(129) Examining Maternity Care Workers' Antiracist Attitudes in the Southeast US

Objective: Racism contributes significantly to persistent racial disparities in maternal health outcomes in the Southeast United States (US). We aimed to identify key predictors of antiracist attitudes in maternity healthcare (MCH) staff.

Study Design: MCH staff completed a cross-sectional online survey adapted from a validated Anti-RaCist (ARC) Survey tool with 5-point Likert scale items. Outcome variables were antiracist attitudes including acknowledging the impact of racism, the likelihood of actually or hypothetically acting on a racist incident, and support for bias training. Predictor variables included job role, age, race, gender identity, and place of highest education. We performed ordinal logistic regression to model the associations between outcome quartile and predictor variables.

Results: Respondents (n=93) included physicians, nurses, patient encounter specialists, administrative and other staff working in a major maternity care system in the US South. We found that some characteristics were associated with higher antiracist attitudes (Table 1). Compared to physicians, all other MCH staff had significantly lower odds of endorsing the impact of racism in healthcare. One or no bias trainings over the last 36 months was associated with 0.34 lower odds of acknowledging the impact of racism. Not witnessing a racist encounter at work was associated with 0.19 lower odds of endorsing the impact of racism in healthcare. Older aged (≥35 years) MCH staff had 0.21 lower odds of reporting that they would act if they witnessed a racist incident. Cis-male MCH staff had higher odds of acting when they actually witnessed a racist incident in their workplace, compared to cis-female MCH staff.

Conclusion: Our results indicate that endorsing antiracist attitudes varied by specific characteristics of MCH staff in this maternity care setting in the US South. Some types of staff were less likely than others to exhibit attitudes showing antiracism. Efforts to improve the quality of maternity care for racial minorities should address factors that promote antiracist attitudes in all maternity care workers.