Background: Healthcare distrust, the belief that healthcare providers or systems often do not act in a patient’s best interest, is an important social determinant of health.(1,2) This distrust disproportionately affects racial and ethnic minorities due in part to sociodemographic factors, healthcare access, and discrimination.(3,4) This study reports baseline impressions of healthcare distrust levels reported during the first 50 events of a national, 75-site, cluster, randomized control trial entitled the Project Talk Trial.
Methods: Participants (N = 1219) completed a validated Healthcare System Distrust Scale comprised of nine questions surrounding beliefs pertaining to the health care system.(5) Responses were scored on a 5-point Likert scale ranging from strongly agree to strongly disagree, with a total sum score ranging from 9-45, with higher scores indicating higher distrust.
Results: Participants who identified, as “more than one race” (n = 22) reported the highest distrust (M = 28.82, SD = 5.40). Among major racial groups, mean scores of healthcare distrust among Black participants (n = 517, M = 27.45, SD = 5.58) were higher than in White participants (n = 394, M = 25.73, SD = 5.19). Participants who identified their ethnicity as Hispanic (n = 277, M = 25.73, SD = 4.96) reported lower rates of distrust than those who did not identify as Hispanic (n = 823, M = 27.05, SD = 5.58).
Conclusions: The Project Talk Trial will provide novel data on healthcare system distrust among broad populations. In this preliminary sample, consistent with prior studies, Black participants reported higher levels of healthcare distrust than their White counterparts. Hispanic individuals reported lower healthcare distrust than non-Hispanic individuals. Those of more than one race reported the highest distrust scores. A limiting factor of this subset is the small sample size of non-Black and non-White identifying racial groups. Following the trial’s final data collection, statistical hypothesis testing will be performed to explore significant differences in baseline healthcare mistrust to inform future clinical practice and healthcare policy.