The role of trust in use of preventive services among low-income African-American women
The role of trust in use of preventive services among low-income African-American women
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DOI：
10.1016/j.ypmed.2004.01.018
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发表时间：
2004-06-01
影响因子：
5.1
通讯作者：
Mandelblatt, J
中科院分区：
文献类型：
--
作者：
O'Malley, AS;Sheppard, VB;Mandelblatt, J
背景本研究探讨了预测对初级保健提供者更高信任度的因素，并研究了患者信任度对低收入非洲裔美国妇女使用预防服务的作用。我们对华盛顿的961名40岁以上的非洲裔美国妇女进行了一项横断面的、基于人口的电话调查。两个方面的信任进行了检查：在一个人的定期初级保健提供者的整体信任，并相信定期提供者没有经济利益冲突。自我报告使用乳房X光检查，巴氏试验，临床乳腺检查，结直肠癌筛查，血压，身高和体重测量，饮食咨询，抑郁症筛查，由一个人的初级保健提供者，进行了评估。总结这些干预措施的总体使用的指数是主要的结果变量。超过三分之二的受访者表示高度信任他们的医生。老年受访者（>65岁）总体上比年轻受访者更信任他们的医生（P < 0.01）。初级保健的特点（护理的连续性，可及性的做法，专业护理的协调，一个人的定期提供者）更强烈地与具有高度的信任比社会人口，健康状况和保险的特点。在控制了保险状况、初级保健和患者特征的影响后，更高的信任度与更多地使用推荐的预防服务显著相关（OR：2.3，95%CI：1.3，4.0）。信任与低收入非洲裔美国妇女使用推荐的预防服务有关。更强的患者提供者的关系，高水平的信任，可能会间接导致更好的健康，通过坚持推荐的预防服务，为低收入的非洲裔美国妇女。(C)2004年癌症预防研究所和爱思唯尔公司。All rights reserved.
Background. This study explored factors that predict higher trust in primary care providers, and examined the role of patient trust on the use of preventive services for low-income African-American women.Methods. We conducted a cross-sectional, population-based telephone survey of 961 African-American women over age 40 in Washington, DC. Two dimensions of trust were examined: overall trust in one's regular primary care provider, and trust that the regular provider had no financial conflict of interest. Self-reported use of mammography, Pap tests, clinical breast exams, colorectal cancer screening, blood pressure, height and weight measurement, diet counseling, and depression screening, as delivered by one's primary care provider, were assessed. An index summarizing overall use of these interventions was the main outcome variable.Results. More than two-thirds of respondents reported high trust in their physician. Older respondents (>65) were more trusting of their physicians overall than were younger respondents (P < 0.01). Primary care characteristics (continuity of care, accessibility of the practice, coordination of specialty care by one's regular provider) were more strongly associated with having high trust than were sociodemographic, health status, and insurance characteristics. Higher trust was significantly associated with greater use of recommended preventive services (OR: 2.3, 95% CI: 1.3, 4.0), controlling for the effects of insurance status, primary care, and patient characteristics.Conclusions. Trust is associated with use of recommended preventive services in low-income African-American women. Stronger patient-provider relationships, with high levels of trust, may indirectly lead to better health through adherence to recommended preventive services for low income African-American women. (C) 2004 The Institute For Cancer Prevention and Elsevier Inc. All rights reserved.