title: Validation of the group-based medical mistrust scale among urban black men.
abstract: BACKGROUND
  Socioculturally relevant measures of medical mistrust are needed to better address health disparities, especially among Black men, a group with lower life expectancy and higher death rates compared to other race/gender groups.
  
  
  OBJECTIVE
  The study aim was to investigate the psychometric properties of the Group-Based Medical Mistrust Scale (GBMMS) in a Black male sample.
  
  
  METHODS
  Data were collected as part of a randomized controlled trial testing educational strategies to support Black men's decisions about prostate cancer screening.
  
  
  METHODS
  Participants included 201 Black men ages 40-75 years recruited in New York City during 2006-2007.
  
  
  METHODS
  The primary measures included: race-based medical mistrust, health care participation, avoidance of health care, perceived access to health care, health care satisfaction, racial identity, residential racial segregation, attitudes towards prostate cancer screening, and past prostate cancer screening behavior.
  
  
  RESULTS
  An exploratory factor analysis suggested a three-factor structure. Confirmatory factor analysis supported the three-factor model. Internal consistency was high for the total GBMMS and the three sub-scales: Suspicion, Discrimination, and Lack of Support. Construct validity was supported by: significant positive correlations between GBMMS and avoidance of health care and racial identity as well as significant negative correlations with health care access, health care satisfaction, and attitudes about prostate cancer screening. ANOVA showed that the GBMMS was associated with greater residential racial segregation. Higher total GBMMS scores were associated with not visiting a physician in the last year and not having a regular physician.
  
  
  CONCLUSIONS
  The present findings provide strong additional evidence that the GBMMS is a valid and reliable measure that may be used among urban Black men.
authors.affiliation: Department of Oncological Science/Cancer Prevention and Control, Mount Sinai School of Medicine, 1425 Madison Avenue, Box 1130, New York, NY 10029, USA. rshelton@post.harvard.edu
authors.forename: Rachel C
authors.initials: RC
authors.lastname: Shelton
authors.forename: Gary
authors.initials: G
authors.lastname: Winkel
authors.forename: Stacy N
authors.initials: SN
authors.lastname: Davis
authors.forename: Nicole
authors.initials: N
authors.lastname: Roberts
authors.forename: Heiddis
authors.initials: H
authors.lastname: Valdimarsdottir
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Hall
authors.forename: Hayley S
authors.initials: HS
authors.lastname: Thompson
mesh_terms: D000328:Adult; D000368:Aged; D044383:Black People / Q000523:psychology*; D005163:Factor Analysis, Statistical; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City; D011594:Psychometrics / Q000379:methods; D016032:Randomized Controlled Trials as Topic; D035502:Trust; D014505:Urban Population; D001741:Black or African American