Representation of Racial Diversity on US Plastic Surgery Websites: A Cross-sectional Study: Racial Diversity on Plastic Surgery Websites.
Journal
Annals of plastic surgery
ISSN: 1536-3708
Titre abrégé: Ann Plast Surg
Pays: United States
ID NLM: 7805336
Informations de publication
Date de publication:
08 Jul 2024
08 Jul 2024
Historique:
medline:
9
7
2024
pubmed:
9
7
2024
entrez:
9
7
2024
Statut:
aheadofprint
Résumé
The racial diversity portrayed in plastic and reconstructive surgery (PRS) media is an important indicator of an inclusive environment for potential patients. To evaluate the degree to which PRS websites demonstrate inclusivity, we assessed the racial composition of both patients and plastic surgeons depicted on the most visited academic and private PRS websites to determine the extent to which racial diversity is represented. A cross-sectional study was conducted in September 2023. The 10 most visited websites in each state were identified. Sociodemographic characteristics including race and sex of patients and plastic surgeons, as well as the type of practice, were collected. Race was classified according to individuals' Fitzpatrick Phototypes into White and non-White. Differences in patient and surgeon representation were compared to the 2020 US Census and the 2020 ASPS demographics using χ2 tests. Subgroup analyses were conducted to identify differences by type of practice and region. We analyzed a total of 2,752 patients from 462 websites belonging to 930 plastic surgeons. PRS websites were predominantly from private practices (93%). Regarding patient representation, 92.6% were female, 7.4% were male, 87.6% were White, and 12.4% were non-White. The surgeon population on the studied webpages was 75.1% male, 92.1% White, and 7.8% non-White. Statistically significant differences were found in the patient population when compared to the 2020 national (P < 0.001) and regional (P < 0.001) US Census demographics and the 2020 ASPS Statistics Report (P < 0.001). Although minority representation was significantly higher on academic websites compared to private practice (22.9% vs. 12.1%; P = 0.007), both were significantly lower than the percentage of minority patients undergoing PRS. This study illuminates racial disparities in the representation of racial groups among patients and plastic surgeons in the most frequented plastic surgery websites. Moreover, it underscores the imperative to bolster racial diversity within the digital content of both private and academic PRS websites. Greater racial representation can foster a more inclusive perception of the plastic surgery field, which may potentially broaden access to care and enrich the professional landscape.
Sections du résumé
BACKGROUND
BACKGROUND
The racial diversity portrayed in plastic and reconstructive surgery (PRS) media is an important indicator of an inclusive environment for potential patients. To evaluate the degree to which PRS websites demonstrate inclusivity, we assessed the racial composition of both patients and plastic surgeons depicted on the most visited academic and private PRS websites to determine the extent to which racial diversity is represented.
METHODS
METHODS
A cross-sectional study was conducted in September 2023. The 10 most visited websites in each state were identified. Sociodemographic characteristics including race and sex of patients and plastic surgeons, as well as the type of practice, were collected. Race was classified according to individuals' Fitzpatrick Phototypes into White and non-White. Differences in patient and surgeon representation were compared to the 2020 US Census and the 2020 ASPS demographics using χ2 tests. Subgroup analyses were conducted to identify differences by type of practice and region.
RESULTS
RESULTS
We analyzed a total of 2,752 patients from 462 websites belonging to 930 plastic surgeons. PRS websites were predominantly from private practices (93%). Regarding patient representation, 92.6% were female, 7.4% were male, 87.6% were White, and 12.4% were non-White. The surgeon population on the studied webpages was 75.1% male, 92.1% White, and 7.8% non-White. Statistically significant differences were found in the patient population when compared to the 2020 national (P < 0.001) and regional (P < 0.001) US Census demographics and the 2020 ASPS Statistics Report (P < 0.001). Although minority representation was significantly higher on academic websites compared to private practice (22.9% vs. 12.1%; P = 0.007), both were significantly lower than the percentage of minority patients undergoing PRS.
CONCLUSIONS
CONCLUSIONS
This study illuminates racial disparities in the representation of racial groups among patients and plastic surgeons in the most frequented plastic surgery websites. Moreover, it underscores the imperative to bolster racial diversity within the digital content of both private and academic PRS websites. Greater racial representation can foster a more inclusive perception of the plastic surgery field, which may potentially broaden access to care and enrich the professional landscape.
Identifiants
pubmed: 38980944
doi: 10.1097/SAP.0000000000004051
pii: 00000637-990000000-00496
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of interest and sources of funding: none declared.
Références
Chawla S, Shihadeh H, Patel A. An analysis of racial diversity in the breast reconstruction and aesthetic surgery literature. Plast Reconstr Surg Glob Open. 2022;10:e4487.
Baxter NB, Howard JC, Chung KC. A Systematic review of health disparities research in plastic surgery. Plast Reconstr Surg. 2021;147:529–537.
DiPaolo N, Hulsebos IF, Yu J, et al. Race and ethnicity influences outcomes of adult burn patients. J Burn Care Res. 2023;44:1223–1230.
Kauke-Navarro M, Knoedler L, Knoedler S, et al. Ensuring racial and ethnic inclusivity in facial vascularized composite allotransplantation. Plast Reconstr Surg Glob Open. 2023;11:e5178.
Wang SM, Njoroge MW, Mundy LR, et al. Evaluating disparities in pathways to breast reconstruction. J Reconstr Microsurg. 2023;39:671–680. doi:10.1055/s-0043-1764486.
doi: 10.1055/s-0043-1764486
Johnstone T, Thawanyarat K, Rowley M, et al. Racial disparities in postoperative breast reconstruction outcomes: a national analysis. J Racial Ethn Health Disparities. 2024;11:1199–1210. doi:10.1007/s40615-023-01599-1.
doi: 10.1007/s40615-023-01599-1
Food and Drug Administration. Diversity plans to improve enrollment of participants from underrepresented racial and ethnic populations in clinical trials. Fed Regist. 2022;87:22211–22212.
Institute of Medicine (US) Committee on Ethical and Legal Issues Relating to the Inclusion of Women in Clinical Studies, Mastroianni AC, Faden R, Federman D, eds. In: Women and Health Research: Ethical and Legal Issues of Including Women in Clinical Studies: Volume I. Washington (DC): National Academies Press (US); 1994.
Rufai SR, Davis CR. Aesthetic surgery and Google: ubiquitous, unregulated and enticing websites for patients considering cosmetic surgery. J Plast Reconstr Aesthet Surg. 2014;67:640–643.
Warden AM, Mackenzie EL, Larson JD, et al. Optimize Your First Impression: A comparison of the aesthetic websites of private practices and academic institutions. Aesthetic Plast Surg. 2022;46:2573–2579.
Dorfman RG, Mahmood E, Ren A, et al. Google ranking of plastic surgeons values social media presence over academic pedigree and experience. Aesthet Surg J. 2019;39:447–451.
Givens VB, Perkins SW. Preoperative imaging and online photo galleries: the #key to surgical commitment. Surg J (N Y). 2021;7:e322–e326.
Furnas HJ, Korman JM, Canales FL, et al. Patient Reviews: Yelp, Google, Healthgrades, Vitals, and RealSelf. Plast Reconstr Surg. 2020;146:1419–1431.
Kammien AJ, Zhao KL, Wride AM, et al. Visual representation of diversity in online patient education materials for reduction mammaplasty. J Plast Reconstr Aesthet Surg. 2023;87:284–286.
Tirrell AR, Bekeny JC, Baker SB, et al. Patient representation and diversity in plastic surgery social media. Aesthet Surg J. 2021;41:1094–1101.
Abeles EB, Bekheet F, Aravind P, et al. Lack of Fitzpatrick skin type diversity in online patient education images of breast augmentation. Plast Reconstr Surg. 2023;151:534e–536e.
Parmeshwar N, Reid CM, Park AJ, Brandel MG, Dobke MK, Gosman AA. Evaluation of information sources in plastic surgery decision-making. Cureus. 2018;10, e2773
Ligh CA, Lett E, Broach RB, et al. The impact of race, age, gender, income, and level of education on motivations to pursue cosmetic surgery and surgeon selection at an academic institution. Plast Reconstr Surg. 2020;145:932e–939e.
Parmeshwar N, Stuart ER, Reid CM, et al. Diversity in plastic surgery: trends in minority representation among applicants and residents. Plast Reconstr Surg. 2019;143:940–949.
Fassas SN, Krane NA, Zonner JG, et al. Google search analysis: what do people want to know about rhinoplasty and where do they find the answers? Facial Plast Surg Aesthet Med. 2022;24:363–368.
McMullan M. Patients using the Internet to obtain health information: how this affects the patient-health professional relationship. Patient Educ Couns. 2006;63(1–2):24–28.
van Kessel R, Kyriopoulos I, Mastylak A, Mossialos E. Changes in digital healthcare search behavior during the early months of the COVID-19 pandemic: a study of six English-speaking countries. PLOS Digit Health. 2023;2:e0000241.
Zalis S. (2019) Inclusive ads are affecting consumer behavior, according to new research. Think with Google. Available at: https://www.thinkwithgoogle.com/future-of-marketing/management-and-culture/diversity-and-inclusion/thought-leadership-marketing-diversity-inclusion/. Accessed February 10, 2024.
von Elm E, Altman DG, Egger M, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Int J Surg. 2014;12:1495–1499.
Bailyn E. (2024) Google Click-Through Rates (CTRs) by Ranking Position in 2024. First Page Sage. Available at: https://firstpagesage.com/reports/google-click-through-rates-ctrs-by-ranking-position/. Accessed February 10, 2024.
Dean B. (2023) Here's What We Learned About Organic Click Through Rate. Backlinko. Available at: https://backlinko.com/google-ctr-stats. Accessed February 10, 2024.
Semrush. (2023) Top 106 SEO Statistics. Available at: https://www.semrush.com/blog/seo-statistics/. Accessed February 10, 2024.
Cho DY, Kneib CJ, Shakir A, et al. Underrepresentation of racial minorities in breast surgery literature: a call for increased diversity and inclusion. Ann Surg. 2021;273:202–207.
Bradford PS, Degeorge BR Jr., Williams SH, et al. How to embrace antiracism as a US plastic surgeon: definitions, principles, and practice. Plast Reconstr Surg Glob Open. 2020;8:e3185.
Montemurro P, Porcnik A, Hedén P, et al. The influence of social media and easily accessible online information on the aesthetic plastic surgery practice: literature review and our own experience. Aesthetic Plast Surg. 2015;39:270–277.
Sherman MD, Ricco J, Nelson SC, et al. Implicit bias training in a residency program: aiming for enduring effects. Fam Med. 2019;51:677–681.
Zeidan AJ, Khatri UG, Aysola J, et al. Implicit bias education and emergency medicine training: step one? Awareness. AEM Educ Train. 2018;3:81–85.
ASPS. (2022) ASPS procedural statistics release. Available at: https://www.plasticsurgery.org/documents/news/Statistics/2022/plastic-surgery-statistics-report-2022.pdf. Accessed February 10, 2024.
U.S. Census Bureau. (2023) U.S. Census Bureau QuickFacts: United States. Available at: https://www.census.gov/quickfacts/. Accessed February 21, 2024).
The American Society of Plastic Surgeons. Plastic Surgery Statistics Report. Published 2020. Available at: https://www.plasticsurgery.org/documents/News/Statistics/2020/plastic-surgery-statistics-full-report-2020.pdf. Accessed May 3, 2024
Massie JP, Cho DY, Kneib CJ, et al. Patient representation in medical literature: are we appropriately depicting diversity? Plast Reconstr Surg Glob Open. 2019;7:e2563.
Maisner RS, Kapadia K, Zhu A, et al. Diversity in plastic surgery: analysis of representation of sex and ethnic diversity in plastic surgery residency social media accounts. In: Annals of Plastic Surgery. Vol 88. ; 2022. doi:10.1097/SAP.0000000000003186
Heir JS, Sandhu BS, Barber HD. Considerations for esthetic facial surgery in the African-American patient. Atlas Oral Maxillofac Surg Clin North Am. 2000;8:113–125.
Quinn SC, Garza MA, Butler J, et al. Improving informed consent with minority participants: results from researcher and community surveys. J Empir Res Hum Res Ethics. 2012;7:44–55.
Campbell DE, Wright RT. Shut-up I don't care: understanding the role of relevance and interactivity on customer attitudes toward repetitive online advertising. J Electronic Commerce Res. 2008;9:62–76.
Butler PD, Britt LD, Longaker MT. Ethnic diversity remains scarce in academic plastic and reconstructive surgery. Plast Reconstr Surg. 2009;123:1618–1627.
Noel OF, Berg A, Onyango N, et al. Ethnic and gender diversity comparison between surgical patients and caring surgeons. Plast Reconstr Surg Glob Open. 2020;8:e3198.
Silvestre J, Serletti JM, Chang B. Racial and ethnic diversity of U.S. plastic surgery trainees. J Surg Educ. 2017;74:117–123.
Ware OR, Dawson JE, Shinohara MM, et al. Racial limitations of fitzpatrick skin type. Cutis. 2020;105:77–80.
Cho DY, Kneib CJ, Massie JP, et al. Visual representation of racial diversity in aesthetic surgery literature. J Plast Reconstr Aesthet Surg. 2021;74:223–243.