Distrust, Race, and Research

University of Pittsburgh, Pittsburgh, Pennsylvania, United States
Archives of Internal Medicine (Impact Factor: 17.33). 11/2002; 162(21):2458-63. DOI: 10.1001/archinte.162.21.2458
Source: PubMed


Investigators have voiced concerns that distrust of research and the medical community impedes successful recruitment of African Americans into clinical research.
To examine possible differences in distrust by race and to determine to what extent other sociodemographic factors explain any racial differences in distrust.
We analyzed data from 527 African American and 382 white respondents of a national telephone survey on participation in clinical research. Our main outcome measure was a 7-item index of distrust.
African American respondents were more likely than white respondents not to trust that their physicians would fully explain research participation (41.7% vs 23.4%, P<.01) and to state that they believed their physicians exposed them to unnecessary risks (45.5% vs 34.8%, P<.01). African American respondents had a significantly higher mean distrust index score than white respondents (3.1 vs 1.8, P<.01). After controlling for other sociodemographic variables in a logistic regression model, race remained strongly associated with a higher distrust score (prevalence odds ratio, 4.7; 95% confidence interval, 2.9-7.7).
Even after controlling for markers of social class, African Americans were less trusting than white Americans. Racial differences in distrust have important implications for investigators as they engage African Americans in research.

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    • "Our findings of ‘concern with experimentation’ and ‘travel difficulty’ as barriers to participation are similar to a recent meta-analysis by Mills et al. [21]. Non-white people, especially African Americans were significantly more likely than white people to cite concern with experimentation as a barrier, which indicates discomfort with the experimentation process [42,43]. This may be due to historical research abuses of blacks and the persistence of health inequities experienced by racial minorities [34,42,43]. "
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    • "These disparities are even greater among the undocumented population. Giselle Corbie-Smith, MD, and her colleagues found that African Americans were “more likely to believe that their physicians would not explain research fully or would treat them as part of an experiment without their consent” [11]. Medical abuses have come to light through the oral tradition of minority groups and published reports. "
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    • "Moreover, Black RDDTS samples are 60–70% female, and hence may contain too few Black men for reliable population estimates of Black men’s smoking (2–4). Blacks’ high non-response rate (low research participation) is widely understood as a function of distrust of researchers, and dissatisfaction with their failure to improve health in the Black communities they study (11). "
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