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歧视会滋生不信任吗?审视中介和非中介歧视经历在医疗不信任中的作用。

Does Discrimination Breed Mistrust? Examining the Role of Mediated and Non-Mediated Discrimination Experiences in Medical Mistrust.

作者信息

Williamson Lillie D, Smith Marisa A, Bigman Cabral A

机构信息

Department of Communication, University of Illinois at Urbana-Champaign, Urbana, IL, USA.

出版信息

J Health Commun. 2019;24(10):791-799. doi: 10.1080/10810730.2019.1669742. Epub 2019 Sep 27.

Abstract

Medical mistrust is associated with a decreased likelihood of engaging in various health behaviors, including health utilization and preventive screening. Despite calls for research to address medical mistrust, few studies have explicitly delved into antecedents to medical mistrust. The current study a) examines the relationship between discrimination experiences and medical mistrust and b) experimentally tests the influence of mediated vicarious discrimination on reported levels of medical mistrust. Participants ( = 198) were randomly assigned to view news stories in one of four experimental conditions: no exposure, no discrimination control, implicit racial discrimination, and explicit racial discrimination. Results indicated prior personal and vicarious discrimination experiences were related to medical mistrust. Furthermore, exposure to mediated discrimination influenced medical mistrust in different ways for Black and White participants. Among Black participants, medical mistrust was significantly higher for those exposed to the implicit racial discrimination condition than the control condition. Marginal differences were found for White participants such that those exposed to both explicit and implicit racial discrimination conditions reported higher medical mistrust than those exposed to the control condition. Our findings are discussed in terms of the theoretical and practical implications for health communication scholars seeking to examine and influence health behaviors.

摘要

医疗不信任与参与各种健康行为(包括医疗服务利用和预防性筛查)的可能性降低有关。尽管呼吁开展研究以解决医疗不信任问题,但很少有研究明确深入探讨医疗不信任的 antecedents。本研究 a)考察歧视经历与医疗不信任之间的关系,b)通过实验测试间接替代性歧视对报告的医疗不信任水平的影响。参与者(= 198)被随机分配到四个实验条件之一观看新闻报道:无接触、无歧视对照、隐性种族歧视和显性种族歧视。结果表明,先前的个人和替代性歧视经历与医疗不信任有关。此外,接触间接歧视对黑人和白人参与者的医疗不信任产生了不同的影响。在黑人参与者中,接触隐性种族歧视条件的人比对照条件的人医疗不信任显著更高。白人参与者存在边际差异,即接触显性和隐性种族歧视条件的人比接触对照条件的人报告的医疗不信任更高。我们从对寻求研究和影响健康行为的健康传播学者的理论和实践意义方面讨论了我们的发现。

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