Medical Mistrust in Perinatal Mental Health

Conteh, Nkechi; Gagliardi, Jane P.; McGahee, Shunda M.; Molina, Rose L.; Clark, Crystal T.; Clare, Camille A.

doi:10.1097/hrp.0000000000000345

Cited by 23 publications

(10 citation statements)

References 84 publications

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“…Various strategies have been suggested to reduce mistrust among Black pregnant women, including incorporating compassion and acknowledgment of past injustices in vaccine decision-making conversations [ 9 ], community engagement and advocacy [ 46 , 47 ], collaborative care, and policy reform [ 46 ]. For Jamaican women specifically, an important strategy to decrease mistrust may be to divert COVID-19 vaccine messaging from government agencies to healthcare professionals, given the greater trust in healthcare professionals in this cohort.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated With Coronavirus Disease 2019 Vaccine Uptake Among Pregnant Women and Nonpregnant Women of Reproductive Age in Jamaica

Pinkney

Bogart

Carroll

et al. 2023

Open Forum Infectious Diseases

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Background Despite high rates of COVID-19-related maternal mortality, Jamaica currently has little data on COVID-19 vaccine uptake among pregnant women. Study Design We conducted a cross-sectional, web-based survey of 192 reproductive-aged women in Jamaica from February 1- 8, 2022. Participants were recruited from a convenience sample of patients, providers, and staff at a teaching hospital. We assessed self-reported COVID-19 vaccination status and COVID-19-related medical mistrust (operationalized as vaccine confidence, government mistrust, and race-based mistrust). We used multivariable modified Poisson regression to test the association between vaccine uptake and pregnancy. Results Of 192 respondents, 72 (38%) were pregnant. Most (93%) were Black. Vaccine uptake was 35% in pregnant women versus 75% in nonpregnant women. Pregnant women were more likely to cite healthcare providers versus the government as trustworthy sources of COVID-19 vaccine information (65% vs. 28%). Pregnancy, low vaccine confidence, and government mistrust were associated with a lower likelihood of COVID-19 vaccination (adjusted prevalence ratio (aPR) and 95% confidence interval (CI) 0.68 (0.49 - 0.95); 0.61 (0.40 - 0.95); and 0.68 (0.52 - 0.89) respectively). Race-based mistrust was not associated with COVID-19 vaccination in the final model. Conclusion Pregnancy, low vaccine confidence, and government mistrust were associated with a lower likelihood of COVID-19 vaccination among reproductive-aged women in Jamaica. Future studies should evaluate the efficacy of strategies proven to improve maternal vaccination coverage, including standing “opt-out” vaccination orders and collaborative provider and patient-led educational videos tailored for pregnant individuals. Strategies that decouple vaccine messaging from government agencies also warrant evaluation.

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Section: Discussionmentioning

confidence: 99%

Factors Associated With Coronavirus Disease 2019 Vaccine Uptake Among Pregnant Women and Nonpregnant Women of Reproductive Age in Jamaica

Pinkney

Bogart

Carroll

et al. 2023

Open Forum Infectious Diseases

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show abstract

“…Research has begun to highlight Black and Latinx women’s experiences of PMH and barriers to accessing services across the globe. Findings underscore the relationship between the underutilization of mental health services and various cultural and socioeconomic factors, such as stigma, differences in help-seeking attitudes, medical mistrust, and access to services within the community (Conteh et al, 2022; Sambrook Smith et al, 2019). In addition, medical mistrust is perpetuated through present-day experiences such as racism and discrimination in the criminal justice system and in drug testing and depression screening among pregnant women (Sidebottom et al, 2020).…”

Section: Racial Inequities Maternal Mortality and Underutilization Of...mentioning

confidence: 94%

“…With this approach, the community and academic partners exchange information and expertise to learn from each other. A similar approach advocated for a bidirectional community collaborative, which gives community voices a seat at the table during the decision-making process with partnering organizations (Conteh et al, 2022). Creating partnerships in this manner could provide researchers and the field of academia with opportunities to right many of the wrongs done to underserved and marginalized communities.…”

Section: Filling the Gapsmentioning

confidence: 99%

Filling the GAAAPPS: Generating affirming Asian American perinatal psychological services.

Yuen,

Vozar,

Elliott

2024

Practice Innovations

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Women in the perinatal period face a unique set of mental health challenges as they navigate both physical changes and emotional transitions. Perinatal mental health has been linked to child outcomes such as social-emotional development, cognitive development, and physical growth. In addition, women of racial/ethnic minority groups are confronted with barriers to accessing services and are therefore less likely to utilize mental health services. While international attention has recently focused on the experiences of women of color in the perinatal period, Asian American and Pacific Islander (AAPI) women are largely overlooked. This review explores the intersections of perinatal and Asian American mental health literature, including access barriers, acculturative stress, battling stereotypes, and discrimination. Each of these factors should be understood within the context of the historical treatment of Asian Americans. Special considerations for developing programs designed to support and empower AAPI women during the perinatal period include utilizing a collaborative approach, integrating traditional values, and conceptualizing challenges within the context of each socioecological level (e.g., individual, family, and systems level). This article centers on the experiences of cisgender AAPI women, and further research is needed centering nonbinary birthing folks. To develop mental health services and programs with cultural humility, providers should center both individual and community perspectives and approach conversations from a position of transparency and openness. Clinical Impact StatementThis article celebrates the diversity of the Asian population and advocates for the development of affirming perinatal psychological services specifically for Asian American and Pacific Islander women. Additionally, it provides suggestions for providers hoping to uplift this group while ultimately working toward decolonization of the mental health system.

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“…However, Sims did use anesthesia on his wealthy, white patients (Khabele et al, 2021). The use of Sims' work in modern medicine represents the exploitation of slaves and suggests a potential cause for the mistrust black individuals have toward academia (Conteh et al, 2022).…”

Section: Academic Discriminationmentioning

confidence: 99%

Is It All in Our Heads? An Investigation into American and Historical Legacies of Racism and Social Frameworks that Perpetuate Racial Inequalities in Twenty-First Century Healthcare Systems

Nampally¹

2022

ArestyRURJ

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Racial bias in the healthcare system, originating from the eminent founders of science and medicine, has numerous adverse effects on black populations and continues to have harmful consequences today (Byrd and Clayton, 2001). From poor clinical decision-making to preventing people of color from entering prominent fields in medicine, racism is ubiquitous in medicine and healthcare (Byrd and Clayton, 2001). The impact of racial bias on patient care is of great interest with many studies illustrating the detrimental impacts of bias on minority groups, specifically in black communities. However, there is additional research that concludes racial bias does not play a role in patient care or in medicine (Dehon et al., 2017). The lack of acknowledgment within academia concerning racial disparities in healthcare and science further oppresses black voices. With my research, I investigate the extent to which various biased social frameworks in healthcare, medicine, and science negatively impact black individuals. I also address major historical events during the creation of the modern-day healthcare system and how these events perpetuate racism today. Focusing on the twenty-first century, I demonstrate that systemic historical and social events during this period eternalize racism in the modern-day American healthcare system.

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Medical Mistrust in Perinatal Mental Health

Cited by 23 publications

References 84 publications

Factors Associated With Coronavirus Disease 2019 Vaccine Uptake Among Pregnant Women and Nonpregnant Women of Reproductive Age in Jamaica

Factors Associated With Coronavirus Disease 2019 Vaccine Uptake Among Pregnant Women and Nonpregnant Women of Reproductive Age in Jamaica

Filling the GAAAPPS: Generating affirming Asian American perinatal psychological services.

Is It All in Our Heads? An Investigation into American and Historical Legacies of Racism and Social Frameworks that Perpetuate Racial Inequalities in Twenty-First Century Healthcare Systems

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