title: Racial differences in medical mistrust among men diagnosed with prostate cancer.
abstract: BACKGROUND
  Mistrust of healthcare providers and systems is a significant barrier to quality healthcare. However, limited empirical data are available on perceptions of medical mistrust among individuals who are diagnosed with cancer. The objective of this study was to identify sociodemographic, clinical, and cultural determinants of mistrust among men diagnosed with prostate cancer.
  
  
  METHODS
  The authors conducted an observational study among 196 African-American men (n = 71) and white men (n = 125) who were newly diagnosed with prostate cancer during 2003 through 2007.
  
  
  RESULTS
  Race, education, healthcare experiences, and cultural factors had significant effects on mistrust. African-American men (P = .01) and men who had fewer years of formal education (P = .001) reported significantly greater levels of mistrust compared with white men and men who had more education. Mistrust also was greater among men who had been seeing their healthcare provider for a longer period (P = .01) and among men with lower perceptions of interdependence (P = .01).
  
  
  CONCLUSIONS
  The current findings suggested that efforts to enhance trust among men who are diagnosed with prostate cancer should target African-American men, men with fewer socioeconomic resources, and men with lower perceptions of interdependence. Reasons for deterioration in trust associated with greater experience with specialty providers should be explored along with the effects of interventions that are designed to address the concerns of individuals who have greater mistrust.
authors.affiliation: Department of Psychiatry and Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA. chanita@mail.med.upenn.edu
authors.forename: Chanita Hughes
authors.initials: CH
authors.lastname: Halbert
authors.forename: Benita
authors.initials: B
authors.lastname: Weathers
authors.forename: Ernestine
authors.initials: E
authors.lastname: Delmoor
authors.forename: Brandon
authors.initials: B
authors.lastname: Mahler
authors.forename: James
authors.initials: J
authors.lastname: Coyne
authors.forename: Hayley S
authors.initials: HS
authors.lastname: Thompson
authors.forename: Thomas Ten
authors.initials: TT
authors.lastname: Have
authors.forename: David
authors.initials: D
authors.lastname: Vaughn
authors.forename: S Bruce
authors.initials: SB
authors.lastname: Malkowicz
authors.forename: David
authors.initials: D
authors.lastname: Lee
mesh_terms: D001741:Black or African American; D001294:Attitude to Health; D003469:Culture; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology* / Q000523:psychology*; D011471:Prostatic Neoplasms / Q000208:ethnology* / Q000523:psychology*; D012959:Socioeconomic Factors; D035502:Trust; D044465:White People