Assessing Readiness for Change: Tailoring DEI Initiatives in Medical Settings

This talk presents a framework for tailoring diversity, equity, and inclusion (DEI) initiatives in medical settings through an assessment of readiness for change. Drawing from qualitative data from over 560 Black Americans’ reports of racially charged medical encounters, Dr. Amanda Almond illustrates how microaggressions rooted in racial stereotypes, size bias, and biological myths of race undermine patient trust and health outcomes. Integrating the Transtheoretical Model of Behavior Change (TTM) and Bystander Intervention Theory, the framework identifies stage-matched processes for promoting anti-racist action among healthcare providers. A new Decisional Balance Measure is introduced to assess attitudes toward DEI training and align interventions with varying levels of motivation. This readiness-based approach advances DEI beyond compliance by addressing provider ambivalence, fostering accountability, and promoting equitable systems of care rooted in validation, affirmation, and transformation.