Trust in the Health Care System and the Use of Preventive Health Services by Older Black and White Adults
Trust in the Health Care System and the Use of Preventive Health Services by Older Black and White Adults
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DOI：
10.2105/ajph.2007.123927
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发表时间：
2009-07-01
影响因子：
12.7
通讯作者：
Thomas, Stephen B.
中科院分区：
文献类型：
--
作者：
Musa, Donald;Schulz, Richard;Thomas, Stephen B.
目标.我们试图找到种族差异的影响，在医疗保健系统的信任对预防性卫生服务的使用中老年人。我们对1681名黑人和白色老年人进行了电话调查。调查问题探讨了受访者对医生，医学研究和健康信息来源的信任。我们使用逻辑回归和控制协变量来评估种族和信任对预防性卫生服务使用的影响。我们通过因素分析确定了4种类型的信任：信任自己的私人医生，信任医生的护理能力，信任正式和非正式的健康信息来源。与白人相比，黑人对自己的医生的信任度明显降低，对非正式健康信息来源的信任度更高。对自己医生的更大信任与常规检查、前列腺特异性抗原检测和乳房X光检查的使用有关，但与流感疫苗无关。对非正式信息来源的更大信任与乳腺X线照片的利用相关。对自己私人医生的信任与预防保健服务的利用有关。黑人对他们的医生相对较高的不信任可能会导致健康差距，导致预防服务的利用率降低。通过非正式途径向黑人传播保健信息可能会增加黑人对预防保健服务的利用。(Am J公共卫生。2009;99：1293-1299。doi：10.2105/AJPH.2007.123927）
Objectives. We sought to find racial differences in the effects of trust in the health care system on preventive health service use among older adults.Methods. We conducted a telephone survey with 1681 Black and White older adults. Survey questions explored respondents' trust in physicians, medical research, and health information sources. We used logistic regression and controlled for covariates to assess effects of race and trust on the use of preventive health services.Results. We identified 4 types of trust through factor analysis: trust in one's own personal physician, trust in the competence of physicians' care, and trust in formal and informal health information sources. Blacks had significantly less trust in their own physicians and greater trust in informal health information sources than did Whites. Greater trust in one's own physician was associated with utilization of routine checkups, prostate-specific antigen tests, and mammograms, but not with flu shots. Greater trust in informal information sources was associated with utilization of mammograms.Conclusions. Trust in one's own personal physician is associated with utilization of preventive health services. Blacks' relatively high distrust of their physicians likely contributes to health disparities by causing reduced utilization of preventive services. Health information disseminated to Blacks through informal means is likely to increase Blacks' utilization of preventive health services. (Am J Public Health. 2009;99:1293-1299. doi:10.2105/AJPH.2007.123927)