PT  - JOURNAL ARTICLE
AU  - Kaur, Arshdeep
AU  - Gottlieb, Laura M.
AU  - Ettinger de Cuba, Stephanie
AU  - Byhoff, Elena
AU  - Fleegler, Eric W.
AU  - Cohen, Alicia J.
AU  - Glasser, Nathaniel J.
AU  - Ommerborn, Mark J.
AU  - Clark, Cheryl R.
AU  - De Marchis, Emilia H.
TI  - Associations Between Patient/Caregiver Trust in Clinicians and Experiences of Healthcare-Based Discrimination
AID  - 10.3122/jabfm.2023.230182R1
DP  - 2024 Jul 01
TA  - The Journal of the American Board of Family
                Medicine
PG  - 607--636
VI  - 37
IP  - 4
4099  - http://www.jabfm.org/content/37/4/607.short
4100  - http://www.jabfm.org/content/37/4/607.full
SO  - J Am Board Fam Med2024 Jul 01; 37
AB  - Background: Higher trust in healthcare providers has been linked to better health outcomes and satisfaction. Lower trust has been associated with healthcare-based discrimination.Objective: Examine associations between experiences of healthcare discrimination and patients’ and caregivers of pediatric patients’ trust in providers, and identify factors associated with high trust, including prior experience of healthcare-based social screening.Methods: Secondary analysis of cross-sectional study using logistic regression modeling. Sample consisted of adult patients and caregivers of pediatric patients from 11 US primary care/emergency department sites.Results: Of 1,012 participants, low/medium trust was reported by 26% identifying as non-Hispanic Black, 23% Hispanic, 18% non-Hispanic multiple/other race, and 13% non-Hispanic White (P = .001). Experience of any healthcare-based discrimination was reported by 32% identifying as non-Hispanic Black, 23% Hispanic, 39% non-Hispanic multiple/other race, and 26% non-Hispanic White (P = .012). Participants reporting low/medium trust had a mean discrimination score of 1.65/7 versus 0.57/7 for participants reporting high trust (P < .001). In our adjusted model, higher discrimination scores were associated with lower trust in providers (aOR 0.74, 95%CI = 0.64, 0.85). A significant interaction indicated that prior healthcare-based social screening was associated with reduced impact of discrimination on trust: as discrimination score increased, odds of high trust were greater among participants who had been screened (aOR = 1.28, 95%CI = 1.03, 1.58).Conclusions: Patients and caregivers reporting more healthcare-based discrimination were less likely to report high provider trust. Interventions to strengthen trust need structural antiracist components. Increased rapport with patients may be a potential by-product of social screening. Further research is needed on screening and trust.