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Understanding Multilevel Factors Related to Urban Community Trust in Healthcare and Research

Author

Listed:
  • Monica Webb Hooper

    (Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA)

  • Charlene Mitchell

    (Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA)

  • Vanessa J. Marshall

    (Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA
    University Hospitals Cleveland Medical Center, Seidman Cancer Center, Cleveland, OH 44106, USA)

  • Chesley Cheatham

    (Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA
    University Hospitals Cleveland Medical Center, Seidman Cancer Center, Cleveland, OH 44106, USA)

  • Kristina Austin

    (The Gathering Place, Beachwood, OH 44122, USA)

  • Kimberly Sanders

    (Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA
    Cleveland Clinic Taussig Cancer Institute, Cleveland, OH 44195, USA)

  • Smitha Krishnamurthi

    (Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA
    Cleveland Clinic Taussig Cancer Institute, Cleveland, OH 44195, USA)

  • Lena L. Grafton

    (NEOMED-CSU Partnership for Urban Health, Cleveland State University, Cleveland, OH 44115, USA)

Abstract

Background: Community and patient engagement in the healthcare system and biomedical research are prerequisites for eliminating health disparities. We conducted a “listening tour” to enhance our understanding of multilevel factors associated with community trust. Methods: Using community-based participatory research (CBPR) methods, we conducted a phenomenological qualitative study. “Town-hall” style discussions were held at nine sites across an urban, Midwestern city. We recruited adults (N = 130) via community networks, social media, flyers, and word-of-mouth. Demographic assessments were self-administered and listening tour sessions were conducted by trained moderators. Themes were framed within the social ecological model (SEM; intrapersonal, interpersonal, institutional, community, and policy levels). Results: Participants were mostly female (68%), African American (80%), had health coverage (97%) and were diagnosed with a chronic health condition (71%). The overarching theme was sociodemographic differences in distrust, such that African Americans and deaf/hearing impaired participants perceived disparities in healthcare, a lower quality of care, and skepticism about biomedical research, relative to Whites. Conclusions: The depth of distrust for healthcare providers, systems, and researchers in underserved communities remains strong and complex. Findings highlight the need to understand the lived experiences of community members, and how distrust is maintained. Multilevel interventions to increase trust and the accrual of underrepresented populations into clinical trials are needed.

Suggested Citation

  • Monica Webb Hooper & Charlene Mitchell & Vanessa J. Marshall & Chesley Cheatham & Kristina Austin & Kimberly Sanders & Smitha Krishnamurthi & Lena L. Grafton, 2019. "Understanding Multilevel Factors Related to Urban Community Trust in Healthcare and Research," IJERPH, MDPI, vol. 16(18), pages 1-16, September.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:18:p:3280-:d:264903
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    References listed on IDEAS

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    1. Anne Scott & Duncan Chambers & Elizabeth Goyder & Alicia O’Cathain, 2017. "Socioeconomic inequalities in mortality, morbidity and diabetes management for adults with type 1 diabetes: A systematic review," PLOS ONE, Public Library of Science, vol. 12(5), pages 1-19, May.
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    2. Alex Hoagland & David M. Anderson & Ed Zhu, 2022. "Medical Bill Shock and Imperfect Moral Hazard," Papers 2211.01116, arXiv.org, revised Mar 2024.

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