title: An exploratory study of how trust in health care institutions varies across African American, Hispanic and white populations.
abstract: BACKGROUND
  Minority and non-minority patients in the United States have different levels of trust in health care; however, few studies have examined how determinants of trust and distrust in health care vary across diverse groups.
  
  
  OBJECTIVE
  To explore how trust in health care institutions varies across diverse populations.
  
  
  METHODS
  We conducted 17 focus groups with 117 participants in Chicago: 9 with African American, 5 with Hispanic, and 3 with white participants. Discussions were audiotaped, transcribed verbatim and coded using grounded theory analysis to identify dominant themes.
  
  
  RESULTS
  We found a core set of factors that contribute to trust and distrust across racial/ethnic groups. In addition, there were unique factors that contributed to distrust among African Americans and Hispanics. Both of these groups discussed expectations of discrimination in the health care setting and African Americans discussed expectations of being experimented on as determinants of distrust. Based on these findings, we developed a hypothetical model of how different factors influence trust and distrust in health care across these different racial/ethnic groups.
  
  
  CONCLUSIONS
  Contributors to trust and distrust in health care institutions are not always uniform across racial/ethnic groups. These differences should be addressed in future research and efforts to enhance trust in health care institutions.
authors.affiliation: Division of General Medicine & Health Innovation Program, University of Wisconsin-Madison, 53705, USA. eajacobs@medicine.wisc.edu
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Jacobs
authors.forename: Emily
authors.initials: E
authors.lastname: Mendenhall
authors.forename: Ann Scheck
authors.initials: AS
authors.lastname: Mcalearney
authors.forename: Italia
authors.initials: I
authors.lastname: Rolle
authors.forename: Eric E
authors.initials: EE
authors.lastname: Whitaker
authors.forename: Richard
authors.initials: R
authors.lastname: Warnecke
authors.forename: Carol Estwing
authors.initials: CE
authors.lastname: Ferrans
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology; D000368:Aged; D002641:Chicago; D003695:Delivery of Health Care; D005260:Female; D017144:Focus Groups; D006630:Hispanic or Latino / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D044469:Racial Groups / Q000523:psychology*; D035502:Trust; D044465:White People / Q000523:psychology; D055815:Young Adult