African Americans consistently report higher levels of medical mistrust than their White counterparts. As a result, medical mistrust is considered to be a contributor to racial health disparities. ...Despite calls to address medical mistrust, few studies have explicitly examined it as a phenomenon of interest; those that have, tended to focus on personal experiences while neglecting vicarious experiences. The current study a) explicitly tests the effects of two types of news story content on reported levels of medical mistrust within an African American adult sample and b) examines two widely used medical mistrust measures. Participants (N = 410) were randomly assigned to view a news story based on a 2 (health care, non-health care) x 2 (racial discrimination, nonracial discrimination) experimental design. Results indicated that individually, both health care content and racial discrimination content increased race-based medical mistrust, but had no effect on general medical mistrust. However, when all four conditions were examined, exposure to health-related racial discrimination stories resulted in higher levels of race-based and general medical mistrust than non-health, nonracial discrimination stories. Findings are discussed in terms of the theoretical and practical implications for health communication scholars.
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BFBNIB, NUK, PILJ, SAZU, UL, UM, UPUK
Abstract
To facilitate maximum uptake of the COVID-19 vaccine, the roles of medical trust and mistrust of healthcare professionals must be examined. Previous work suggests that trust and mistrust may ...have differential impacts on vaccination intention via vaccine necessity and concerns. Multigroup structural equation modeling was utilized to test whether vaccine necessity and concerns mediated the associations between trust in providers and health information, mistrust of providers, and willingness to get the COVID-19 vaccine. The model was found to be invariant across Black and White respondents. Trust in providers and trust in healthcare information exerted indirect effects on intentions through vaccine necessity, while mistrust of providers exerted indirect effects through vaccine concerns. Unlike previous work, the forms of trust did not influence vaccine concerns. The findings have implications for future communication efforts from healthcare professionals and health messengers.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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A systematic review of medical mistrust measures Williamson, Lillie D.; Bigman, Cabral A.
Patient education and counseling,
October 2018, 2018-10-00, 20181001, Volume:
101, Issue:
10
Journal Article
Peer reviewed
•Commonly used scales differed in their operationalization of medical mistrust.•Medical mistrust was most often used in the context of cancer and general health.•When evaluating specific populations, ...measures often focused on African Americans.
Medical mistrust is seen as a barrier to health promotion and addressing health disparities among marginalized populations. This study seeks to examine how medical mistrust has been measured as a step towards informing related health promotion efforts.
A systematic review of medical mistrust scales was conducted using four major databases: PubMed, PsycINFO, ERIC, and Communication & Mass Media Complete. Databases were searched using the terms “medical mistrust scale” “medical mistrust” and “medical distrust.”
The search returned 1595 non-duplicate citations; after inclusion and exclusion criteria were applied, 185 articles were retained and coded. Almost a quarter of studies used a single-item or a few items. Among validated scales, the Group-Based Medical Mistrust Scale, Medical Mistrust Index, and Health Care System Distrust Scale were most frequently used. There were important differences among these scales such as the object of mistrust (e.g., system, individual physician) and referent specificity (e.g., group). The measurement of medical mistrust varied by health topic and sample population.
These differences in scales and measurement should be considered in the context of intervention goals.
Researchers should be aware of differences in measures and choose appropriate measures for a given research question or intervention.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
In response to recent calls to examine medical mistrust antecedents, the present study investigated the influence of negative healthcare (personal, vicarious interpersonal, vicarious media) and ...racial discrimination (personal, vicarious interpersonal, vicarious media) experiences on medical mistrust, and whether these relationships were mediated by perceived racism and perceived financial corruption in healthcare. Multigroup structural equation modeling was utilized to test the model using a cross-sectional survey of Black and White adults. Personal negative healthcare experiences and vicarious media racial discrimination experiences were directly related to medical mistrust for Black and White participants. Additionally, personal negative healthcare experiences exerted indirect effects through both perceived racism in healthcare and perceived financial corruption in healthcare. Vicarious media racial discrimination experiences exerted indirect effects through perceived financial corruption for both Black and White participants and through perceived racism for Black participants. Finally, both types of vicarious interpersonal experiences and racial discrimination experiences exerted indirect effects through perceived racism for White participants. The findings have implications for medical mistrust scholarship going forward. It is necessary to acknowledge the role vicarious experiences plays in medical mistrust antecedents, which may include recognizing the impact of news depictions of racial discrimination on patients' behaviors. Additionally, there is a need to further investigate the role of perceived financial corruption in healthcare in medical mistrust.
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DOBA, IJS, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
While online sources of information, like support groups and wellness influencers, can be beneficial for those seeking additional information about their health conditions, these sources can also ...contain detrimental information. As misinformation and even conspiracies like QAnon proliferate in wellness discourse, particularly in online support groups and on the accounts of wellness influencers, it becomes increasingly important to understand what may contribute to individuals seeking information from these sources. Based on uncertainty in illness theory and the theory of motivated information management, we conducted a cross-sectional survey (N = 544) to test the role of negative health-care experiences and medical mistrust in uncertainty and information seeking from online support groups and wellness influencers across those with chronic and acute health concerns. Results indicated that negative health-care experiences had an indirect effect on information seeking from both online support groups and wellness influencers. This indirect effect, however, operated through uncertainty anxiety but not uncertainty discrepancy. For those with chronic conditions, the indirect effect also included medical mistrust. Implications and future extensions of the results are discussed.
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BFBNIB, NUK, PILJ, SAZU, UL, UM, UPUK
Medical mistrust is associated with a decreased likelihood of engaging in various health behaviors, including health utilization and preventive screening. Despite calls for research to address ...medical mistrust, few studies have explicitly delved into antecedents to medical mistrust. The current study a) examines the relationship between discrimination experiences and medical mistrust and b) experimentally tests the influence of mediated vicarious discrimination on reported levels of medical mistrust. Participants (N = 198) were randomly assigned to view news stories in one of four experimental conditions: no exposure, no discrimination control, implicit racial discrimination, and explicit racial discrimination. Results indicated prior personal and vicarious discrimination experiences were related to medical mistrust. Furthermore, exposure to mediated discrimination influenced medical mistrust in different ways for Black and White participants. Among Black participants, medical mistrust was significantly higher for those exposed to the implicit racial discrimination condition than the control condition. Marginal differences were found for White participants such that those exposed to both explicit and implicit racial discrimination conditions reported higher medical mistrust than those exposed to the control condition. Our findings are discussed in terms of the theoretical and practical implications for health communication scholars seeking to examine and influence health behaviors.
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BFBNIB, NUK, PILJ, SAZU, UL, UM, UPUK
Objective. To assess the influence of patient preferences and urologist recommendations in treatment decisions for clinically localized prostate cancer. Methods. We enrolled 257 men with clinically ...localized prostate cancer (prostate-specific antigen <20; Gleason score 6 or 7) seen by urologists (primarily residents and fellows) in 4 Veterans Affairs medical centers. We measured patients’ baseline preferences prior to their urology appointments, including initial treatment preference, cancer-related anxiety, and interest in sex. In longitudinal follow-up, we determined which treatment patients received. We used hierarchical logistic regression to determine the factors that predicted treatment received (active treatment v. active surveillance) and urologist recommendations. We also conducted a directed content analysis of recorded clinical encounters to determine if urologists discussed patients’ interest in sex. Results. Patients’ initial treatment preferences did not predict receipt of active treatment versus surveillance, Δχ2(4) = 3.67, P = 0.45. Instead, receipt of active treatment was predicted primarily by urologists’ recommendations, Δχ2(2) = 32.81, P < 0.001. Urologists’ recommendations, in turn, were influenced heavily by medical factors (age and Gleason score) but were unrelated to patient preferences, Δχ2(6) = 0, P = 1. Urologists rarely discussed patients’ interest in sex (<15% of appointments). Conclusions. Patients’ treatment decisions were based largely on urologists’ recommendations, which, in turn, were based on medical factors (age and Gleason score) and not on patients’ personal views of the relative pros and cons of treatment alternatives.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK, VSZLJ
This essay advocates for a transformative, community-centric approach to science communication, promoting inclusivity and recognizing the impact of lived experiences. We challenge the prevalent ...population-centric approach and underscore the importance of engaging persistently marginalized communities, notably Black Americans. Drawing from health communication literature, we unveil a comprehensive project aimed at understanding Black Americans’ experiences and perspectives on science.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
National health goals include assessing and improving mental health in understudied US populations. We surveyed 274 individuals (18-35 years old) of Hispanic/Latino/Spanish origin residing in the ...United States. Participants reported poor general mental health compared with Healthy People goals. Stress was negatively associated and perceived supportive communication was positively associated with mental health. A 3-way interaction showed perceived supportive communication mitigated the negative effect of stress on mental health, and perceptions of tangible support without supportive communication degraded overall mental health. Theoretical and practical implications for social support and Hispanic population mental health are discussed.
Trust Takes Two Williamson, Lillie D; Thompson, Kim M; Ledford, Christy J W
Journal of the American Board of Family Medicine,
12/2022, Volume:
35, Issue:
6
Journal Article
Peer reviewed
Open access
Research throughout the COVID-19 pandemic, including investigations of resulting pandemic response strategies, evolving public health recommendations, and vaccine development, has highlighted the ...role of trust between physicians and patients. The focus, however, has largely been on patient trust in physicians. Although the importance of patient trust in physicians has long been recognized, physician trust in patients remains underappreciated. Physician trust in patients is an important factor in the physician-patient relationship. When physicians trust patients, patients can communicate freely, their experiences are validated, and trust may be engendered through reciprocal trust. Thus, a bidirectional approach to trust is necessary that acknowledges the role of physician trust in patients. We posit that shared trust is the dyadic factor that influences positive patient outcomes and is the foundation of shared decision making. Recognizing shared trust as an important outcome of the physician-patient relationship is a necessary step in evaluating how our practice, research, and education can influence or sow distrust of patients. In this commentary, we discuss the importance of attending to shared trust and physician trust in patients, particularly in family medicine.
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