Understanding Multilevel Factors Related to Urban Community Trust in Healthcare and Research

Monica Webb Hooper, Charlene Mitchell, Vanessa J. Marshall, Chesley Cheatham, Kristina Austin, Kimberly Sanders, Smitha Krishnamurthi and Lena L. Grafton
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Monica Webb Hooper: Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA
Charlene Mitchell: Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA
Vanessa J. Marshall: Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA
Chesley Cheatham: Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA
Kristina Austin: The Gathering Place, Beachwood, OH 44122, USA
Kimberly Sanders: Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA
Smitha Krishnamurthi: Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA
Lena L. Grafton: NEOMED-CSU Partnership for Urban Health, Cleveland State University, Cleveland, OH 44115, USA

IJERPH, 2019, vol. 16, issue 18, 1-16

Abstract: Background: Community and patient engagement in the healthcare system and biomedical research are prerequisites for eliminating health disparities. We conducted a “listening tour” to enhance our understanding of multilevel factors associated with community trust. Methods: Using community-based participatory research (CBPR) methods, we conducted a phenomenological qualitative study. “Town-hall” style discussions were held at nine sites across an urban, Midwestern city. We recruited adults (N = 130) via community networks, social media, flyers, and word-of-mouth. Demographic assessments were self-administered and listening tour sessions were conducted by trained moderators. Themes were framed within the social ecological model (SEM; intrapersonal, interpersonal, institutional, community, and policy levels). Results: Participants were mostly female (68%), African American (80%), had health coverage (97%) and were diagnosed with a chronic health condition (71%). The overarching theme was sociodemographic differences in distrust, such that African Americans and deaf/hearing impaired participants perceived disparities in healthcare, a lower quality of care, and skepticism about biomedical research, relative to Whites. Conclusions: The depth of distrust for healthcare providers, systems, and researchers in underserved communities remains strong and complex. Findings highlight the need to understand the lived experiences of community members, and how distrust is maintained. Multilevel interventions to increase trust and the accrual of underrepresented populations into clinical trials are needed.

Keywords: community-based participatory research (CBPR); community engagement; community listening tour; distrust; healthcare; health disparities; cancer (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (4)

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