Racial concordance and trust in health communications: A randomized trial of videos about prostate cancer.

Abstract

5014 Background: Black men have a significantly higher risk of prostate cancer and more aggressive disease compared to White men. The Internet is a popular source of health information and is commonly used by Black adults. However, Black adults are underrepresented in online content about prostate cancer. Given that medical mistrust is greater among Black compared to White adults, this study sought to evaluate the association between racial representation in online content about prostate cancer and trust in the content. A secondary objective was to identify additional attributes that influence trust in online content. Methods: This was a randomized trial of 2904 U.S. adults age ≥40. Participants were randomly assigned to view one of 8 different online videos. Videos used an equivalent script about either prostate cancer screening or clinical trials presented by one of 4 different presenters: Black physician, Black patient, White physician, or White patient. The primary outcome of the study was trust in the information using a Likert scale. Logistic regression models were applied to compare trust in the videos, based upon the characteristics of the speaker and topic of the video. Results: Study participants were 1703 (59%) Black and 1201 (41%) White adults. Black adults were 1.5 times more likely to trust a Black presenter compared to a White presenter (p<0.001). For White adults, no significant difference in trust was identified between Black or White presenters (p=0.21). For both Black and White adults, a physician presenting the information was more trusted than a patient, and videos discussing screening were more likely to be trusted than those discussing clinical trials (Table). Conclusions: Racial concordance is significantly associated with trust in prostate cancer information among Black adults. Additionally, health information is considered more trustworthy when delivered by a physician. These results highlight the importance of physicians in disseminating health information to the public, and of increasing racial diversity among healthcare providers. They also suggest an ongoing need for public education about clinical trials to prioritize issues of mistrust and distrust. [Table: see text]