"f7a587f597500","_type":"span","marks":[],"text":"Epigenetics, the study of inherited genetic trait changes, is a quickly evolving field showing that trauma and its effects may be passed through generations, recognizable through gene expression and cellular activity that is influenced by external factors such as environment. Inherited trauma may be likened to the permanence of scar, the remnants of the initial wound become a scar inscribed into a person that then passes on through their lineage. Generational trauma can impact livelihood via both the mind and body."}],"markDefs":[],"style":"normal"},{"_key":"486e325a5684","_type":"block","children":[{"_key":"486e325a56840","_type":"span","marks":[],"text":"There are social determinants of health that directly impact BIPOC — economic and social conditions, such as living and working conditions (think: the distribution of income, wealth, influence, and power) that influence individual and group differences in health status (think: risk and vulnerability of disease or injury) and access to care."}],"markDefs":[],"style":"normal"},{"_key":"5bc6416a244f","_type":"sectionHeader","title":"How can we create a built-in system for patient advocacy?"},{"_key":"8396cabbd87c","_type":"block","children":[{"_key":"8396cabbd87c0","_type":"span","marks":[],"text":"Trust facilitates care-seeking behavior and promotes patient honesty and adherence. Distrust inhibits care-seeking and may lead to non-adherence. One study in Chicago looked at how trustworthy Black people found their physicians. The study found that participants indicated that trust is determined by the interpersonal and technical competence of physicians. Contributing factors to distrust in physicians included a lack of interpersonal and technical competence, perceived quest for profit, and expectations of racism and experimentation during routine health care. Another study looking at race in patient-physician relationships found that the quality of interpersonal care is vital in facilitating a patient’s involvement in their care, increased patient involvement improves patient satisfaction and outcomes."}],"markDefs":[],"style":"normal"},{"_key":"96b7f39ad00d","_type":"block","children":[{"_key":"96b7f39ad00d0","_type":"span","marks":[],"text":"One way to effectively create institutional change is to promote diversity within the healthcare system. Data suggests that African American patients rate their visits with physicians as less participatory than whites. However, patients seeing physicians of their own race rate their physicians’ decision-making styles as more participatory. Improving cross-cultural communication between physicians and patients and providing patients with access to a diverse group of physicians may lead to more patient involvement in care, higher levels of patient satisfaction, and ultimately, better health outcomes. A study conducted by Stanford looked at Black men in Oakland, found that men seen by Black physicians were more likely to engage with them, and even consent to preventive services like cardiovascular screenings and immunizations. Black doctors were 71% more likely to get their patients to receive a cholesterol screening, whereas non-Black doctors were 45% as likely. The study estimates this approach could reduce the Black-white mortality gap due to heart disease by 19%."}],"markDefs":[],"style":"normal"},{"_key":"43ac32ba5304","_type":"block","children":[{"_key":"43ac32ba53040","_type":"span","marks":[],"text":"Dr. Terri-Ann Bennett believes that providers should be trained early on in their schooling to understand not only bias but also the actual biological differences that result from inherited trauma. Beyond this training, she recommends that providers continually check their bias while working with patients and actively seek to understand why their patients have fears or misunderstandings. Understanding why gives way to an empathetic response, leading with empathy engenders advocacy. Dr. Bennett suggests implicit bias training but also asks that providers take it a step further by enhancing their cultural competency and actively work to have an anti-racist practice."}],"markDefs":[],"style":"normal"},{"_key":"01939b3fe286","_type":"sectionHeader","title":"In conclusion"},{"_key":"a0520b6fd005","_type":"block","children":[{"_key":"a0520b6fd0050","_type":"span","marks":[],"text":"Research shows that patient advocacy is effective. One study looking at a sample of 30–74-year-old self-identified African-American and/or Black women who had received abnormal mammogram results found advocacy to be a positive factor in their medical experiences. The participants felt that engaging in medical advocacy helped address ongoing experiences of mistrust and racism in the medical setting. 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"},{"_key":"8724797ed80c","_type":"span","marks":[],"text":"JAMA"},{"_key":"f32faae9ce4f","_type":"span","marks":[],"text":", "},{"_key":"7f1b0e2df26f","_type":"span","marks":[],"text":"282"},{"_key":"3eb6bea0bcbe","_type":"span","marks":[],"text":"(6), 583–589. "},{"_key":"315f163fe6c8","_type":"span","marks":["52ae7d4e6f1b"],"text":"https://doi.org/10.1001/jama.282.6.583"}],"markDefs":[{"_key":"52ae7d4e6f1b","_type":"externalLink","linkType":"text","url":"https://doi.org/10.1001/jama.282.6.583"}],"style":"small"},{"_key":"fce7197a986b","_type":"block","children":[{"_key":"fce7197a986b0","_type":"span","marks":[],"text":"Jacobs, E. A., Rolle, I., Ferrans, C. E., Whitaker, E. E., & Warnecke, R. B. (2006). Understanding African Americans’ views of the trustworthiness of physicians. Journal of general internal medicine, 21(6), 642–647. "},{"_key":"84ef5e0054c8","_type":"span","marks":["e6a6ed7bf493"],"text":"https://doi.org/10.1111/j.1525-1497.2006.00485"},{"_key":"0a7b2dd4db7d","_type":"span","marks":[],"text":"​ "}],"markDefs":[{"_key":"e6a6ed7bf493","_type":"externalLink","linkType":"text","url":"https://dx.doi.org/10.1111%2Fj.1525-1497.2006.00485.x"}],"style":"small"},{"_key":"98575ad7c337","_type":"block","children":[{"_key":"98575ad7c3370","_type":"span","marks":[],"text":"Marcella Alsan & Owen Garrick & Grant Graziani, 2019. Does Diversity Matter for Health? Experimental Evidence from Oakland. American Economic Review, vol 109(12), pages 4071–4111. "},{"_key":"42ec4000ec71","_type":"span","marks":["a1cfb3ced60b"],"text":"https://doi.org/10.1257/aer.20181446"},{"_key":"6069a899806c","_type":"span","marks":[],"text":""}],"markDefs":[{"_key":"a1cfb3ced60b","_type":"externalLink","linkType":"text","url":"https://doi.org/10.1257/aer.20181446"}],"style":"small"},{"_key":"6019ebaa2bfd","_type":"block","children":[{"_key":"6019ebaa2bfd0","_type":"span","marks":[],"text":"Mende-Siedlecki, P., Qu-Lee, J., Backer, R., & Van Bavel, J. J. (2019). Perceptual contributions to racial bias in pain recognition. "},{"_key":"6019ebaa2bfd1","_type":"span","marks":[],"text":"Journal of experimental psychology. General"},{"_key":"6019ebaa2bfd2","_type":"span","marks":[],"text":", "},{"_key":"6019ebaa2bfd3","_type":"span","marks":[],"text":"148"},{"_key":"6019ebaa2bfd4","_type":"span","marks":[],"text":"(5), 863–889. "},{"_key":"6019ebaa2bfd5","_type":"span","marks":["bd83529a24be"],"text":"https://doi.org/10.1037/xge0000600"}],"markDefs":[{"_key":"bd83529a24be","_type":"externalLink","linkType":"text","url":"https://doi.org/10.1037/xge0000600"}],"style":"small"},{"_key":"e1ead0b84c94","_type":"block","children":[{"_key":"e1ead0b84c940","_type":"span","marks":[],"text":"Molina, Y., Hempstead, B.H., Thompson-Dodd, J. "},{"_key":"e1ead0b84c941","_type":"span","marks":[],"text":"et al."},{"_key":"e1ead0b84c942","_type":"span","marks":[],"text":" Medical Advocacy and Supportive Environments for African-Americans Following Abnormal Mammograms. "},{"_key":"e1ead0b84c943","_type":"span","marks":[],"text":"J Canc Educ"},{"_key":"e1ead0b84c944","_type":"span","marks":[],"text":" 30, 447–452 (2015). 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We know that many patients want to see a provider with a shared race or ethnicity, so are working to increase diverse representation across specialties and markets. We also recognize that both medicine and diversity are local so aim to build Care Teams that mirror the communities in which we operate."}],"markDefs":[],"style":"normal"}],"question":"Do you have BIPOC providers at Tia?","id":"351076ec-a1c0-5804-8bb6-f9bb00df5221","parent":null,"children":[],"internal":{"type":"SanityFaq","contentDigest":"a1959aee5ce41c423d2bcf8f2aeeccd1","counter":2803,"owner":"gatsby-source-sanity"}},{"_id":"5295133d-5d18-4a0d-ae22-c84c969d3dd8","_type":"faq","_createdAt":"2021-03-24T00:33:32Z","_rev":"8IyFyd9T4xYgugDB2QJjWH","_updatedAt":"2023-03-24T17:54:42Z","answer":[{"_key":"21198063508a","_type":"block","children":[{"_key":"779011100af3","_type":"span","marks":[],"text":"The Tia community and our clinics are open to anyone, regardless of gender or sex. 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We aim to cultivate a community that's inclusive, respective, and celebratory of all sexes and genders. Our core competency today lies in providing health information and care to people assigned female at birth. However, many of our providers have experience and training in providing comprehensive care for people of various genders, including gender-affirming care and hormone replacement therapy. 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It encapsulates our vision to cultivate loved and trusted relationships with women about their health —  a stark contrast to the transactional “feel-like-a-number” experiences all-too-many women experience when navigating traditional healthcare. While Tia is a Spanish word, its meaning is symbolic, bridges many cultures around the world and represents the diverse and inclusive community we seek to cultivate."}],"markDefs":[],"style":"normal"},{"_key":"b20d70df2251","_type":"block","children":[{"_key":"b865589494cc0","_type":"span","marks":[],"text":"Have more questions about the origins of Tia? Send us a note to "},{"_key":"b7816327bc78","_type":"span","marks":["76bdcbbf9b92"],"text":"sayhello@asktia.com"}],"markDefs":[{"_key":"76bdcbbf9b92","_type":"externalLink","linkType":"text","url":"mailto:sayhello@asktia.com"}],"style":"normal"}],"question":"What’s the story behind Tia’s name? 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