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. 2020 Jan;29(1):104466.
doi: 10.1016/j.jstrokecerebrovasdis.2019.104466. Epub 2019 Nov 14.

Mistrust of Researchers Correlates with Stroke Knowledge among Minority Seniors in a Community Intervention Trial

Altaf Saadi  1 , Angela Y Kim  2 , Josephine A Menkin  3 , Carmen A Carrillo  4 , Carmen E Reyes  3 , Catherine A Sarkisian  5
Affiliations

Mistrust of Researchers Correlates with Stroke Knowledge among Minority Seniors in a Community Intervention Trial

Altaf Saadi et al. J Stroke Cerebrovasc Dis. 2020 Jan.

Abstract

Background: Medical mistrust influences patients' treatment seeking, adherence, health behaviors, and minority participation in research studies. However, medical mistrust remains understudied within neurological diseases like stroke despite disproportionately affecting minority populations.

Objective: This study examines the relationship of medical mistrust with stroke knowledge among Black, Latino, Korean, and Chinese-Americans.

Methods: Subjects greater than 60 years were enrolled from senior centers to test a culturally-tailored educational curriculum around stroke risk reduction in a randomized controlled trial. A Trust Physician Scale and a modified Trust of Medical Researchers Scale measured medical mistrust. The Stroke Action Test instrument measured stroke knowledge, focusing on intent to call 911 appropriately when presented with stroke symptoms.

Results: Of 225 subjects, 69.5% were female (n = 157) with an average age of 73.7 years (standard deviation 6.7). Blacks had highest trust scores of physicians relative to Latino/a, Korean or Chinese subjects (P< .05). In multivariable analysis, decreased stroke knowledge was associated with decreased researcher trust at baseline (<.05), but not physician trust, when controlling for covariates. Among Latino/a, Korean, and Chinese groups, mainstream acculturation reduced the association between researcher trust and stroke knowledge. A mediation model showed no evidence of physician trust mediating researcher trust.

Conclusions: Among minority seniors participating in a randomized controlled trial, decreased trust of researchers, not physicians, was associated with low baseline knowledge of stroke symptoms. Those least acculturated to US culture may be a particular focus for trust building intervention. Future studies should examine whether researcher mistrust is disproportionately preventing those with the largest knowledge gaps from participating in trials.

Keywords: Stroke; disparities; elderly; health education; minorities; trust.

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Conflict of interest statement

Conflict of Interest Disclosure Statement: The authors (A.S., A.Y.K., J.A.M, C.A.C, C.E.R., and C.A.S.) have nothing to disclose.

Figures

Figure 1.
Figure 1.
Physician (A) and Researcher (B) Trust scores among Study Participants
Figure 2.
Figure 2.
Mediation model *Adjusted for ethnicity, gender, age, insurance, education, Charlson Comorbidity Index
See this image and copyright information in PMC

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