Trust In Physicians Research Articles

Context of Trust in Physicians in Singapore: The Roles of Professional Intimacy, Physician Sexual Orientation, and Patient Sex

Context of Trust in Physicians in Singapore: The Roles of Professional Intimacy, Physician Sexual Orientation, and Patient Sex

Poster 374: Patient knowledge of and willingness to pay for platelet-rich plasma injections: A prospective survey study on orthopedic sports medicine patients

Objectives: The efficacy of platelet-rich plasma (PRP) injections for sports-related injuries is a hotly- debated topic. PRP is a cash-pay procedure that is not covered by insurance, and it is actively advertised for a number of different indications, some without supporting evidence. Yet, an increasing number of patients are asking their physicians for PRP injections. The aim of this study is to better understand patients’ knowledge of PRP and willingness to pay out of pocket. Methods: This ongoing Institutional Review Board-approved prospective study included patients presenting with a new chief complaint at a sports medicine orthopedic office in a large urban academic health system. Patients completed an anonymous survey prior to evaluation by an orthopedic surgeon. The survey collected demographic information, clinical information, knowledge of PRP, willingness to pay for PRP based on expected percentage pain reduction, and motivators behind willingness to pay. Two cohorts included: 1) patients who had heard of PRP and 2) patients who had not. The latter group was given a short educational excerpt on PRP. Two-tailed Mann-Whitney U and Kruskal-Wallis tests evaluated pain scores and willingness to pay for PRP between the cohorts. Spearman rank correlation tests evaluated correlations between household income and willingness to pay. Results: To date, we have enrolled 32 patients of which 37.5% had previous orthopedic surgery, 43.75% had seen another medical provider for their current symptoms and 37.5% had previously heard of PRP. Patients who had heard of PRP (versus those that had not) reported lower median pain scores (median 4.75 versus 5.0 out of 10), the same hindrance of daily activities (median 3.0 out of 5), and longer duration of symptoms (median 5.0 months versus 1.0 month), although not statistically significant. Patients were willing to pay more for a greater anticipated reduction in pain: median of $50, $250, and $500 for 25%, 50% and 100% reduction in pain, respectively (Table 1) (p<0.05). Patients who had heard of PRP were willing to pay more for PRP (median $500 versus $200; Table 1); this was not statistically significant. There was no correlation between patients’ income and willingness to pay. Finally, regarding willingness to pay for a given percent reduction in pain, patients reported their top three motivators to be symptoms affecting their day-to-day life, desire to try non-surgical interventions, and desire to return to normal activity (Table 1). For patients who had not heard of PRP, after being informed of PRP these patients reported physician trust as the greatest motivator behind their willingness to pay (Table 1). Conclusions: This ongoing study demonstrates the correlation between willingness to pay and perceived effectiveness of PRP while also noting motivators to pay. Moreover, we were also able to demonstrate some differences between patients who had heard of PRP versus those that had not. These data may be further refined with ongoing enrollment and will provide important insights into patients’ knowledge and how this impacts decision-making in the context of PRP injections. [Table: see text]

Intolerance of uncertainty, experiential avoidance, and trust in physician: a moderated mediation analysis of emotional distress in advanced cancer.

We tested whether patients' trust in physician moderated the hypothesized indirect association between intolerance of uncertainty (IU; inability to tolerate the unknown) and emotional distress through the mediator, experiential avoidance (EA; efforts to avoid negative emotions, thoughts, or memories), in patients with advanced cancer. The sample included 108 adults with Stage III or IV cancer (53% female; Mage = 63 years) recruited from a metropolitan cancer center. All constructs were measured by standardized self-report instruments. The PROCESS macro for SPSS tested the moderated mediation model. IU evidenced significant direct and indirect relationships with anxiety and depressive symptoms. Trust in physician moderated the indirect relationship between IU and anxiety (not depressive symptoms), albeit in an unexpected direction. Specifically, the indirect relationship between IU and anxiety symptoms through EA was significant for those with moderate to high physician trust but not low trust. Controlling for gender or income did not change the pattern of findings. IU and EA may be key intervention targets, particularly in acceptance-or meaning-based interventions for patients with advanced cancer.

Exploring the Relationship Between Intolerance of Uncertainty and Trust in Physicians from Spousal and Parent-Child Perspectives.

The present study aimed to probe the intergenerational transmission of intolerance of uncertainty (IU) and trust in physicians. Besides, through the actor-partner interdependence model (APIM), the predictive effect of parents' IU on their own and their spouses' trust in physicians was examined. A mediation model was further constructed to probe the mechanisms by which parents' IU affects children's trust in physicians. The Intolerance of Uncertainty Scale-12 (IUS-12) and the Wake Forest Physician Trust Scale (WFPTS) were employed to conduct the questionnaire survey among 384 families (each family with a father, mother, and one child). IU and trust in physicians were found to be intergenerationally transmitted. The results of the APIM analyses showed that fathers' total IUS-12 scores negatively predicted their own (β = -0.419, p < 0.01) and mothers' (β = -0.235, p < 0.01) total WFPTS scores. Mothers' total IUS-12 scores negatively predicted their own (β = -0.353, p < 0.01) and fathers' (β = -0.138, p = 0.017) total WFPTS scores. The results of mediation analyses indicated that parents' total WFPTS scores and children's total IUS-12 scores mediated the effect of parents' total IUS-12 scores on children's total WFPTS scores. The public's IU is a crucial influencing factor of their trust in physicians. Besides, the IU between couples and between parents and children could be mutually affected. On the one hand, husbands' IU could affect their own and their wives' trust in physicians, and vice versa. On the other hand, parents' IU and trust in physicians could affect their children's IU and trust in physicians, respectively.

Ask Questions (ASQ): Implementation of a question prompt list communication intervention in a network of outpatient medical oncology clinics.

e24185 Background: High-quality, patient-centered communication is not experienced equitably across patient populations, likely contributing to healthcare disparities. Question Prompt Lists (QPL) improve patient active participation and other aspects of patient-physician communication in diverse populations and settings. This descriptive, single-arm study assessed the implementation and patient perceptions of a previously-developed, evidence-based QPL, the ASQ brochure, across a network of oncology clinics providing care in a diverse population across Michigan. Methods: The QPL was revised in collaboration with community and physician stakeholders. Implementation was assessed through the reach, adoption, and efficacy domains of the RE-AIM framework. Eligible patients had a cancer diagnosis and were scheduled for a first appointment with an oncologist at any of eight participating clinics. All participants received the ASQ brochure and completed three surveys: one at baseline, one immediately before their appointment, and one following their appointment. Surveys assessed sociodemographic characteristics; communication-related outcomes (knowledge, self-efficacy in interacting with physicians, trust in physicians, distress); and perceptions of the ASQ brochure. Analyses included descriptive statistics and univariable and multivariable linear mixed-effects models. Results: Reach: A total of 81 patients participated with a consent rate of 68.3%. Self-identified racial/ethnic groups were representative of the population served by the clinic network (72.4% white, 21.0% black, 3.7% American Indian/Native Alaskan, and 1.2% Mexican/Hispanic). Adoption: All eight invited clinics participated and recruited patients. Efficacy: All outcomes improved significantly, with no significant differences by clinic site or patient race. Patient perceptions of the ASQ brochure were overwhelmingly positive. Conclusions: The implementation of the ASQ brochure was successful in this oncology clinic network providing care to a diverse patient population. Findings suggest this simple, evidence-based communication intervention should be implemented widely in similar clinical contexts.

Polish adaptation and validation of Physician's Trust in the Patient Scale

Polish adaptation and validation of Physician's Trust in the Patient Scale

Trust in physicians and definitive diagnosis time among Japanese patients with specific intractable diseases: A cross-sectional study.

Trust in physicians is an important metric in shared decision-making. Many patients with rare diseases experience misdiagnosis or delayed diagnosis because of difficulties in diagnosis or access to specialists. What impact do these have on trust in physicians? This study focused on patients with rare diseases, evaluated the effects of a delayed diagnosis and misdiagnosis on trust in physicians, and clarified the backgrounds of patients who have experienced delayed diagnoses. Patients with any of the 334 intractable diseases in Japan were registered, and a questionnaire survey was conducted on 1,000 valid registrations. Scores were calculated on a five-point Likert scale, and Cronbach's alpha coefficient was calculated to determine internal consistency, which was 0.973. Independent sample t-tests and analysis of variance were used to compare average trust scores based on patient demographics. The mean trust in physician score of patients who waited ≤ 1 year until definitive diagnosis was 47.66 ± 11.69, while those of patients who waited > 1 year was 45.07 ± 11.63 (p = 0.004). The average trust scores of patients with or without a misdiagnosis were 46.69 ± 11.96 and 47.22 ± 11.65 (p = 0.550), respectively. Among patients with time to a definitive diagnosis of > 1 year, 62.8% had a period from symptom onset to initial hospital visit of > 1 year. A longer time to definitive diagnosis lowered the degree of trust in physicians. Many patients who experienced delayed diagnoses also had a long time from symptom onset to the initial medical visit. This aspect is important for understanding the background of patients who experienced delayed definitive diagnoses.

Effects of connection-based physician-patient relationships on perceptions of outcome: A vignette experiment

ObjectivesTo investigate the effects of media reports of medical outcomes and connection-based medicine on trust in physicians. In “connection-based medicine,” people use personal connections to obtain better medical resources. MethodsVignette experiments were used to investigate attitudes toward physicians among 230 cancer patients and their families (Sample 1) and a cross-validated sample of 280 employees from various industries (Sample 2). ResultsFor both samples, negative media reports were associated with lower trust in physicians; when the reports were positive, the participants generally perceived physicians as more competent and trustworthy. However, with negative reports, patients and families perceived connection-based physicians as less right and professional than non-connection-based physicians; the public (represented by the employee sample) perceived connection-based physicians as less right than non-connection-based physicians and negative outcomes to be caused more by connection-based physicians than non-connection-based physicians. ConclusionsMedical reports can influence the perception of a physician's traits, which are important for trust. Positive reports promote evaluation of Rightness, Attribution, and Professionalism, whereas negative results may elicit the opposite effect, especially for connection-based physicians. Practical implicationsPositive media images of physicians can help facilitate trust. Connection-based medical treatment should be reduced to improve access to medical resources in China.

Factors influencing the preoperative anxiety in lung cancer patients undergoing video-assisted thoracoscopic surgery: The role of information needs, illness perception and patient trust

ObjectivesThis study aimed to investigate preoperative anxiety in patients with lung cancer scheduled for video-assisted thoracoscopic surgery (VATS) and explore the influence of demographic factors, information needs, illness perception, and patient trust in preoperative anxiety. MethodsThis cross-sectional study was conducted at a tertiary referral center in China from August 14 to December 1, 2022. Patients with lung cancer (N = 308) scheduled for VATS were evaluated using the Amsterdam Anxiety and Information Scale (APAIS), Brief Illness Perception Questionnaire (BIPQ), and Wake Forest Physician Trust Scale (WFPTS). Multivariate linear regression was employed to determine the independent predictors of preoperative anxiety. ResultsThe average total APAIS anxiety score was (10.6 ± 4.2). Of the sample, 48.4% reported high preoperative anxiety (APAIS-A: ≥10). Multivariate linear regression analysis showed that preoperative anxiety was higher in women (B = 0.860); and that preoperative length of stay ≥24 h (B = 0.016), more information needs (B = 0.988), more severe illness perceptions (B = 0.101) and more patient trust (B = −0.078) may lead to higher preoperative anxiety levels. ConclusionsPreoperative anxiety is common in patients with lung cancer scheduled for VATS. Therefore, more attention should be paid to women and patients with a preoperative length of stay of ≥24 h. Meeting information needs, transforming positive disease perceptions, and strengthening the doctor-patient trusting relationship are key protective factors for preoperative anxiety.

Ask questions (ASQ): Implementation of a question prompt list communication intervention in a network of outpatient medical oncology clinics

ObjectiveThis descriptive, single-arm study assessed the implementation and patient perceptions of an evidence-based Question Prompt List (QPL), the ASQ brochure, across a network of oncology clinics in a diverse patient population. MethodThe QPL was revised in collaboration with stakeholders. Implementation was assessed using the RE-AIM framework. Eligible patients were scheduled for a first appointment with an oncologist at any of eight participating clinics. All participants received the ASQ brochure and completed three surveys: one at baseline, one immediately before, and one following their appointment. Surveys assessed sociodemographic characteristics; communication-related outcomes (perceived knowledge, self-efficacy in interacting with physicians, trust in physicians, distress); and perceptions of the ASQ brochure. Analyses included descriptive statistics and linear mixed-effects models. ResultsReach: Participants (n = 81) represented the diverse population served by the clinic network. Efficacy: All outcomes improved significantly, with no significant differences by clinic site or patient race. Adoption: All eight invited clinics participated and recruited patients. Patient perceptions of the ASQ brochure were overwhelmingly positive. ConclusionImplementation of the ASQ brochure was successful in this oncology clinic network providing care to a diverse patient population. Practical ImplicationsThis evidence-based communication intervention can be implemented widely in similar medical contexts and populations.

A Comparative Study of Patients’ Trust in Physicians and Nurses in COVID-19 and Non-COVID 19 Wards in a Reference Hospital in Tehran, Ira

"Trust in health care professionals is considered as a basis for patients’ care. This study aimed to compare the level of patients' trust in physicians and nurses in both general and COVID-19 wards in a reference hospital in Tehran during the pandemic. This was a cross-sectional descriptive study. The study population comprised patients from Baqiyatallah Hospital in 2022. The data collection tool was the scale of patients’ trust in nurses and the Wake-Forest physician trust scale. Data analysis was performed using SPSS-26 software. The level of patients’ trust in physicians in COVID-19 wards was significantly lower than in Non-COVID-19 wards (P&lt;0.001), but there was no difference between the two groups in the trust of nurses. The lowest level of trust was in the receiving of required information from nurses, which had a lower score compared to other questions in the questionnaire, and the average amount of receiving required information for patients in general wards was significantly lower than that of patients in COVID-19 (P=0.006). Trust in nurses and physicians in both COVID-19 and general wards was optimum. During the COVID-19 pandemic, the medical staff worked tirelessly and despite the difficulties and complications of the pandemic, patients have high trust in physicians and nurses. "

Surprising pandemic experiences: A confrontation between principle-based and virtue ethics, and a plea for virtue ethics training for medical students and residents. A rudimentary outline of a four-step model.

In past years, physicians have, with a certain continuity, reported increasing numbers of burnout, depression and compassion fatigue in their daily practice. These problems were attributed, not only but also, to a loss of public trust and an increase in violent behaviour of patients and family members towards medical professionals in all walks of life. Recently, however, during the breakout of the coronavirus disease 2019 (COVID-19) pandemic in 2020, there were public expressions of appreciation and respect for health care workers that almost universally have been assessed as indications of a re-establishment of public trust in physicians and appreciation for the medical professions' commitments. In other words, shared experiences of what society was in need of: the experience of a 'common good'. Those responses during the COVID-19 pandemic increased positive feelings among practicing physicians, such as commitment, solidarity, competency, and experiences concerning obligations for the common good and a sense of belonging to one and the same community for all. Essentially, these responses of raised self-awareness of commitment and solidarity between (potential) patients and medical personal point towards the social importance and power of these values and virtues. This shared domain in ethical sources of behaviour seems to hold a promise of overcoming gaps between the different spheres of doctors and patients. That promise justifies stressing the relevance of this shared domain of Virtue Ethics in the training of physicians. In this article, therefore, we shall make a plea for the relevance of Virtue Ethics before proposing an outline of an educational programme for Virtue Ethics training for medical students and residents. Let us start by very briefly presenting on Aristotelian virtues and its relevance to modern medicine in general, and during the current pandemic in particular. We shall follow up this short presentation by a Virtue Ethics Training Model and the respective settings in which it takes place. This model has four steps as follows: (a) include moral character literacy in the formal curriculum; (b) provide ethics role modelling and informal training in moral character in the healthcare setting by senior staff; (c) create and apply regulatory guidelines regarding virtues and rules; and (d) assess success of training by evaluation of moral character of physicians. Applying the four-step model may contribute to strengthening the development of moral character in medical students and residents, and decrease the negative consequences of moral distress, burnout and compassion fatigue in health care personnel. In the future, this model should be empirically studied.

450 Barriers and Enablers to Medication Deprescribing among Older patients attending a Geriatric Clinic in Southwestern Nigeria: A Cross-Sectional Study

Abstract Introduction Polypharmacy is an increasing health problem, leading to rise in morbidity and mortality, especially among older patients. Deprescribing has been recommended for managing polypharmacy, but deprescribing medication in older patients is still uncommon (1). Safe deprescribing interventions can reduce exposure to inappropriate polypharmacy among older patients. However, few empirical data exist on the barriers and enablers to medication deprescribing among older patients in sub-Saharan African countries. Aim This study aimed to assess the barriers and enablers of medication deprescribing among older patients. Methods A cross-sectional study of 415 older patients aged ≥60 years, selected consecutively at the geriatric clinic in a Tertiary Hospital was carried out between May and July 2022. An interviewer-administered semi-structured questionnaire was used to obtain information on their socio-demographic characteristics, and barriers and enablers of medication deprescribing were assessed with modified Revised Patients’ Attitudes Towards Deprescribing (rPATD) Questionnaire (2). Descriptive analyses were carried out using SPSS 23. Results The mean age of the respondents was 69.6 ± 6.4 years and 252 (60.7%) were females. There were 218 (52.5%) respondents with multimorbidity (≥2 medical conditions), and 126 (30.4%) with polypharmacy (≥ 5 medications). Cardiovascular disease 331 (81.0%), and endocrine system disease 111 (26.7%) were the most common disease condition. The enablers to deprescribing were willing to stop one or more regular medicines, if recommended by a physician 251 (60.5%), and willing to stop if the medicines can be restarted in the future if needed 205 (49.4%). While the barriers were would be worried about missing out on medicine benefits 78 (18.8%) and would be reluctant to stop medicines prescribed by a physician 63 (15.2%). Conclusion The older patients were receptive to deprescribing. Satisfaction with medicines and trust in physician’s recommendations are important factors influencing patients’ willingness to have their medicines deprescribed.The most common barrier was worries about missing out on medicine benefits.These findings calls for healthcare professionals to focus on communication strategies to facilitate shared decision-making regarding medication use and deprescribing with patient and family. Improvement in deprescribing through interdisciplinary approach may improve clinical outcomes.

E-Health Literacy Scale, Patient Attitudes, Medication Adherence, and Internal Locus of Control.

Health literacy is related to a variety of health outcomes, including disease control, health-related quality of life, and risk for death. Few studies have investigated the relation of electronic health literacy (e-health literacy) to outcomes or the mechanism by which they may be related. Secondary data were drawn from participants in a larger study on chronic disease self-management who were age 40 years and older, had at least one chronic health condition and a health literacy score of 8th grade or below on the validated short form of the Rapid Estimate of Adult Literacy in Medicine. Participants completed the e-Health Literacy Scale (eHEALS), the Multidimensional Health Locus of Control scale, a modified version of the Attitudes Toward Health Care Providers Scale (ATHCPS), the Wake Forest Physician Trust Scale (WFPTS), and the Gonzalez-Lu adherence questionnaire. Hypothesized relations were evaluated in a bootstrapped path analytic model using the Mplus statistical software. Participants included 334 individuals (mean age: 57.5 years; 173 women and 161 men) with Black, Indigenous, and People of Color accounting for 83.3% of the participants and White individuals making up 16.7% of the participants. Model results showed that after controlling for age, education, gender, and race, the eHEALS score was significantly related to the ATHCPS and WFPTS but not to the Gonzalez-Lu adherence questionnaire (p < .05). The eHEALS score was significantly related to the Multidimensional Health Locus of Control scale. Analysis of indirect effects showed that a portion of the relation between e-health literacy and patient attitude and adherence was mediated by internal locus of control (all p < .05). In this study, e-health literacy was related to important patient attitude and behavior variables via locus of control. This finding has implications for the importance of improving patients' ability to use the internet to access and effectively use health information. [HLRP: Health Literacy Research and Practice. 2023;7(2):e80-e88.].

PD32-03 ASSOCIATION BETWEEN TRUST, OUTCOMES AND RACIAL DISPARITY IN PROSTATE CANCER CARE

You have accessJournal of UrologyCME1 Apr 2023PD32-03 ASSOCIATION BETWEEN TRUST, OUTCOMES AND RACIAL DISPARITY IN PROSTATE CANCER CARE Sumedha Chhatre, Joseph Gallo, Thomas Guzzo, Knashawn Morales, Neha Vapiwala, Keith Van Arsdalen, Alan Wein, S Bruce Malkowicz, and Ravishankar Jayadevappa Sumedha ChhatreSumedha Chhatre More articles by this author , Joseph GalloJoseph Gallo More articles by this author , Thomas GuzzoThomas Guzzo More articles by this author , Knashawn MoralesKnashawn Morales More articles by this author , Neha VapiwalaNeha Vapiwala More articles by this author , Keith Van ArsdalenKeith Van Arsdalen More articles by this author , Alan WeinAlan Wein More articles by this author , S Bruce MalkowiczS Bruce Malkowicz More articles by this author , and Ravishankar JayadevappaRavishankar Jayadevappa More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003325.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Trust is an important aspect of healthcare and of the patient-physician relationship. Differences in levels of trust among patients may help explain variations in care seeking and use of medical services. However, these associations remain understudied. Objective is to study the association between patient-physician trust and treatment choice and outcomes among low, intermediate and high-risk, White and African American prostate cancer patients. METHODS: We used data from a multi-centered randomized controlled study among localized prostate cancer patients. Trust was measured at baseline using Patient Trust - Wake Forest Physician Trust Scale (PTWF). Outcomes were assessed at baseline, and at 3, 6, 12 and 24-month follow-up. Treatments were robotic-assisted laparoscopic radical prostatectomy, radiation therapy and active surveillance. Participants were categorized into risk groups as: low risk (PSA <10 ng/ml, Gleason ≤6, clinical stage T1-2a), intermediate risk (PSA 10 -20 ng/ml, Gleason 7, clinical stage T2b), and high risk was (PSA >20, Gleason ≥8, clinical stage T2c-3a). Association between treatment type, and trust (PTWF score) and race for each risk category was assessed using multinomial logistic models. RESULTS: Of the 743 localized prostate cancer patients recruited for the study, 82% were White and 14% were African American. Retention rate was >75% during follow-up. Proportion of risk categories was: 34% low-risk, 32% intermediate-risk and 34% high-risk. Baseline trust was comparable between White and African American patients (mean=19.5, standard deviation (std)=6.1 vs. mean=20.5, std=6.8, p=0.8032). Also, baseline trust was comparable between intervention group and usual care group (mean=19.3, std=6.0 vs mean=19.8, std=6.4; p=0.397). Results of multinomial regression indicated that trust and race were not associated with treatment choice independently. CONCLUSIONS: This is one of the largest study that has assessed the relationship between trust, race and outcomes in localized prostate cancer patients. We observed that baseline trust was comparable between White and African American patients. Also, neither trust, not race was associated with treatment choice and outcomes. Thus, other factors such as patient-centered preference assessment, may be associated with treatment choice in prostate cancer patients. Source of Funding: PCORI CE-12-11-4973 © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e908 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sumedha Chhatre More articles by this author Joseph Gallo More articles by this author Thomas Guzzo More articles by this author Knashawn Morales More articles by this author Neha Vapiwala More articles by this author Keith Van Arsdalen More articles by this author Alan Wein More articles by this author S Bruce Malkowicz More articles by this author Ravishankar Jayadevappa More articles by this author Expand All Advertisement PDF downloadLoading ...

Association between acculturation and physician trust for internal migrants: A cross-sectional study in China.

Physician trust is a critical determinant of the physician-patient relationship and is necessary for an effective health system. Few studies have investigated the association between acculturation and physician trust. Thus, this study analyzed the association between acculturation and physician trust among internal migrants in China by using a cross-sectional research design. Of the 2000 adult migrants selected using systematic sampling, 1330 participants were eligible. Among the eligible participants, 45.71% were female, and the mean age was 28.50 years old (standard deviation = 9.03). Multiple logistic regression was employed. Our findings indicated that acculturation was significantly associated with physician trust among migrants. The length of stay (LOS), the ability of speaking Shanghainese, and the integration into daily life were identified as contributing factors for physician trust when controlling for all the covariates in the model. We suggest that specific LOS-based targeted policies and culturally sensitive interventions can promote acculturation among Shanghai's migrants and improve their physician trust.

Abstract OT2-04-01: A Video Intervention to Improve Patient Understanding of Tumor Genomic Testing in Patients With Metastatic Cancer

Abstract Background: Tumor genomic testing (TGT) has become increasingly adopted as part of standard cancer care for many cancers. Despite national guidelines around patient education prior to TGT, available evidence suggests that most patients’ understanding of genomics remains limited, particularly lower income and minority patients, and most patients are not informed regarding potential incidental germline findings. Purpose: The primary object of this ongoing clinical trial is to evaluate the effectiveness of concise, animated videos to provide patient pre-test education prior to TGT as a supplement to patient-provider discussion. Trial Design: This prospective observational cohort study will enroll a total of 150 cancer patients in three clinical cohorts: Cohort 1: breast cancer (n=50); Cohort 2: lung cancer (n=50); Cohort 3: cancer patients of any tumor type (n=50). The primary objective is to assess change in patient knowledge of TGT following exposure to the video to evaluate the hypothesis that exposure to a brief educational video will increase patient knowledge about tumor genomic testing. Secondary objectives include assessing changes following exposure to the video, including: 1) genomic knowledge 2) trust in Physician 3) comparison of results between the three patient cohorts. Methods: Based on published guidelines around pre-TGT provider-patient education and patient focus groups and interviews, content for a series of videos was developed to standardize patient pretest education of TGT. A base animated video was created to be applicable to any cancer type; additional tumor type content was added for the breast and lung cancer-specific videos. Participant recruitment is occurring at The Ohio State University’s Comprehensive Cancer Center. Eligibility criteria include: age 18 years or older, biopsy-confirmed cancer, and provider plan to undergo TGT. This study requires participants to complete surveys at three timepoints: before video viewing (T1), immediately after video viewing (T2), and after provider communicates TGT results to the patient (T3). Four survey instruments are completed at T1/T2/T3: video message-specific recall, objective genomic knowledge/understanding, the 11-item Trust in Physician, and attitudes around genetic/genomic testing. TGT intention surveys are captured at T1 and T2. Participant evaluation of the video is collected at T2. For the primary objective, we will use a two-sided Wilcoxon signed-rank test with alpha of 0.05, giving us 90% power to detect an effect size of 0.47 in change of recall accuracy from pre- to post- video intervention. All secondary outcomes will be summarized using descriptive statistics and compared pre-/post-video using Wilcoxon signed-rank test. For comparisons of MBC and MLC, endpoints will include 1) baseline and pre-/post-video intervention change in genomic knowledge/understanding in MBC versus MLC patients; 2) baseline and pre-/post-video intervention change in trust in provider. The baseline and the change from pre- to post-video intervention in the secondary outcomes will be compared between MBC and MLC patients using Wilcoxon rank sum test. Conclusions: The long-term goal of this project is to test this broadly applicable, modular video-based intervention to be administered prior to tumor NGS to ensure equitable access to informed care. The use of a short video in this setting is innovative and we are demonstrating capacity to complete such a project. Study enrollment began March 30, 2022 and to date, 33 participants have enrolled (n=18 breast cancer; n=9 lung cancer; n=6 other cancer types). ClinicalTrials.gov NCT05215769. Citation Format: Daniel Stover, Deloris Veney, Heather Hampel, Amanda E. Toland, Carolyn Presley, Tasleem Padamsee, Clara Lee, Shelly Hovick, Leigha Senter. A Video Intervention to Improve Patient Understanding of Tumor Genomic Testing in Patients With Metastatic Cancer [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr OT2-04-01.

Association between trust in COVID-19 information sources and engaging in infection prevention behaviors in Japan: A longitudinal study

ObjectiveWe examined changes in people’s trust in information sources in Japan during the COVID-19 pandemic over the course of 1 year and investigated longitudinal associations between trust in such sources and engaging in infection prevention behaviors. MethodsWe conducted a longitudinal survey of Japanese populations under a declared state of emergency at two time points, August 2020 and August 2021. We surveyed sociodemographic data, seven Trust in COVID-19 information sources and six COVID-19 preventive behaviors. ResultsIn all, 784 participants completed the two surveys. Physicians were the most consistently trusted information source over the 1-year period. We identified three preventive behaviors that were positively associated with trust in physicians as an information source (social distancing, wearing masks, and washing hands with soap), four preventive behaviors that were positively associated with trusting infected patients (social distancing, using ventilation, wearing masks, and using hand sanitizer), and one preventative behavior that was negatively associated with trust in government (avoiding closed spaces). ConclusionIn the ongoing pandemic, information from physicians and patients may encourage people to engage in long-term preventive behaviors. Practice implicationsPhysicians and patients should be promoted as trusted and behavior influencing sources of information during the pandemic.

Trust in physicians predicts COVID-19 booster uptake among older adults: Evidence from a panel survey

• Centers for Disease Control and Prevention recommend that older adults receive COVID-19 booster vaccination. • We investigated the primary determinants of older adults receiving a booster vaccination. • Statistically significant relationships between trust in physicians, age, evangelical identity, and booster vaccination status were detected in this study.

Public trust of physicians in China improved since the COVID-19 pandemic Began

RationalePublic trust in physicians had declined in China for decades before the COVID-19 pandemic. During the COVID-19 pandemic, frontline physicians have experienced high work volume despite a high risk of COVID-19 infection. The willingness of physicians to treat COVID patients with a high risk of exposure to the infection may have improved public trust in physicians. ObjectiveThis study analyzes how public trust in physicians has changed since the pandemic started using a nationally representative survey. MethodsWe used the China Family Panel Studies (CFPS), with 179,123 respondents 10 years or older who were eligible to answer the question on public trust in physicians from 2012 to 2020. Public trust has been measured by an 11-point Likert scale. A quasi pre-post study design using a segmented regression impact model was used to evaluate the impact of the COVID-19 pandemic on public trust in physicians. ResultsAt the start of the observation period, the average public trust score was 6.86 out of 10.00. The immediate unadjusted change of mean score for public trust during COVID-19 was significantly higher (Coef. = 0.361; 95% CI = 0.359, 0.364). Moreover, a significant increase in the unadjusted trend during the COVID-19 pandemic was observed in the mean score for public trust (Coef. = 0.005; 95% CI = 0.004, 0.006). The results were similar to the estimates obtained when we adjusted for demographic characteristics and health status. ConclusionsThe mean score for public trust increased during the COVID-19 pandemic. This study provides a new perspective on restoring public trust in physicians, a significant concern of the Chinese healthcare system. During the COVID-19 pandemic, social and mainstream media helped to establish the “good doctor” image, which may have improved patients’ trust in physicians. Improving health literacy through effective communication and education may help increase public trust in physicians.