Department of Communication Arts, University of Wisconsin-Madison.
Behav Med. 2023 Jan-Mar;49(1):40-52. doi: 10.1080/08964289.2021.1958740. Epub 2021 Sep 2.
In response to recent calls to examine medical mistrust antecedents, the present study investigated the influence of negative healthcare (personal, vicarious interpersonal, vicarious media) and racial discrimination (personal, vicarious interpersonal, vicarious media) experiences on medical mistrust, and whether these relationships were mediated by perceived racism and perceived financial corruption in healthcare. Multigroup structural equation modeling was utilized to test the model using a cross-sectional survey of Black and White adults. Personal negative healthcare experiences and vicarious media racial discrimination experiences were directly related to medical mistrust for Black and White participants. Additionally, personal negative healthcare experiences exerted indirect effects through both perceived racism in healthcare and perceived financial corruption in healthcare. Vicarious media racial discrimination experiences exerted indirect effects through perceived financial corruption for both Black and White participants and through perceived racism for Black participants. Finally, both types of vicarious interpersonal experiences and racial discrimination experiences exerted indirect effects through perceived racism for White participants. The findings have implications for medical mistrust scholarship going forward. It is necessary to acknowledge the role vicarious experiences plays in medical mistrust antecedents, which may include recognizing the impact of news depictions of racial discrimination on patients' behaviors. Additionally, there is a need to further investigate the role of perceived financial corruption in healthcare in medical mistrust.
针对最近呼吁检查医疗不信任的前因,本研究调查了负面医疗保健(个人、间接人际、间接媒体)和种族歧视(个人、间接人际、间接媒体)经历对医疗不信任的影响,以及这些关系是否通过感知到的医疗保健中的种族主义和感知到的财务腐败来调解。使用黑人和白人成年人的横断面调查,采用多组结构方程模型来测试模型。个人负面医疗保健经历和间接媒体种族歧视经历与黑人和白人参与者的医疗不信任直接相关。此外,个人负面医疗保健经历通过医疗保健中的感知种族主义和医疗保健中的感知财务腐败产生间接影响。对于黑人和白人参与者,间接媒体种族歧视经历通过感知财务腐败产生间接影响,而对于黑人参与者,通过感知种族主义产生间接影响。最后,两种类型的间接人际经历和种族歧视经历通过白人参与者的感知种族主义产生间接影响。这些发现对未来的医疗不信任研究具有重要意义。有必要承认间接经历在医疗不信任前因中的作用,这可能包括认识到新闻对种族歧视的描述对患者行为的影响。此外,有必要进一步研究医疗保健中感知到的财务腐败在医疗不信任中的作用。