Racial/Ethnic Differences in Trust in Health Care: HIV Conspiracy Beliefs and Vaccine Research Participation

Westergaard, Ryan P.; Beach, Mary Catherine; Saha, Somnath; Jacobs, Elizabeth A.

doi:10.1007/s11606-013-2554-6

Cited by 44 publications

(35 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Furthermore, clinician respect for patients may be particularly relevant in HIV care due to several factors such as racial/ethnic differences between patients and clinicians, [12-19] HIV-related stigma, [20-22] and stigma towards substance use disorders. [23-25] Patients with active substance abuse perceive less respect from clinicians and demonstrate less engagement in HIV care. [10]…”

Section: Introductionmentioning

confidence: 99%

Respecting patients is associated with more patient-centered communication behaviors in clinical encounters

Flickinger

Saha

Roter

et al. 2016

Patient Education and Counseling

Self Cite

View full text Add to dashboard Cite

Objective Attitudes towards patients may influence how clinicians interact. We investigated whether clinician-reported respect for patients was associated with communication behaviors during HIV care encounters. Methods We analyzed audio-recordings of visits between 413 adult HIV-infected patients and 45 primary HIV care providers. The independent variable was clinician-reported respect for the patient and outcomes were clinician and patient communication behaviors assessed by the Roter Interaction Analysis System (RIAS). We performed negative binomial regressions for counts outcomes and linear regressions for global outcomes. Results Clinicians with higher respect When clinicians had higher respect for a patient, they engaged in more rapport-building, social chitchat, and positive talk. Patients of clinicians with higher respect for them engaged in more rapport-building, social chitchat, positive talk, and gave more psychosocial information. Encounters between patients and clinicians with higher respect for them had more positive clinician emotional tone [regression coefficient 2.97 (1.92-4.59)], more positive patient emotional tone [2.71 (1.75-4.21)], less clinician verbal dominance [0.81 (0.68-0.96)] and more patient-centeredness [1.28 (1.09-1.51)]. Conclusions Respect is associated with positive and patient-centered communication behaviors during medical encounters by clinicians and patients. Practice Implications Clinicians should be mindful of their respectful attitudes of respect and work to foster positive regard for patients to promote more patient-centered communication and higher quality of care. Educators should consider methods to enhance trainees’ respect in communication skills training.

show abstract

Section: Introductionmentioning

confidence: 99%

Respecting patients is associated with more patient-centered communication behaviors in clinical encounters

Flickinger

Saha

Roter

et al. 2016

Patient Education and Counseling

Self Cite

View full text Add to dashboard Cite

show abstract

“…African Americans' distrust of medicine has deep roots. However, even though African Americans are more likely than white people to believe in HIV conspiracies, they are significantly more willing to participate in HIV trials (Westergaard et al 2013). And Fisher and Kalbaugh (2011) found that minorities are overrepresented in phase I clinical trials, in which there is often no clinical benefit to participants.…”

Section: Distrust and Rumorsmentioning

confidence: 99%

Guinea Pig Kids: Myths or Modern Tuskegees?

Leiter

Herman

2014

Sociological Spectrum

View full text Add to dashboard Cite

“…For example, in a national survey of African Americans, 48% agreed that HIV is manmade, 53% that there is a cure for AIDS that is being withheld from the poor, and 44% that people who take ART are human guinea pigs for the government (Bogart & Thorburn, 2005). Studies continue to show high levels of such beliefs in convenience samples of African Americans, including those living with HIV (Bogart et al, 2010a; Clark et al, 2008; Ford et al, 2013; Westergaard et al, 2014). …”

Section: Introductionmentioning

confidence: 99%

“…For example, African American men who believed that people who take ART are human guinea pigs for the government were less likely to adhere to treatment at optimal levels for viral suppression. Null associations between belief in conspiracies and behaviors have been found in samples that include racial/ethnic groups other than (and in addition to) African Americans, and that have indicated higher endorsement of conspiracy beliefs among African Americans, especially compared to Whites (Clark et al, 2008; Gillman et al, 2013; Westergaard et al, 2014). Thus, mistrust among African Americans in particular may have greater implications for health behaviors and consequent disparities.…”

Section: Introductionmentioning

confidence: 99%

Medical mistrust among social network members may contribute to antiretroviral treatment nonadherence in African Americans living with HIV

Bogart

Wagner

Green

et al. 2016

Social Science & Medicine

View full text Add to dashboard Cite

Rationale African Americans living with HIV are less likely to adhere to antiretroviral treatment (ART) compared to other racial/ethnic groups. Medical mistrust is thought to be a factor in this disparity. Objective We examined (1) whether exposure to HIV conspiracy beliefs, a specific type of HIV-related mistrust (about the origins and treatment of HIV) in social networks is associated with ART nonadherence among African Americans living with HIV; and (2) the characteristics of individuals who discuss HIV-related mistrust in the social networks of African Americans living with HIV. Methods At baseline and 6- and 12-months post-baseline, 175 African Americans living with HIV on ART completed egocentric social network assessments, from which we assessed the structure and composition of their personal networks (the social context immediately surrounding them). HIV-related mistrust was operationalized with an indicator of whether any social network member had expressed HIV conspiracy beliefs to the participant. Daily medication adherence was monitored electronically. Results At baseline, 63% of participants agreed with at least one conspiracy belief, and 55% reported hearing at least one social network member (“alter”) express conspiracy beliefs. In a multivariate linear repeated measures regression, expression of conspiracy beliefs by similar others in the network (in terms of age, gender, HIV status, sexual orientation, and race/ethnicity) was associated with ART nonadherence (i.e., percentage of prescribed doses taken). In a multivariate logistic regression, expression of conspiracy beliefs was more likely among social network members who were HIV-positive, who knew the participants’ serostatus, and with whom participants interacted frequently, and less likely among more well-connected social network members. Conclusion HIV-related mistrust in the network may be most influential when expressed by similar others who may be HIV-positive themselves.

show abstract

Racial/Ethnic Differences in Trust in Health Care: HIV Conspiracy Beliefs and Vaccine Research Participation

Cited by 44 publications

References 36 publications

Respecting patients is associated with more patient-centered communication behaviors in clinical encounters

Respecting patients is associated with more patient-centered communication behaviors in clinical encounters

Guinea Pig Kids: Myths or Modern Tuskegees?

Medical mistrust among social network members may contribute to antiretroviral treatment nonadherence in African Americans living with HIV

Contact Info

Product

Resources

About