Initial development and validation of the healthcare professionals' implicit bias checklist




Zhang, Yunyun


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Implicit bias refers to prejudiced attitudes towards a social group or its members based on a subconscious association of these groups with stereotypes (Hagiwara et al., 2020; Sukhera et al., 2019). It is a source of inequitable care through biased mental health diagnoses, clinical treatment, and interactions between helping professionals and clients (Gopal et al., 2021; Hall et al., 2015). In contemporary days, there are two dominant assessments, including Evaluative Priming Task (EPT; Fazio et al., 1986) and Implicit Association Test (IAT; Greenwald et al., 1998), to measure implicit bias. Scholars challenged their psychometric properties and failure to attune to current societal trends and attitudes (Meissner et al., 2019; Schimmack, 2021). To address the gap, I proposed to develop the Healthcare Professionals’ Implicit Bias Checklist (HPIBC) with empirical support and contextual attunement to assess counselors’ implicit biases. I used the online community to collect a purposeful sample targeting counseling professionals and counselor trainees in the counseling profession. I conducted an exploratory factor analysis (EFA) with a sample of 362 participants and a confirmatory factor analysis (CFA) with a sample of 200 participants. I check for reliability using Cronbach’s alpha coefficient for internal consistency (? = .84). I also conducted a bivariate correlation analysis to show convergent validity between the HPIBC and Cultural Competence Self-Assessment Checklist (r = -.43, p < .001, medium to large effect size). The EFA produced a three-factor, 25-item, that accounts for 60.36% of the total variances after rotation. The CFA validated the three-factor structure of the instrument from the EFA. To this end, the HPIBC is a 25-item scale with sound psychometric properties to assess counseling professionals’ implicit biases about lifestyle beliefs, sex positivity beliefs, and gender identity beliefs. Though the HPIBC is a reliable and valid assessment for research and clinical purposes, additional studies need to be conducted to further evaluate its psychometric properties.


A dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of DOCTOR OF PHILOSOPHY in COUNSELOR EDUCATION from Texas A&M University-Corpus Christi in Corpus Christi, Texas.


CFA, cognitive schema, counseling advocacy, EFA, implicit bias, intersectionality



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