Division of Preventive Medicine, University of Alabama at Birmingham, AL 35205, USA.
J Natl Med Assoc. 2011 Feb;103(2):123-30. doi: 10.1016/s0027-9684(15)30261-3.
African Americans are thought to be more distrustful of clinical research compared to elderly whites, but it is unknown whether specific types of distrust in clinical research, such as interpersonal or societal distrust, vary according to race. The primary objective was to identify racial differences in interpersonal or societal distrust in clinical research among African Americans and whites.
Seven hundred seventy-six older African Americans and whites were surveyed about their interpersonal and societal distrust using a 7-item index of distrust in clinical research. We combined the 2 societal distrust items into a societal distrust subscale. We also assessed trust in primary care physicians, access to care, health/functional status, previous exposure to clinical research, awareness of the Tuskegee Syphilis Study, perceived discrimination in health care, and sociodemographic characteristics.
High societal distrust was more common among African Americans compared to whites (21% vs 7% in the top quartile of the societal distrust, p < .0001), but there were no racial differences in responses to the individual interpersonal distrust index items. In sequentially built multivariable analyses, the relationship between African American race and societal distrust (odds ratio, 2.2; 95% CI, 1.2-3.7) was not completely explained by other factors such as trust in one's physician, previous discrimination, or awareness of the Tuskegee Syphilis Study.
Racial differences according to the type of distrust in clinical research may warrant assessing specific types of distrust separately among racially diverse populations in future studies.
与老年白人相比，非裔美国人被认为对临床研究的信任度较低，但目前尚不清楚他们对临床研究的具体类型（如人际或社会不信任）的不信任程度是否因种族而异。主要目的是确定非裔美国人和白人在临床研究中的人际或社会不信任方面的种族差异。
对 776 名年龄较大的非裔美国人和白人进行了关于他们对临床研究的人际和社会不信任的调查，使用了 7 项不信任临床研究的不信任指数。我们将 2 项社会不信任项目合并为一个社会不信任子量表。我们还评估了对初级保健医生的信任、获得医疗保健的机会、健康/功能状况、以前接触过临床研究、对塔斯基吉梅毒研究的认识、感知医疗保健中的歧视以及社会人口统计学特征。
与白人相比，非裔美国人的社会高度不信任更为常见（社会不信任的前四分之一中，21%与 7%，p<0.0001），但对人际不信任指数项目的个别回答没有种族差异。在逐步建立的多变量分析中，非裔美国人种族与社会不信任（比值比，2.2；95%可信区间，1.2-3.7）之间的关系不能完全用其他因素来解释，如对医生的信任、以前的歧视或对塔斯基吉梅毒研究的认识。
根据对临床研究的不信任类型的种族差异可能需要在未来的研究中在不同种族的人群中分别评估特定类型的不信任。
