Aspiras Olivia, Lucas Todd, Thompson Hayley S, Manning Mark A
Charles Stewart Mott Department of Public Health, College of Human Medicine, Michigan State University, East Lansing, USA.
Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, USA.
J Behav Med. 2023 Oct;46(5):871-881. doi: 10.1007/s10865-023-00415-9. Epub 2023 May 4.
Mistrust in the information and treatment provided by medical professionals and organizations hinders cancer screening among African Americans. However, its impact on responses to health messaging aimed at bolstering screening uptake is unknown. The present study examined the effects of medical mistrust on message framing and culturally targeted health messaging about colorectal cancer (CRC) screening. Screening eligible African Americans (N = 457) completed the Group-Based Medical Mistrust scale and then viewed an informational video about CRC risks, prevention, and screening, during which all participants received either a gain or loss-framed message about screening. Half of participants received an additional culturally targeted screening message. After messaging, all participants completed Theory of Planned Behavior measures of CRC screening receptivity, as well as items assessing expectations about experiencing racism when obtaining CRC screening (i.e., anticipatory racism). Hierarchical multiple regressions showed that medical mistrust predicted lower screening receptivity and greater anticipatory racism. Additionally, effects of health messaging were moderated by medical mistrust. Among participants high in mistrust, targeted messaging-regardless of message frame-bolstered normative beliefs about CRC. Additionally, only targeted loss-framed messaging bolstered attitudes toward CRC screening. Although targeted messaging reduced anticipatory racism among participants with high mistrust, anticipatory racism did not mediate messaging effects. Findings indicate medical mistrust may be an important culturally-relevant individual difference to attend to in addressing CRC screening disparities, including its potential to impact responses to cancer screening messaging.
对医学专业人员和组织提供的信息及治疗的不信任阻碍了非裔美国人进行癌症筛查。然而，其对旨在提高筛查接受率的健康信息的反应的影响尚不清楚。本研究考察了医疗不信任对信息框架以及关于结直肠癌（CRC）筛查的针对性文化健康信息的影响。符合筛查条件的非裔美国人（N = 457）完成了基于群体的医疗不信任量表，然后观看了一段关于CRC风险、预防和筛查的信息视频，在此期间，所有参与者都收到了一条关于筛查的获益或损失框架信息。一半的参与者还收到了一条针对性的文化筛查信息。信息传达后，所有参与者完成了关于CRC筛查接受度的计划行为理论测量，以及评估在进行CRC筛查时对经历种族主义的预期（即预期性种族主义）的项目。分层多元回归显示，医疗不信任预示着较低的筛查接受度和较高的预期性种族主义。此外，健康信息的效果受到医疗不信任的调节。在高度不信任的参与者中，无论信息框架如何，针对性信息都增强了对CRC的规范信念。此外，只有针对性的损失框架信息增强了对CRC筛查的态度。虽然针对性信息减少了高度不信任参与者中的预期性种族主义，但预期性种族主义并未介导信息效果。研究结果表明，医疗不信任可能是在解决CRC筛查差异时需要关注的一个重要的与文化相关的个体差异，包括其对癌症筛查信息反应的潜在影响。
