Florida State University researchers are part of a multi-institution team that has received nearly $3.4 million to conduct a five-year investigation into how patients seeking care may be treated differently when providers themselves are under the weather or fearful of becoming sick.
Anastasia Makhanova, FSU psychology alumna and assistant professor of psychology at the University of Arkansas, is the principal investigator for the National Institutes of Health-funded grant that also includes FSU Assistant Professor of Anthropology Eric Shattuck and Professors of Psychology Jon Maner and Ashby Plant. FSU’s share of the grant is $539,479.
The full team, with contributors hailing from six institutions including the University of Texas at San Antonio, University of Arkansas, University of Arkansas for Medical Sciences, University of New Mexico, and Loma Linda University, will evaluate if adverse situational conditions, or ASC, cause subtle differences in physician behavior, potentially impacting patient outcomes and treatment bias.
“R01 research grants are the top tier of NIH funding,” said Shattuck, whose work explores connections between the immune system and social interaction. “They are highly competitive and fund projects over five years, so our work can be adequately developed. We are at a point in science where many problems we are trying to solve require perspectives from different fields, and I am delighted NIH saw our interdisciplinary team as a strength.”
In this research, ASC for health care providers includes two categories: the provider being sick and the provider’s fear of becoming sick. The former leads to a temporary increase in inflammation as one’s immune system fights off the infection. The latter refers to cues of pathogen threat such as visibly sick patients and rising rates of influenza or COVID-19.
Prior research shows that pathogen threat can affect how individuals relate and interact with others, and inflammation can biologically impact cognition, leading to such symptoms as brain fog. The team will also study stress and burnout as ASC for providers.
“The project is an ideal example of interdisciplinary research, as it takes scientific discovery and translates it into something immediately valuable and useful for health practitioners.”
– Jon Maner, professor psychology
“ASC can increase disparities in the quality of care that racial and ethnic minority patients receive,” said Plant, who specializes in bias regulation and examines the quality of relations among people of different identities. “Unlike projects that focus on reducing bias directly, which often are only modestly effective, we are identifying and targeting the conditions that impact health care providers and their job performance.”
Two studies are planned to test the ways ASC impacts physicians’ treatment of patients. In the first, physicians will be given either the seasonal flu vaccine or a placebo. Those who receive the vaccine will experience mild increases in immune system activity, triggering the feeling of powering through work when sick. When compared with the physicians’ initial survey responses on ASC, the researchers can determine if greater acute inflammation is associated with more biased treatment.
In the second study, another group of physicians will be surveyed on how they are feeling both emotionally and physically, and responses will be compared to patients’ charts from the same day. Using data collected over one year, this study will determine if providers are more vulnerable to bias on days when they experience more versus less ASC.
“I am excited to increase the external validity of our future findings,” Makhanova said. “This research helps us better understand situational pressures that can make health care providers more vulnerable to biased decision-making, especially towards patients from minority groups.”
Makhanova is a two-time FSU alumna who earned her master’s degree in 2016 and doctorate in 2019, both in social psychology. As a student, she conducted research with both Plant and Maner, and also began collaborating with Shattuck shortly after joining UA’s faculty in 2019.
“This project includes researchers in psychology, anthropology, public health and medicine, building bridges between social science and community health clinics,” said Maner, an expert on the connections among motivation, emotion and social cognition. “The project is an ideal example of interdisciplinary research, as it takes scientific discovery and translates it into something immediately valuable and useful for health practitioners.”
Research is an important component of FSU Health, a major university initiative to improve health and health care delivery. Visit fsuhealth.fsu.edu to learn more about how researchers and partners in clinical practice are working together to build healthier communities in North Florida and beyond.
To learn more about psychology research and the FSU Department of Psychology, visit psychology.fsu.edu. For more information on the FSU Department of Anthropology, visit anthro.fsu.edu.