title: Medical mistrust and less satisfaction with health care among Native Americans presenting for cancer treatment.
abstract: OBJECTIVE
  To assess barriers to cancer care among Native Americans, whose health outcomes compare unfavorably with those of the general U.S. population.
  
  
  METHODS
  We undertook a comparative community-based participatory research project in which newly-diagnosed cancer patients were prospectively surveyed using novel scales for medical mistrust and satisfaction with health care. Socio-demographic information was obtained. Mean scale scores for mistrust and satisfaction were analyzed by race. Multivariable models were used to adjust for income, education level, and distance lived from cancer care institute.
  
  
  RESULTS
  Participation refusal rate was 38%. Of 165 eligible patients, 52 were Native American and 113 where non-Hispanic White. Native Americans expressed significantly higher levels of mistrust (p=0001) and lower levels of satisfaction (p=.0001) with health care than Whites. In multivariable analyses, race was the only factor found to be significantly predictive of higher mistrust and lower satisfaction scores.
  
  
  CONCLUSIONS
  Native Americans exhibit higher medical mistrust and lower satisfaction with health care.
authors.affiliation: Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA. aguadagn@mdanderson.org
authors.forename: B Ashleigh
authors.initials: BA
authors.lastname: Guadagnolo
authors.forename: Kristin
authors.initials: K
authors.lastname: Cina
authors.forename: Petra
authors.initials: P
authors.lastname: Helbig
authors.forename: Kevin
authors.initials: K
authors.lastname: Molloy
authors.forename: Mary
authors.initials: M
authors.lastname: Reiner
authors.forename: E Francis
authors.initials: EF
authors.lastname: Cook
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Petereit
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D054625:Healthcare Disparities; D006801:Humans; D007198:Indians, North American / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000208:ethnology* / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000208:ethnology; D017060:Patient Satisfaction / Q000208:ethnology*; D011446:Prospective Studies; D012959:Socioeconomic Factors; D035502:Trust