STIGMA RESEARCH OF THE MONTH: Effectiveness of a comprehensive bystander anti-racism intervention for healthcare staff in Australia
This Australian study (Public Health Research & Practice, volume 36, issue 1, Woodland et al.) evaluated an anti-racism initiative across a local health district in Sydney, including a one-hour face-to-face bystander intervention workshop.
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The training used discussion, practical exercises and scenarios based on real experiences of racism from staff, patients and carers. It also opened with a video from the health district's Chief Executive explicitly endorsing bystander intervention, making it clear from the outset that speaking up was supported by leadership.
The researchers found significant improvements after the training. Among participants with matched pre- and post-workshop data, 21% felt confident responding to a racist incident before the workshop, compared with 70% afterwards. The proportion who said they were likely to respond at work also increased from 78% to 90%.
Importantly, the workshop wasn't a standalone intervention. It was part of a broader Addressing Racism in Healthcare Strategy, which included leadership involvement, organisational policies, communications and resources for staff and managers.
The takeaway:
Bystander training can give healthcare workers practical skills and greater confidence to respond to racism, but telling people to speak up isn't enough. They also need to know that the organisation, particularly its leaders, will support them when they do.
The researchers argue that successful bystander anti-racism initiatives require organisational readiness, senior leadership support and an environment where staff feel supported to intervene.
There are limitations. The study was conducted in one Sydney health district and relied on self-reported measures of people's likelihood of intervening, rather than whether they actually intervened when racism occurred. However, the findings provide promising evidence that even a relatively short training intervention, when backed by broader organisational action, can increase healthcare workers' confidence and willingness to speak up against stigma and discrimination.
Actions to take:
Make leadership support explicit. Don't just tell people they can speak up. Make it clear that leaders expect and support bystander intervention
Use real scenarios from your setting to explore what stigma and discrimination actually look like and how people could respond
Give people opportunities to practise, rather than relying on awareness or knowledge alone
Don't treat training as a standalone solution. Embed it within broader organisational action addressing policies, systems and workplace norms
Evaluate what happens afterwards, including whether increased confidence translates into action and whether changes last over time