A scoping review of interventions seeking to improve aspects of patient-provider relationships involving Black pregnant and post-partum people

Aims: To provide a map of the evidence related to interventions targeting patient-provider relationships among Black perinatal people. Design: A scoping review of the literature was conducted. Data Sources: The database search included English language articles within three databases: PubMed, the Cumulative Index for Nursing and Allied Health Literature, and Medline without date restriction on June 15 and16 2022. Review Methods: This scoping review used the six-stage process first described by Arksey and O'Malley and recommended by the Joanna Briggs Institute: (1) specify the research question, (2) identify relevant literature, (3) select studies, (4) map out the data, (5) synthesize, and report the results and (6) consult experts. Studies were included if they (1) reported results of intervention studies related to patient-provider interaction, (2) were written in English and (3) were original research. The articles were reviewed with content analysis methodology to categorize and interpret the findings. Results: Studies included randomized controlled trials (n = 5) and qualitative studies (n = 3) published between 2001 and 2018. Black pregnant people made up more than half of the participants in five of the eight studies (63%). Interventions were divided into three categories: delivery models (n = 4), mHealth risk assessment tools (n = 2) and patient-provider communication tools (n = 2). Conclusion: This study addressed the unknown role of patient-provider relationship interventions in improving the quality of care received by Black perinatal people. Findings suggest that structural and interpersonal components may have the potential to improve outcomes for Black pregnant people but could be further improved if culturally tailored. Further research is urgently needed to address discrimination and stigma in patient-provider relationships. The findings of this study could inform novel intervention development and should drive research. Impact: A scoping review determined that there are no interventions with Black pregnant people which targeted discrimination and bias in patient-provider relationships. No Patient or Public Contribution: The authors did not include stakeholders such as patients, service users, caregivers or members of the public in the development of this scoping review, as it is a work that serves to set the stage for further community-based work. The results will however be communicated to community members at a planned advisory board in the future.

Automated summary

This study conducted a scoping review to provide evidence on interventions targeting patient-provider relationships among Black perinatal people, finding that structural and interpersonal components may improve outcomes for Black pregnant people. However, further research is urgently needed to address discrimination and stigma in patient-provider relationships and cultural tailoring is recommended.