Abstract LB372: Examining medical mistrust and access to cancer preventive care in a diverse sample

Abstract

Abstract Background: Medical mistrust has been linked to lower health care utilization, satisfaction and preventive actions among underserved populations. Further exploration of medical mistrust within these groups is needed to inform research and clinical approaches to improve trust and health equity. This study examined the relationship between medical mistrust and access to cancer preventive care among Black, American Indian (AI) and White participants in Virginia. Methods: A convenience sample (N=1,288) designed to oversample underrepresented communities in Virginia completed surveys assessing medical mistrust, access to medical care and colorectal cancer screening. Measures included the medical mistrust index, visiting a doctor in the last year (yes/no), ever having a colonoscopy (yes/no), perceived health status, race, age, sex, education, marital status, insurance coverage and rurality. Bivariate tests evaluated significant (p<.05) associations between outcomes of having a doctor visit in the last year and colonoscopy screening with medical mistrust, health status, and sociodemographics; significant findings were included in logistic regression models. Differences among endorsements of individual mistrust scale items by race was also assessed. Results: Sample was μ age=45 (SD=18), 47% female, 40% Black, 36% White, 14% AI, 45% had ≤ high school diploma/GED, 63% married, majority resided in metro areas (91%) and were medically insured (85%). Among the sample 80% had visited doctor in the last year and 63% of those eligible had a colonoscopy. Medical mistrust was significantly higher among Black and AI participants compared to White. In overall and stratified logistic regression models medical mistrust was not associated with visiting a doctor in the last year or obtaining a colonoscopy. 5 of 7 items of the medical mistrust index were endorsed more often among Black and AI participants compared to White. These included feeling that medical institutions deceive people (Black: r=0.07, p<0.01; AI: r=0.07, p=0.01; White: r=-0.11, p<0.01), cover-up mistakes (Black: r=0.11, p<0.01; AI: r=0.96, p=0.04; White: r=-0.13, p<0.01), conduct harmful experiments (Black: r=0.07, p<0.02; White: r=-0.10, p<0.01), lack competency (AI: r=0.07, p=0.01; White: r=-0.08, p<0.01), and make mistakes often (AI: r=0.10, p<0.01; White: r=-0.09, p<0.01). Conclusions: Medical mistrust was significantly higher among Black and AI participants compared to White but this was not associated with accessing medical care. Given differential endorsement of items dealing with medical errors and their concealment, these results suggest a need to investigate patient experiences after care is initiated to understand what factors may contribute to medical mistrust and care outcomes long term. Citation Format: Jackie Knigh Wilt, Maria D. Thomson. Examining medical mistrust and access to cancer preventive care in a diverse sample [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(7_Suppl):Abstract nr LB372.