Mundy Lindsey M, Judd Suzanne E, Clay Olivio J, Howard Virginia J, Durant Raegan W, Ballard Erin E, Crowe Michael
Department of Psychology, University of Alabama at Birmingham (UAB), Birmingham, AL, USA.
Department of Biostatistics, School of Public Health, UAB, Birmingham, AL, USA.
J Gen Intern Med. 2025 Mar 31. doi: 10.1007/s11606-025-09474-x.
When providing healthcare services to diverse populations of middle-aged and older adults, it is important to understand factors that may influence the amount of trust they have in their doctors, such as demographic factors and previous experiences of discrimination.
We examined correlates of general trust in doctors in a national sample of adults in the USA.
The REGARDS longitudinal cohort study included measures of trust in doctors and discrimination at a follow-up visit. Cross-sectional sequential linear regression models, with general trust in doctors as the outcome, first included demographic factors and then added discrimination in a medical care setting.
The baseline REGARDS sample included community-dwelling participants across the contiguous USA who identified as White or Black/African American and were aged 45 or older. Our analytic sample included 8500 participants who completed the second in-home REGARDS visit and were aged 52 years or older.
Trust was measured by the General Trust in Doctors Scale. Participants also reported whether they had ever experienced discrimination in a medical care setting.
Female sex (b = -1.41, p < 0.05), Black/African American race (b = -0.40, p < 0.05), and having a higher level of education (b = -0.45, p < 0.05) were each independently related to lower trust in doctors. Older age (b = 0.10, p < 0.05) was associated with higher trust. Previous discrimination had a negative association with trust (b = -4.27, p < 0.05) and the relationship between race and trust was reduced to zero (b = 0.28, p = 0.155) with discrimination in the model.
Previous discrimination experiences in a medical care setting completely attenuated the relationship between race and trust in doctors, a prominent finding that should be considered when providing healthcare services to diverse populations of adults.
在为不同的中老年人群提供医疗服务时，了解可能影响他们对医生信任程度的因素非常重要，例如人口统计学因素和以往的歧视经历。
我们在美国成年人的全国样本中研究了对医生的总体信任的相关因素。
REGARDS纵向队列研究在随访时纳入了对医生的信任和歧视的测量。以对医生的总体信任为结果的横断面序贯线性回归模型，首先纳入人口统计学因素，然后加入医疗环境中的歧视因素。
REGARDS基线样本包括美国本土社区居住的参与者，他们自认为是白人或黑人/非裔美国人，年龄在45岁及以上。我们的分析样本包括8500名完成了REGARDS第二次家庭访视且年龄在52岁及以上的参与者。
信任程度通过医生总体信任量表进行测量。参与者还报告了他们是否曾在医疗环境中经历过歧视。
女性（b = -1.41，p < 0.05）、黑人/非裔美国人（b = -0.40，p < 0.05）以及受教育程度较高（b = -0.45，p < 0.05）均与对医生的较低信任独立相关。年龄较大（b = 0.10，p < 0.05）与较高信任相关。以往的歧视与信任呈负相关（b = -4.27，p < 0.05），并且在模型中加入歧视因素后，种族与信任之间的关系降至零（b = 0.28，p = 0.155）。
医疗环境中以往的歧视经历完全削弱了种族与对医生信任之间的关系，这一显著发现为不同成年人群提供医疗服务时应予以考虑。
