Advisor(s)

Mieke Thomeer McBride

Committee Member(s)

Cindy Cain
Elizabeth Baker
Gillum Pitts
Verna Keith

Document Type

Dissertation

Date of Award

1-29-2026

Degree Name

Doctor of Philosophy (PhD)

School

College of Arts and Sciences

Department

Medical Sociology

Abstract

The goal of this dissertation is to examine the varying perspectives, or frames, of providers regarding decision-making in the NICU, which includes how they view neonates and their families, their roles as providers, and the way their frames possibly impact the care they give to the infants. In this dissertation, I conduct in-depth interviews with 34 NICU providers and professionals that provide their services in the NICU, including doctors, nurse practitioners, nurses, various therapists (i.e. respiratory, physical, occupational), and two other providers from two other professions. Within the NICU, a common stereotype exists that is a belief that White boy babies are the sickest babies among White girls, Black boys, and Black girls, which is named the “Wimpy White Boy Syndrome” (WWBS). For my dissertation, I examine and understand the frames that were created from this belief, where it came from, and how it continues to be perpetuated among providers. I research how this internalized belief impacts the babies’ care and whether the providers view it as evidence-based or anecdotal in practice. Additionally, I identify what role families would play in the providers’ perceptions. I use interviews of 34 NICU providers to answer my research questions, analyzing these interviews using qualitative methods. WWBS is not a formal diagnosis, and there is no research finding this “syndrome”. Therefore, garnering interviews with providers, I provide better understanding of their thoughts and beliefs surrounding WWBS, when they were taught about this belief, and how it impacts the care they provide to their patients. While the interviews did yield the perceptions of these providers surrounding Wimpy White Boy Syndrome, there was an additional finding regarding how they frame and discuss the families in the NICU, as well. I found that my sample of providers are all conscientious of this WWBS belief that permeates NICUs across the country. They are unsure where the phrase originated, but they mostly suggest it is from statistics or observation. While most of the providers do agree with the WWBS and believe it is factual, they also provide explanations for NICU infants’ outcomes that is counter to that belief. For example, there is discussion surrounding how a mother’s poor health will impact the outcome of their preterm infant – making the outcome worse. Yet, research consistently demonstrates that White women are healthier and have better health, so this would be a contradiction. There is not a clear explanation for the existence of WWBS. Additionally, the providers discuss involved/easy and stressful families as mattering for NICU outcomes. The providers’ expectations are that the families be involved but not too involved. It stresses providers out if the family is too demanding or if the family is not present at all. These expectations seeped into their care, as some admit to avoiding the difficult families and thus, avoiding the babies (besides their standard checks). Providers’ frames surrounding both WWBS and families lends itself to a possible disparity in care for the infants in the NICU.

Keywords

Infant health;Neonatal intensive care unit;Preterm babies;Provider bias;Strong Black Girl;Wimpy White Boy Syndrome

ProQuest Publication Number

32278514

ISBN

9798273398627

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