Measuring African American Women's Trust in Provider During Pregnancy

Abstract

Significant racial disparities exist in pregnancy outcomes, but few researchers have examined the relationship between trust in providers and pregnancy outcomes. The Trust in Physician Scale (TPS), the most widely used tool, has not been tested in pregnancy. We assessed the psychometric properties of the TPS and identified correlates of trust in 189 pregnant African American women. Evidence supports internal consistency reliability (>.85) and internal structure of the TPS (CFI = .97; RMSEA = .05; χ(2) (42) = 65.93, p = .001), but TPS scores did not predict pregnancy outcomes. African American women reported a high level of trust in obstetric providers. Trust did not differ by provider type (physician or midwife) but was related to the women's history of perceived racism and strength of ethnic identity.

A Canary in the Coal Mine: Exploring African American Women's Lived Experience of Childbirth

“…Previous literature identified two distinct gaps in care that had the potential for contributing to health disparity: structural variable and process variables (Peters, 2014). After the data were analyzed, the students were variables in both categories thus verifying and extending the findings of this previous study in profound ways that tied into the deeper historical context of the community and the mission of the medical school.…”

“…A study that surveyed African-American women reported that women's trust in their health care providers was related to the woman's history of perceived racism in the community (Peters, 2014). My study, thus, has verified findings that community matters and discrimination faced in a community is translated into perceptions of care and may impact birth outcomes.…”

“…45! perinatal outcomes (Peters, 2014). The study utilized the RaLES-brief (Harrel, 1997), a 9-item tool to evaluate if a patient has experienced racism within the healthcare setting, as well as a trust in physician scale (Anderson and Dedrick, 1990).…”

“…The second gap that the literature identified as contributing to disparities is termed process variables (Peters, 2014). In the unpredictable world of a medical institution, where care is provided by multiple actors at multiple points of contact at multiple locations within that institution, the women voiced wariness at each encounter.…”

Supporting Rural Women During Pregnancy

“…Typical prenatal care is rushed, brief, and focused on the health and development of the fetus, making it difficult to develop a trusting relationship. Trust is an important component of the patient- provider relationship, but has not been adequately studied in vulnerable populations (Peters, Benkert, Templin, & Cassidy-Bushrow, 2014). Determining how to interact with a healthcare provider to obtain optimal support has become a priority in rural health research (Price & Proctor, 2009).…”