title: Understanding African Americans' views of the trustworthiness of physicians.
abstract: BACKGROUND
  Many scholars have written about the historical underpinnings and likely consequences of African Americans distrust in health care, yet little research has been done to understand if and how this distrust affects African Americans' current views of the trustworthiness of physicians.
  
  
  OBJECTIVE
  To better understand what trust and distrust in physicians means to African Americans.
  
  
  METHODS
  Focus-group study, using an open-ended discussion guide.
  
  
  METHODS
  Large public hospital and community organization in Chicago, IL.
  
  
  METHODS
  Convenience sample of African-American adult men and women.
  
  
  METHODS
  Each focus group was systematically coded using grounded theory analysis. The research team then identified themes that commonly arose across the 9 focus groups.
  
  
  RESULTS
  Participants indicated that trust is determined by the interpersonal and technical competence of physicians. Contributing factors to distrust in physicians include a lack of interpersonal and technical competence, perceived quest for profit and expectations of racism and experimentation during routine provision of health care. Trust appears to facilitate care-seeking behavior and promotes patient honesty and adherence. Distrust inhibits care-seeking, can result in a change in physician and may lead to nonadherence.
  
  
  CONCLUSIONS
  Unique factors contribute to trust and distrust in physicians among African-American patients. These factors should be considered in clinical practice to facilitate trust building and improve health care provided to African Americans.
authors.affiliation: John H. Stroger, Jr. Hospital of Cook County & Rush University Medical Center, Chicago, IL, USA. ejacobs@rush.edu
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Jacobs
authors.forename: Italia
authors.initials: I
authors.lastname: Rolle
authors.forename: Carol Estwing
authors.initials: CE
authors.lastname: Ferrans
authors.forename: Eric E
authors.initials: EE
authors.lastname: Whitaker
authors.forename: Richard B
authors.initials: RB
authors.lastname: Warnecke
mesh_terms: D000328:Adult; D000368:Aged; D044383:Black People; D002641:Chicago; D003142:Communication; D004522:Educational Status; D005260:Female; D006801:Humans; D008875:Middle Aged; D010817:Physician-Patient Relations; D035502:Trust; D014930:Women; D001741:Black or African American