Parents' trust in their child's physician: using an adapted Trust in Physician Scale.
ABSTRACT To assess the performance of the Pediatric Trust in Physician Scale (Pedi-TiPS) that refers to a child's physician and is a modified version of the Trust in Physician Scale (TiPS), and to explore the association of trust to demographic variables.
We performed a cross-sectional survey of parents in pediatric specialty and primary care sites. Parents completed an anonymous questionnaire that included the Pedi-TiPS. Our main outcome variable was total Pedi-TiPS score (higher scores = higher trust). Reliability was determined by Cronbach's alpha. Bivariate comparisons and linear regression modeling explored potential associations between demographic variables and total score.
Five hundred twenty-six parents completed surveys (73% response rate). The mean total score was 45.4 (SD 6), with good internal consistency (alpha = .84). In bivariate analysis, lower scores were associated with being a father (P = 0.03), older parent age (P = 0.02), private insurance status (P < 0.01), parent education greater than high school (P = 0.04), and not having a child age <3 years (P = 0.03). In a regression model adjusted for other factors, parents who were either African American (P = 0.05), or "other" race (P < 0.01), parents with private insurance (P = 0.02), and parents who had no children <3 years of age (P = 0.04) had lower trust.
The Pedi-TiPS has properties similar to the original instrument. We found associations between trust and demographic factors that should be confirmed with further studies.
- SourceAvailable from: Sara Anne Jahnke
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- "The adult literature also demonstrates that medical mistrust is a robust predictor of underutilization of health services (LaVeist et al., 2009). Among adults, the continuity of physician relationship and provider communication style have been linked with patient trust (Moseley et al., 2006). Our participants also reported these factors affected trust. "
ABSTRACT: Urban adolescents face many barriers to health care that contribute to health disparities in rates of sexually transmitted infections (STIs) and unintended pregnancy. Designing interventions to increase access to health care is a complex process that requires understanding the perspectives of adolescents. We conducted six focus groups to explore the attitudes and beliefs about general and sexual health care access as well as barriers to care among urban, economically disadvantaged adolescents. Participants first completed a written survey assessing health behaviors, health care utilization, and demographics. The discussion guide was based on the Theory of Planned Behavior and its constructs: attitudes, subjective norms, and perceived behavioral control. Transcripts of group discussions were analyzed using directed content analysis with triangulation and consensus to resolve differences. Fifty youth participated (mean age 15.5 years; 64% female; 90% African American). Many (23%) reported missed health care in the previous year. About half (53%) reported previous sexual intercourse; of these, 35% reported no previous sexual health care. Youth valued adults as important referents for accessing care as well as multiple factors that increased comfort such as good communication skills, and an established relationship. However, many reported mistrust of physicians and identified barriers to accessing care including fear and lack of time. Most felt that accessing sexual health care was more difficult than general care. These findings could inform future interventions to improve access to care and care-seeking behaviors among disadvantaged youth.Vulnerable Children and Youth Studies 07/2014; 9(3):279-290. DOI:10.1080/17450128.2014.925170
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ABSTRACT: In healthcare, there is an undeniable need for cultural competence in order to address the health needs of our growing, pluralistic families, eliminate existing health disparities, mend a fragmented system of care where some receive better services than others, and meet the required standards of accreditation bodies within health training programs. This review addresses the foundation, history, and complexity of cultural competency in healthcare and medicine. There is a description of current training in and evaluation of cultural competency, models of cultural competence, and future directions in research and training in the area of cultural competency.Family & community health 32(3):247-56. DOI:10.1097/FCH.0b013e3181ab3c00 · 0.99 Impact Factor
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