Search

Substantial evidence indicates that medical mistrust, resulting from experiences with discrimination and marginalisation, is a determinant of health disparities in minority populations. However, this research is largely limited to the US and other industrialised countries. To broaden our understanding of the role of medical mistrust on health-care decision making, we conducted a study on healthcare experiences and perceptions in a rural, underserved indigenous community in northwest Namibia (n = 86). Mixing semi-structured interview questions with the medical mistrust index (MMI), we aim to determine the relevance of the MMI in a non-industrialised population and compare index scores with reports of healthcare experiences. We find that medical mistrust is a salient concept in this community, mapping onto negative healthcare experiences and perceptions of discrimination. Reported healthcare experiences indicate that perceived incompetence, maltreatment and discrimination drive mistrust of medical personnel. However, reporting of recent healthcare experiences are generally positive. Our results indicate that the concept of medical mistrust can be usefully applied to communities in the Global South. These populations, like minority communities in the US, translate experiences of discrimination and marginalisation into medical mistrust. Understanding these processes can help address health disparities and aid in effective public health outreach in underserved populations.

Background: The circumstances surrounding chronic kidney disease and its impact on families can be complex and difficult to navigate, leading to these cases being labeled "challenging." Case presentation: We present the case of an adolescent with kidney failure due to unremitting systemic illness and multiple complications ultimately resulting in the family's request to forgo dialysis. Medical team members wrestled with meeting the family's needs among internal and external constraints. Conclusion: Past experiences, systemic inequities, differing perspectives, and consequential decision-making within individual belief systems can lead to friction between and among medical team members and families. As pediatric nephrologists, we must shift our focus from the "challenging" patient or family to addressing what is challenging their ability to flourishing. [ABSTRACT FROM AUTHOR]

The article discusses the impact of vaccine hesitancy on public health, particularly in the context of the COVID-19 pandemic and the upcoming flu season. It highlights the various factors contributing to vaccine hesitancy, such as safety concerns, skepticism about efficacy, and mistrust in medical and governmental institutions. The research emphasizes the importance of understanding and addressing vaccine hesitancy to ensure individuals are informed and able to protect their health effectively. Additionally, the article explores how vaccine hesitancy has affected flu vaccine coverage and emphasizes the need for reliable health information to combat misinformation and promote vaccination. [Extracted from the article]

Introduction: The Coronavirus Disease 2019 (COVID-19) pandemic placed enormous pressure on healthcare systems around the world, but it also provided valuable insights for healthcare organizations during this challenging period. Objective: This study aimed to explore nurses' lived experiences of vulnerability in hospital nursing management during the COVID-19 pandemic, and reflect on the lessons learned. Methods: In this phenomenological study, 14 participants, including nurse managers at different levels and staff nurses, were selected by purposive sampling from one center university hospital. Data collection was done through in-depth individual semistructured interviews with participants and a review of weekly reports of crisis management meetings at the university hospital. Interviews were analyzed using Colaizzi's method in seven phases by MAXQDA software Version 10. Results: One overarching theme, four themes, and 15 subthemes were obtained from analyses of interviews. Four themes of "nurses' attrition," "distrust of society to the organization," "fragility in the organization's performance," and "intensified inequalities" were extracted as threats to nursing management at the hospital. Subsequently, the weekly reports of crisis management meetings at the university hospital were analyzed to extract the solutions and lessons. Conclusion: The unpreparedness of the healthcare system against a crisis can led to the loss of organizational assets, including medical staff and the credibility of the healthcare system. Limitations of the infrastructure at hospital became more obvious during the pandemic and caused serious threats to the healthcare system. Despite severe challenges along with the pandemic, it offered four valuable lessons in nursing management. [ABSTRACT FROM AUTHOR]

Background and goal: Marginalized patients often feel unwelcome in healthcare. The concept of culturally safe healthcare (CSH) represents an important paradigm shift from provider control to patients who feel safe voicing health concerns and believe that they are heard by providers. This study has five goals: review works describing CSH, identify CSH themes, describe provider behaviors associated with CSH, describe interventions, and discuss how health communication can advance CSH. Methods: A scoping review was conducted for articles published between 2019 and 2023 following modified PRISMA guidelines. Online databases included Pubmed (Medline), CINAHL, Web of Science, Google Scholar, and Redalyc. Thematic analysis was also conducted. Results: Twenty-one articles meeting inclusion criteria were identified and analyzed. Of these, five explained features of CSH, four were empirical studies, seven were content analyses, and five were interventions. Five themes were identified including (1) how patients perceive CSH, (2) sociocultural determinants of health inequity, (3) mistrust of care providers, (4) issues with the biomedical model of healthcare, and (5) the importance of provider-patient allyship. Care provider communication behaviors fostering CSH were discussed. Three CSH interventions were highlighted. Finally, there was a discussion for how health communication scholars can contribute to CSH. Conclusions: CSH offers a paradigm shift from provider control to marginalized patients' experience of patient-provider communication. Recommendations for how health communication scholars can contribute to the implementation of CSH included developing guiding theories and measurement, evaluation of CSH outcomes, and conducting focus groups with patients to assess the meaning of cultural safety. [ABSTRACT FROM AUTHOR]

Medical mistrust is an important barrier to accessing health care among Latinx populations in the United States (US). However, research on the validity and reliability of medical mistrust scales is limited. We examined the validity and reliability of a modified bilingual version of the Group-Based Medical Mistrust scale (mGBMMS) among a sample of Latinx adults. Participants included 308 Latinx adults (ages 18–25), who responded in Spanish (n = 134) or English (n = 174). Following feedback from bilingual/bicultural staff during the English-Spanish translation process, we made three changes to the original GBMMS. Validation testing of our 12-item mGBMMS scale included: split-half and internal consistency reliability; discriminant, convergent, and predictive validity; and both exploratory and confirmatory factor analyses. The mGBMMS had good internal consistency (overall sample: Cronbach's α = 0.79; Spanish: Cronbach's α = 0.73; English: Cronbach's α = 0.83). The mGBMMS showed good convergent (moderately correlated with the experiences of discrimination scale, r = 0.46, p < 0.001) and discriminant (weakly correlated with the acculturation scale, r = 0.11, p = 0.06) validity. Split-half reliability was 0.71 (p < 0.001). Exploratory and confirmatory factor analyses found a two-factor solution. The mGBMMS was associated with satisfaction with care (OR = 0.60, 95%CI: 0.42–0.87), a sign of good predictive validity. Findings suggest that the mGBMMS is a valid and reliable scale to utilize among bilingual (Spanish/English) populations in the US. Further validation studies should be considered among Latinx respondents of different ages, backgrounds, languages, and US regions. [ABSTRACT FROM AUTHOR]

This article explores the concept of distrust and its impact on individuals' rights and well-being. It specifically focuses on the historical context of the Tuskegee Study and how it has contributed to the distrust of the healthcare system among black Americans. The author argues that distrust can hinder individuals' view of their rightful opportunities and compromise their autonomy and dignity. The article proposes principles for an "ethics of distrust" to minimize the creation of distrust. It also discusses the value of well-placed trust in allowing individuals to exercise their rights and make choices based on the assumption that their rights will be respected. The text concludes by calling for further exploration of the ethics of distrust and the development of principles to address its impact. [Extracted from the article]

Background: Symptoms of emotional and physical stress near death may be related to previous experiences of trauma. Objective: To investigate current evidence regarding the following: (1) Is previous trauma identified in people who are dying, and if so, how? (2) How is previous trauma associated with the experience of death/dying in people with or without cognitive impairment? and (3) What palliative care interventions are available to people with previous trauma at the end of life? Design: This integrative review was conducted per Whittemore and Knafl's guidelines, which involves a stepped approach, specifically (1) problem identification, (2) literature search, (3) data evaluation, (4) data analysis and (5) presentation. Methods: This integrative review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Electronic databases were searched in August 2021 and updated in August 2023. The articles were quality appraised, and narrative data were analysed using Grounded Theory (GT). Results: Of 1310 studies screened, 11 met the inclusion criteria (four qualitative and seven quantitative) conducted in Australia, Canada, Japan and the United States; and American studies accounted for 7/11 studies. Eight were focused on war veterans. Descriptive studies accounted for the majority, with only two publications testing interventions. Re-living trauma near death has additional features to a diagnosis of post-traumatic stress disorder alone, such as physical symptoms of uncontrolled, unexplained acute pain and this distress was reported in the last weeks of life. Conclusion: This study proposes that re-living trauma near death is a recognisable phenomenon with physical and psychological impacts that can be ameliorated with improved clinical knowledge and appropriate management as a new GT. Further research is needed to enable past trauma identification at the end of life, and trauma-informed safe interventions at the end of life are an urgent need. [ABSTRACT FROM AUTHOR]

Background: While conspiracy theories cover many different themes, medical conspiracy theories (MCTs) have become particularly prevalent in modern societies. As beliefs in MCTs can become a source of "infodemics", influence individual health behaviors and cause distrust in medical institutions and personnel, healthcare workers must find ways to overturn patients' conspiracy thinking. However, as the medical world is not free of these beliefs, in this study, we investigated beliefs in MCTs among medical and health science students and their association with reported health behaviors. Methods: Our sample was derived from a self-administered, anonymized, computer-assisted web survey conducted among 1,175 medical and health science students enrolled at the Poznan University of Medical Sciences, Poland. Results: From a set of twenty different MCTs, one-third of students rejected all of them, 18% believed in one, 15% in two, 10% in three, and 24% supported four or more conspiracy theories. In addition, many students were hesitant or unsure about MCTs. We also found that nursing and midwifery students were the most likely to believe in MCTs, while medical and dental students were the least supportive. Support for MCTs was higher among students in the early years of their studies and who declared themselves religious and conservative. This study also highlights the association between students' support for MCTs and their reported health behaviors, including avoiding vaccinations, using alternative medicine, taking vitamin C, or using social media as an essential source of health information. Conclusions: As medical and health science students are prone to conspiratorial thinking, they should be trained to act as a trusted and reliable source of medical information, to mitigate conspiratorial beliefs, and to act as role models for their patients and society, effectively shaping health behaviors in the population. [ABSTRACT FROM AUTHOR]

Organ donation is an ambivalent prosocial behavior. It triggers altruistic values and reminds people of death related thoughts at the same time. Due to the characteristics of organ donation, prior studies examined the impact of different types of mortality salience (conventional manipulation: ask participants to write down their thoughts once they are physically dead vs. narrative manipulation: ask participants to read a narrative of a cancer patient) on organ donation. However, without acknowledging the unique feature of organ donation, different types of mortality salience generated opposing results in organ donation. Hence, in this article, the purpose of Study 1 is to investigate if an organ donation campaign can remind people of their own mortality. Furthermore, although previous studies discovered that non-cognitive factors, such as mortality salience and medical mistrust, affect organ donation, few studies investigated how to resolve those non-cognitive factors to promote organ donation rate. Therefore, the purpose of Study 2 is to study how to help people address the fear of death caused by organ donation. Two online experiments were executed on Amazon Turk Prime to bridge the knowledge gaps. Study 1 found that an organ donation campaign can increase people's death related thoughts. Study 2 discovered that an enhanced altruistic worldview value can help people diminish organ donation triggered fear by decreasing medical mistrust. In addition, this study also revealed that medical mistrust as a causal factor mediated the effect between worldview value and perceptions of organ donation. [ABSTRACT FROM AUTHOR]

Background: HIV self-testing (HIVST) offers an innovative and promising approach to increasing HIV testing among Black men in the United States, a population disproportionately affected by HIV. However, engaging Black men in traditional HIV prevention programs has been challenging due to stigma, medical mistrust, and limited access to preventive health services. This formative qualitative study aimed to explore the potential of utilizing barbershops as an example of a nontraditional healthcare venue to promote and distribute HIVST. Methods: Four virtual focus group discussions (FGDs) consisting of 19 participants in North Carolina were conducted with Black men, including barbershop business owners, barbers, and their customers, to assess perceptions of HIVST and the acceptability of partnering with barbershop businesses to promote HIVST. FGDs were digitally recorded, transcribed, and analyzed using a deductive coding approach to thematic analysis. Results: Participants reported that the trusting relationship between barbers and their customers, which may not exist between Black men and health care providers, is a facilitator of collaborating with barbershop businesses to reach Black men for HIVST distribution. Participants recommended providing education for barbers on the use of HIVST, as well as how to inform self-testers about linkage to care following HIVST to build the credibility of the barbers in delivering the intervention. Participants also raised the issue of the cost of HIVST to barbershop customers as a potential barrier to implementation, as well as the possibility that the implementation of such interventions could be seen as out of place in a barbershop business venue. Participants also expressed a strong belief that compensation to barbershops and their employees should accompany any intervention. Conclusion: These findings suggest that barbershop business venues may provide an appropriate venue for HIVST promotion and distribution, though factors like cost, training, and incentivization of implementers are necessary to consider in implementation planning. Furthermore, partnerships between public health actors and the business community must be built on equitable engagement to ensure the long-term viability of these critical initiatives. [ABSTRACT FROM AUTHOR]

Believing the world is more just for oneself than for others—referred to as personal justice ascendancy—can protect and enhance well-being. For African Americans, personal justice ascendancy may be multifaceted, encompassing comparisons not only to other African Americans but also to White Americans. The present research examined relationships between these two specific personal justice ascendancies and psychological well-being among African Americans. African American adults (N = 274) reported their beliefs about justice for self, for other African Americans, and for White Americans. We measured life satisfaction, perceived stress, and perceptions of healthcare systems as outcomes. Overall, participants believed the world to be more just for White Americans, but less just for other African Americans, than the self. Personal justice ascendancy over African Americans and White Americans both predicted greater life satisfaction and lower perceived stress. Personal justice ascendancy over African Americans predicted more negative perceptions of healthcare, whereas personal justice ascendancy over White Americans predicted more positive healthcare perceptions. Findings suggest effects of personal justice ascendancy on well-being and health-related attitudes are governed by multiple social comparisons for African Americans. Attending to and understanding nuances in these comparisons could further inform efforts to understand and address racial health disparities. [ABSTRACT FROM AUTHOR]

Black youth and rural adolescents are two groups who experience asthma disparities. Racism and discrimination in health care likely lead to group-based (systems-level) medical mistrust for some adolescents. Group-based medical mistrust, one pathway by which racism drives health inequities, is associated with poorer outcomes for patients with chronic conditions. Despite its potential importance in adolescent asthma, previous research has not considered group-based medical mistrust in this population. To fill this gap, we characterize group-based medical mistrust among rural adolescents with poorly controlled asthma, examining demographic differences. We analyzed baseline data from a school-based clinical trial in which 164 adolescents (mean age = 16.3; 76.2% Black) completed the Group-Based Medical Mistrust Scale (GBMMS). Using linear regression, we tested associations with race, gender, and age, controlling for recent medical visits and insurance status. The total GBMMS mean score was 2.3 (SD = 1.22); subscale scores ranged from 2.3 to 2.4. Black adolescents reported significantly higher total GBMMS scores (β =.45, p =.003) and significantly higher scores on two GBMMS subscales: suspicion of health care providers (β =.56, p =.007) and lack of support from health care providers (β =.36, p =.007). Gender and age were not associated with GBMMS scores. Health care providers need to consider medical mistrust and its role in their clinical care. Together with their institutions, health care providers and researchers should work toward changing systems that perpetuate racism to build trust as a means of reducing asthma disparities among adolescents. [ABSTRACT FROM AUTHOR]

Experiences of racism and heterosexism in medical settings are social and systemic barriers to 'on-time' receipt of sexual and reproductive health services among women with both racial and sexual minority identities. Medical mistrust based on experiences related to these dual identities is associated with avoidance and delays in care. However, investigators are just beginning to apply an intersectional lens to quantitatively understanding such barriers. The purpose of this study was to examine the independent and interaction effects of racial and heterosexist medical mistrust on timing of sexual/reproductive health care among Black sexual minority women who have sex with women and men. A total of 320 women participated in an online study of factors affecting sexual health in this population. Ordinal logistic regression was used to assess the independent and interaction effects of racial and heterosexist medical mistrust on self-reported time since last sexual/reproductive health visit. Results indicated an interaction between the two types of medical mistrust. Research on Black women who have sex with women and men's experiences of racism and heterosexism in the US healthcare system can lead to the development of the comprehensive training programmes needed to alleviate medical mistrust among women with racial and sexual minority identities. [ABSTRACT FROM AUTHOR]

The article focuses on the complexities surrounding decisions to withdraw life-sustaining treatment in light of recent case studies. Topics include the impact of new research on the decision-making process for traumatic brain injury patients, the influence of high-profile recovery cases on family expectations, and the challenges of inconsistent prognostic information from different clinicians.

Introduction: Discharge "against medical advice" (AMA) in the obstetric population is overall under-studied but disproportionally affects marginalized populations and is associated with worse perinatal outcomes. Reasons for discharges AMA are not well understood. The objective of this study is to identify the obstacles that prevent obstetric patients from accepting recommended care and highlight the structural reasons behind AMA discharges. Methods: Electronic health records of patients admitted to antepartum, peripartum, or postpartum services between 2008 and 2018 who left "AMA" were reviewed. Progress notes from clinicians and social workers were extracted and analyzed. Reasons behind discharge were categorized using qualitative thematic analysis. Results: Fifty-seven (0.12%) obstetric patients were discharged AMA. Reasons for discharge were organized into two overarching themes: extrinsic (50.9%) and intrinsic (40.4%) obstacles to accepting care. Eleven participants (19.3%) had no reason documented for their discharge. Extrinsic obstacles included childcare, familial responsibilities, and other obligations. Intrinsic obstacles included disagreement with provider regarding medical condition or plan, emotional distress, mistrust or discontent with care team, and substance use. Discussion: The term "AMA" casts blame on individual patients and fails to represent the systemic barriers to staying in care. Obstetric patients were found to encounter both extrinsic and intrinsic obstacles that led them to leave AMA. Healthcare providers and institutions can implement strategies that ameliorate structural barriers. Partnering with patients to prevent discharges AMA would improve maternal and infant health and progress towards reproductive justice. Significance: What is Already Known on this Subject?: Obstetric patients who leave "against medical advice (AMA)" have worse perinatal outcomes and often are from marginalized communities. The term, AMA, is also stigmatizing, placing blame on individual decision making rather than systemic barriers to access. Reasons for leaving AMA are not well understood in the obstetric population. What does this Study add?: We reframe the discussion around leaving AMA by describing obstacles in accepting care. Patients experienced both extrinsic and intrinsic obstacles to accepting medical care, from childcare issues to disagreement with treatment plan. Partnering with patients to overcome these obstacles would improve maternal and infant health and increase equity and reproductive justice. [ABSTRACT FROM AUTHOR]

Background: People with HIV (PWH) have higher risk of COVID-19 mortality. SARS-CoV-2 vaccination is highly effective among PWH, although vaccine hesitancy could limit the population-level impact. Setting: From February 2021 to April 2022, PWH from 8 sites in the Centers for AIDS Research Network of Integrated Clinical Systems completed a vaccine hesitancy instrument as part of routine care. Methods: Participants were defined as vaccine hesitant if they had not received the SARS-CoV-2 vaccine and would probably/definitely not receive it. We assessed factors associated with SARS-CoV-2 vaccine hesitancy using logistic regression adjusted for demographics, unsuppressed viral load (VL > 200 copies/mL), month, and time on ART; using inverse probability weighting for survey nonresponse. Results: Overall, 3288 PWH with a median age of 55 were included; 18% were female and 94% were virally suppressed. At the time of survey, 27% reported they had not received the SARS-CoV-2 vaccine, and 9% (n = 279) reported vaccine hesitancy. Factors associated with vaccine hesitancy included female sex (adjusted odds ratio [AOR] = 2.3; 95% confidence interval (CI): 1.6-3.2), Black vs. White race (AOR 1.7; 95% CI: 1.2 to 2.4), younger age (AOR 1.4; 95% CI: 1.2 to 1.5), and unsuppressed VL (AOR 1.9; 95% CI: 1.3 to 3.0). Conclusion: Overall, over one-quarter of PWH in this multisite cohort were unvaccinated for SARS-CoV-2 when interviewed February 21-April 22. Vaccine hesitancy was reported by approximately 9% of PWH and was higher among women, Black PWH, younger PWH, PWH with unsuppressed VL, and those in the South/Midwest. Renewed efforts are needed to address concerns of PWH about vaccinations against COVID-19 as the pandemic evolves, and vaccines in general, given the potential for future pandemics. [ABSTRACT FROM AUTHOR]

This article explores the relationships between the American health-care system, trust in institutions, and decision-making processes that have affected COVID-19 vaccine uptake. Findings are based on an analysis of a nationally representative sample of 137 individuals who participated in semi-structured qualitative interviews during the rollout of the first publicly available vaccine in the first quarter of 2021. The vast majority of respondents reported negative experiences with American health care that predated the pandemic, which generated distrust in medical institutions, including hospitals, private health insurance corporations, the pharmaceutical industry, and related government institutions. The article considers the impact of institutional distrust on attitudes about vaccine uptake. Responses fell along a spectrum from vaccine refusal to vaccine acceptance. Sentiment across categories revealed a high degree of hesitancy framed in terms of institutional distrust. The data reveal a complex landscape of beliefs and perceptions, illustrating widespread hesitancy and ambivalence among participants. [ABSTRACT FROM AUTHOR]

Innovation research fighting for public attention and counteracting science-skeptical views raise the need for insights into why individuals are motivated to engage with scientific knowledge. Guided by the Planned Risk Information Seeking Model (PRISM), additionally considering mistrust in science and innovativeness, the study aimed to explain individuals' intention to seek information about medical innovations. Findings of an online survey among German residents (N = 5,322) supported the utility of the extended PRISM to predict seeking intent. Most of the postulates of the PRISM were supported; mistrust served as a barrier to engagement with scientific knowledge, whereas innovativeness was of minor relevance. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has brought unprecedented challenges to healthcare and public health messaging in the United States. One area of focus has been vaccination uptake among Black Americans, who have experienced COVID-19 deaths disproportionate to their share of the United States population, raising questions about the processes involved in vaccination perceptions and behaviors. Guided by the Risk Information Seeking and Processing model, this study explored the roles of medical mistrust and social media as a source of risk information in Black Americans' vaccine hesitancy. Survey results from a YouGov panel sample of Black Americans (n = 1,136; 53.5% female) showed that social media use and medical mistrust were positively associated with belief in misinformation related to the COVID-19 vaccine, which, in turn, was positively related to vaccine hesitancy through perceived information insufficiency and information seeking intentions. Furthermore, we found that belief in misinformation and subjective norms toward anti-vaccination also serially mediated the association between social media use and medical mistrust with vaccine hesitancy. Theoretical and practical implications are discussed. [ABSTRACT FROM AUTHOR]

Uptake of the COVID-19 vaccine among pregnant persons is lower than the general population. This scoping review explored pregnant people's attitudes towards the COVID-19 vaccine, reasons for vaccine hesitancy, and whether attitudes about COVID-19 vaccines differ by country of origin. A scoping review was conducted across PubMed, Embase, CINHAL, and Scopus. Inclusion criteria were articles published in English from 2019–2022 focused on attitudes towards COVID-19 vaccination among pregnant persons. Data analysis was done via the 5Cs framework for vaccine hesitancy: Constraints, Complacency, Calculation, Confidence, and Collective Responsibility. 44 articles were extracted. A lack of confidence in vaccine safety was the most prevalent theme of hesitancy among pregnant persons. This was largely driven by a lack of access to information about the vaccine as well as mistrust of the vaccine and medical professionals. Meanwhile, vaccine acceptance was mostly driven by a desire to protect themselves and their loved ones. Overall, COVID-19 vaccine hesitancy among pregnant persons continues to be high. Vaccine hesitancy is primarily driven by fear of the unknown side effects of the vaccine on pregnant persons and their fetuses along with a lack of information and medical mistrust. Some differences can be seen between high income and low- and middle-income countries regarding vaccine hesitancy, showing that a single solution cannot be applied to all who are vaccine hesitant. General strategies, however, can be utilized to reduce vaccine hesitancy, including advocating for inclusion of pregnant persons in clinical trials and incorporating consistent COVID-19 vaccine counseling during prenatal appointments. [ABSTRACT FROM AUTHOR]

Objectives: To explore how the use of, and trust in, different sources of advice and information on COVID-19 differed across the four UK nations and between different sociodemographic groups and their associations with COVID-19 vaccination status. Methods: We used a UK-wide representative survey conducted in July 2021, which included data on uptake of COVID-19 vaccination, trust in information sources, use of sources and geographical and sociodemographic variables. We used multivariate logistic regression to identify factors associated with completed or planned COVID-19 vaccination. Results: Trust in the NHS, followed by trust in scientists, were the strongest predictors of vaccination intention. NHS websites were the most used (56% across the UK); only the Scottish government website had a higher level of reported use (58%). Using either source was associated with a positive vaccination status as were use of the GP and television as sources of advice. Use of social media, family and friends, and 'none' of the sources enquired about, were all linked to a lower likelihood of being or intending to get vaccinated. Compared to those in England, respondents in other UK nations were less likely to trust the central UK government for advice on COVID-19. There was considerable variation by age in trust and use of some, but not all, sources of advice, with predicted probabilities ranging from 35% among the youngest age group to 62% among those aged 65 years or older. There were also significant differences by annual household income and by occupational class for trust in government, with higher incomes correlating with greater likelihood of trust. Conclusions: This study demonstrates high levels of trust in the key sources of public health advice and there was a positive association between using official sources of advice and vaccination intentions, even in the context of overall high vaccination rates. Our findings highlight the need for the UK and devolved governments to value the importance of public trust in the health system and take appropriate measures to avoid undermining such trust. [ABSTRACT FROM AUTHOR]

Objective: Vaccine hesitancy is a global concern and a significant threat to COVID‐19 vaccination programs. This study aimed to explore vaccine hesitancy from the perspective of the Indonesian community related to policies and cultural beliefs. Design: A descriptive qualitative approach was utilized in this study. Sample: Twenty participants were recruited from various settings to ensure the representation of experiences in different contexts in Indonesia. Measurement: Audio‐recorded, semi‐structured, individual, in‐depth interviews were carried out. Content analysis was performed to identify the main key themes. Results: Twenty participants were recruited from various regions of Java Island, Indonesia. The participants revealed hesitancy about the COVID‐19 vaccine, including the themes of mistrust, controversy, and the culture and beliefs of the community. Conclusions: This study highlights COVID‐19 vaccine hesitancy in Indonesia, which may have implications for the community's perceptions and beliefs regarding the uptake of the COVID‐19 vaccine. The trust issue remains a major challenge to convincing the community to accept the vaccine at the grassroots level. Targeted education and communication strategies are essential in addressing trust issues surrounding COVID‐19 vaccines among critical stakeholders and religious leaders in Indonesia. Public health nursing plays a crucial role in fostering community acceptance and ensuring the success of vaccination programs. [ABSTRACT FROM AUTHOR]

Background: Medical distrust may hinder kidney transplantation (KT) access. Among KT candidates evaluated for waitlisting, we identified factors associated with high distrust levels and quantified their association with waitlisting. Methods: Among 812 candidates (2018–2023), we assessed distrust using the Revised Health Care System Distrust Scale across composite, competence, and values subscales. We used linear regression to quantify the associations between candidate and neighborhood‐level factors and distrust scores. We used Cox models to quantify the associations between distrust scores and waitlisting. Results: At KT evaluation, candidates who were aged 35–49 years (difference = 1.97, 95% CI: 0.78–3.16), female (difference = 1.10, 95% CI: 0.23–1.97), and Black (difference = 1.47, 95% CI: 0.47–2.47) were more likely to report higher composite distrust score. For subscales, candidates aged 35–49 were more likely to have higher competence distrust score (difference = 1.14, 95% CI: 0.59–1.68) and values distrust score (difference = 0.83, 95% CI: 0.05–1.61). Race/ethnicity (Black, difference = 1.42, 95% CI: 0.76–2.07; Hispanic, difference = 1.52, 95% CI: 0.35–2.69) was only associated with higher values distrust scores. Female candidates reporting higher rescaled values distrust scores (each one point) had a lower chance of waitlisting (aHR = 0.78, 95% CI: 0.63–0.98), whereas this association was not observed among males. Similarly, among non‐White candidates, each 1‐point increase in both rescaled composite (aHR = 0.87, 95% CI: 0.77–0.99) and values (aHR = 0.82, 95% CI: 0.68–0.99) distrust scores was associated with a lower chance of waitlisting, while there was no association among White candidates. Conclusion: Female, younger, and non‐White candidates reported higher distrust scores. Values distrust may contribute to the long‐standing racial/ethnic and gender disparities in access to KT. Implementing tailored strategies to reduce distrust in transplant care may improve KT access for groups that experience persistent disparities. [ABSTRACT FROM AUTHOR]

In 2020, the COVID-19 pandemic emerged against a backdrop of long-standing racial inequities that contributed to significant disparities in COVID-19 mortality, morbidity, and eventually, vaccination rates. COVID-19 also converged with two social crises: anti-Black racism and community and police violence. The goal of this study was to examine the associations between community violence, police violence, anti-Black racism, and COVID-19 vaccination. Survey data were collected from a sample of 538 Black residents of Chicago between September 2021 and March 2022. Structural equation modeling was used to test associations between neighborhood violence, police violence, racism, medical mistrust, trust in COVID-related information, depressive symptoms, and having received a COVID-19 vaccination. In line with predictions, neighborhood violence had a significant indirect effect on vaccination via trust in COVID-related information from a personal doctor. Additionally, racism had a significant indirect effect on vaccination via trust in COVID-related information from a personal doctor, as well as via medical mistrust and trust in COVID-related information from a personal doctor. These findings add to the growing body of literature demonstrating the importance of medical mistrust when examining COVID-19 vaccination disparities. Furthermore, this study highlights the importance of considering how social and structural factors such as violence and racism can influence medical mistrust. [ABSTRACT FROM AUTHOR]

The article focuses on critiquing bioethics' alignment with neoliberal economic principles, particularly in contexts like vaccine-sensitive rationing which it argues often neglects systemic injustices and economic complexities. Topics include the critique of principlist approaches in bioethics, the influence of market ideologies on ethical frameworks, and the marginalization of voices critical of neoliberalism within bioethical discourse.

The article explores the ethical concerns surrounding normothermic regional perfusion (NRP) in organ procurement after cardiac death. It identifies four main ethical concerns with NRP and suggests ex situ perfusion as an alternative. The text also discusses different methods for organ procurement and transplantation, highlighting the advantages of hypothermic oxygenated perfusion (HOPE) over normothermic machine perfusion (NMP) and NRP. It emphasizes the need for more research and adherence to legal and ethical standards in organ donation. The article provides contact information for subscribing to The National Catholic Bioethics Center and obtaining permission to reuse material from Ethics & Medics. [Extracted from the article]

Background: Influenza (flu) and COVID-19 vaccination rates are subpar across the US, especially in racial and/or socioeconomic minority groups who are understudied in public health literature. Objective: The objective of this mixed-methods study was to elucidate attitudes of patients at the Turtle Creek Primary Care Center, a clinic that cares for ∼70% non-white patients, towards flu and COVID-19 vaccines, with the goal of establishing vaccine education gaps and increasing vaccine uptake in minority communities. Design/Patients: This study was conducted as a cross-sectional analysis. Authors completed 123 patient phone surveys of patients cared for at the Turtle Creek clinic inquiring about flu and COVID-19 infection status and vaccination uptake (August 26–October 10, 2021). Approach/Key Results: We found that rates of vaccination were subpar in the Turtle Creek community, with only 54% having received the COVID-19 vaccine and only 44% receiving the flu vaccine regularly. There was a strong association between COVID-19 and flu vaccine acceptance and a notable correlation between vaccine acceptance and age. When assessing how vaccine acceptance was influenced by trusted sources of information, those who cited trusting "medical professionals" and "word of mouth" had higher odds of COVID-19 vaccine acceptance but those who cited trusting "social media" had decreased odds of acceptance. Finally, we uncovered 14 common factors for either vaccine acceptance or refusal that clustered into four overarching themes of trust, need, safety, and availability. Conclusion: These data highlight the necessity of improved vaccine education and reveal targetable populations and approaches for disseminating vaccine information. [ABSTRACT FROM AUTHOR]

Copyright of AIDS & Behavior is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Older adults who are frail are one of the most sedentary and the least physically active age groups. Prolonged sedentary time is associated with increased risk of negative health outcomes. To help design effective and sustainable content and optimize the uptake of sedentary behaviour interventions, an in-depth understanding of older adults' perceptions of sedentary behaviour is needed; however, most qualitative studies have been conducted in healthy older adults. The aim of this study was to explore perspectives of sedentary behaviour within the context of older adults who are pre-frail and frail after the winter and spring. We included participants if they: (1) spoke English or attended with a translator or caregiver, (2) were ≥ 60 years, and (3) were frail on the Morley Frail Scale. We utilized a qualitative description methodology including a semi-structured in-depth interview and thematic content analysis. Concepts from the COM-B (Capability Opportunity Motivation–Behaviour) model were used to guide the semi-structured interviews and analysis. To ensure credibility of the data, we used an audit trail and analyst triangulation. We recruited 21 older adults (72 ± 7.3 years, 13 females, 13 frail) from southwestern Ontario, Canada. Two individuals were lost to follow-up due to medical mistrust and worse health. We transcribed 39 audio recordings. We identified three salient themes: (1) older adults rationalize their sedentary behaviours through cognitive dissonance (reflective motivation), (2) urban cities in southwestern Ontario may not be "age-friendly" (physical opportunity), and (3) exercise is something people "have to do", but hobbies are for enjoyment despite medical conditions (psychological capability). Perspectives of sedentary behaviour were different in the winter versus spring, with participants perceiving themselves to be less active in winter. Incorporating dissonance-based interventions as part of an educational program could be used to target the reflective motivation and psychological capability components. Future research should consider interdisciplinary collaborations with environmental gerontology to develop age-friendly communities that promote meaningful mobility to target physical opportunity. [ABSTRACT FROM AUTHOR]

AbstractBlack women in the USA experience some of the poorest health outcomes and this is especially true for those involved in the carceral system who are at elevated risks for HIV/STIs, reproductive health, and chronic diseases. This study aimed to investigate Black women’s experience accessing healthcare services. We conducted semi-structured interviews with 43 women from Project EWORTH under community supervision in New York City. We analysed responses focusing on barriers to healthcare engagement. All interviews were recorded, and data analysis was conducted using NVivo. Themes influencing Black women’s ability to engage with healthcare providers and systems included: 1) disclosed provider mistrust/judgement; 2) feeling disrespected by providers and the medical system; 3) mistrust of medical providers/system/hospital/government; 4) lack of health communication; 5) low health literacy; 6) provider gender preference. Findings highlight the need to improve trust and collaboration between healthcare providers and Black women. This study addresses the critical gap in understanding perceptions of discrimination, stigma, and barriers to attaining health care. Funders and accreditation agencies must hold providers and organisations accountable for acquiring and making available diversity, equity and inclusion training for providers, demonstrating increasingly equitable medical relationships through responsiveness to patient feedback, and increasing the number of Black providers. [ABSTRACT FROM AUTHOR]

Introduction: Establishing routine primary care visits helps to prevent serious health issues. College students are less likely than the general population to have a regular primary care provider and engage in routine health visits. Recent research provides evidence that telehealth is a convenient alternative to in-person primary care and that college students are comfortable using this technology, suggesting that telehealth has the potential to mitigate this disparity. As attitudes toward telehealth are one critical precursor to behavioral intention and actual utilization of telehealth, the goal of this study was to investigate which factors predict positive or negative attitudes toward telehealth. Methods: Data for this study were collected from a sample of 621 college students at a large southeastern university between September 19, 2022 and December 19, 2022. Results: The study found that college students who reported more trust in physicians, less medical mistrust, and less discrimination in health care settings reported more positive attitudes toward telehealth. Conclusions: These findings suggest that health care providers' skills in delivering patient-centered culturally informed care and building trust and rapport with patients might promote more positive attitudes toward telehealth and, potentially, greater overall utilization of health care services (including both telehealth and in-person services) among college students. This study lays the foundation for future research to examine psychological mechanisms underlying individuals' utilization of telehealth. [ABSTRACT FROM AUTHOR]

Migrant-origin families may have a pronounced need for psychosocial support and healthcare services, but they face barriers in using services. To ensure the timely use of services, it is important that families understand how service systems work and trust care providers. Thirty-two migrant-origin mothers living in Finland participated in five focus-group interviews and shared their wishes for social and healthcare professionals on how trust and understanding can be increased. The data were analyzed with Qualitative Content Analysis. We identified six main themes related to the use of services and professionals' behavior. These were the need for professionals to justify and explain questions, to meet each family as individuals, the importance of non-verbal communication, the need to talk about racism and discrimination, the importance of cultural sensitivity in services, and a discussion of positive aspects of life after migration and children's strengths. To foster trust and mutual understanding in social and healthcare services, professionals should be aware of potential cultural differences in family life, while avoiding pre-conceived ideas. Misunderstandings can rise from language barriers and unclear or intimidating questions. It is important that professionals explain what they do and justify why they might inquire about a family's personal matters. Working with interpreters is necessary when professionals and parents do not share a common fluent language. Professionals should also pay attention to their non-verbal communication and to being friendly. Finally, it is important to show interest in families' experienced hardships such as racism as well as their strengths. [ABSTRACT FROM AUTHOR]

Historical, cultural, and social trauma, along with social determinants of health (SDOH), shape health outcomes, attitudes toward medicine, government, and health behaviors among communities of color in the United States (U.S.). This study explores how trauma and fear influence COVID-19 testing and vaccination among Black/African American, Latinx/Indigenous Latin American, and Native American/Indigenous communities. Leveraging community-based participatory research methods, we conducted 11 virtual focus groups from January to March of 2021 with Black/African American (n = 4), Latinx/Indigenous Latin American (n = 4), and Native American/Indigenous (n = 3) identifying community members in Inland Southern California. Our team employed rapid analytic approaches (e.g., template and matrix analysis) to summarize data and identify themes across focus groups and used theories of intersectionality and trauma to meaningfully interpret study findings. Historical, cultural, and social trauma induce fear and mistrust in public health and medical institutions influencing COVID-19 testing and vaccination decisions in communities of color in Inland Southern California. This work showcases the need for culturally and structurally sensitive community-based health interventions that attend to the historical, cultural, and social traumas unique to racial/ethnic minority populations in the U.S. that underlie fear and mistrust of medical, scientific, and governmental institutions. [ABSTRACT FROM AUTHOR]

Despite differential uptake of COVID-19 vaccination between Black and non-Hispanic White Americans early in the pandemic, the gap narrowed over time. We tested five hypotheses that could explain the reduction in the disparity. Using a national probability panel of over 1800 individuals surveyed from April 2021 to July 2022, we assessed receipt of recommended doses of COVID-19 vaccines along with (a) reported exposure to deaths due to COVID-19, (b) trust in US health authorities, such as the CDC, (c) knowledge about the safety and efficacy of COVID-19 vaccination, (d) media use as a source of information, and (e) access to COVID-19 vaccines. Only increases in knowledge about the safety and efficacy of COVID-19 vaccines uniquely mediated the increase in vaccination uptake among non-Hispanic Black compared to White, Asian and Hispanic panelists. While trust in CDC and exposure to COVID-19 deaths were related to vaccination acceptance at baseline, those factors were not associated with change in reported vaccination coverage. In addition, neither differential access nor media use explained the increase. Enhanced knowledge about the safety and efficacy of COVID-19 vaccination transmitted from within the Black community likely helped to increase vaccination relative to other racial-ethnic groups. [ABSTRACT FROM AUTHOR]

An adult university hospital ethics committee evaluated a proposed TA-NRP protocol in the fall of 2018. The protocol raised ethical concerns about violation of the Uniform Determination of Death Act and the prohibition known as the Dead Donor Rule, with potential resultant legal consequences. An additional concern was the potential for increased mistrust by the community of organ donation and transplantation. The ethics committee evaluated the responses to these concerns as unable to surmount the ethical and legal boundaries and the ethics committee declined to endorse the procedure. These concerns endure. [ABSTRACT FROM AUTHOR]

The article discusses colon capsule endoscopy (CCE) as an alternative diagnostic test for colorectal and gastrointestinal diseases, comparing it to traditional colonoscopy. Despite its potential benefits, CCE has faced challenges in gaining widespread acceptance in the medical community. The article highlights the need for further research, such as the ColoCap study, to evaluate the effectiveness and role of CCE in diagnostic practices. Additionally, it mentions the potential of incorporating artificial intelligence into CCE readings and the importance of addressing concerns about completion rates, cost-effectiveness, and missed cancer data to increase adoption. [Extracted from the article]

The article discusses a study conducted in San Francisco, California, that aimed to improve research participation from people experiencing homelessness (PEH) by utilizing remote blood collection devices. PEH face various challenges that make traditional venipuncture difficult, such as transient locations, lack of access to transportation, and damaged veins. The study used a US FDA device for capillary blood collection as an alternative to venipuncture, and the success rate for capillary collection was reasonably good. The article also explores the potential applications of capillary collection devices in other settings, such as medical deserts and remote geographic areas. [Extracted from the article]

Background: Medical mistrust may worsen communication between ICU surrogate decision-makers and intensivists. The prevalence of and risk factors for medical mistrust among surrogate decision-makers are not known. Research Question: What are the potential sociodemographic risk factors for high medical mistrust among surrogate decision-makers of critically ill patients at high risk of death? Study Design and Methods: In this pilot cross-sectional study conducted at a single academic medical center between August 2022 and August 2023, adult patients admitted to the medical ICU and their surrogate decision-makers were enrolled. All patients were incapacitated at enrollment with Sequential Organ Failure Assessment scores of ≥ 7 or required mechanical ventilation with vasopressor infusion. Surrogate decision-maker sociodemographic characteristics were age, race, sex, education, relationship to the patient, employment, prior exposure to a loved one transitioning to hospice or comfort-focused care, and religiousness. The primary outcome was surrogate decision-maker medical mistrust, measured using the Medical Mistrust Multiformat Scale. Multiple linear regression was used to determine sociodemographic characteristics associated with higher medical mistrust. Results: Thirty-one patients and their surrogate decision-makers were enrolled during the study period, surpassing our goal of 30 pairs and indicating recruitment feasibility. Mean ± SD surrogate age was 53.8 ± 14.5 years, 24 surrogates were female, and mean medical mistrust score was 17.1 ± 5.4. Race was associated with medical mistrust, with Black participants showing higher medical mistrust compared with White participants (β =10.21; 95% CI, 3.40-17.02; P = .010). Religiousness was associated with lower medical mistrust (β = –2.94; 95% CI, –4.43 to –1.41; P = .003). Prior exposure to hospice or comfort-focused care was associated with higher medical mistrust (β = 7.06; 95% CI, 1.21-12.91; P = .025). Interpretation: We found that recruiting ICU surrogates and measuring medical mistrust within 48 h of ICU admission was feasible. Several surrogate sociodemographic characteristics were associated with changes in medical mistrust. These preliminary findings will inform the design of future studies.

Background Underlying causes of vaccine hesitancy could significantly affect successful uptake of the SARS-CoV2 vaccine booster doses during new waves of COVID-19. Booster rates among US adults are far below what is needed for immunity, but little is known about booster hesitancy among fully vaccinated adults and whether medical mistrust exacerbates barriers to uptake.Methods A cross-sectional survey was completed among 119 adults in Philadelphia, PA who reported having received the primary SARS-CoV2 vaccine series but not a booster dose. Using the LaVeist Medical Mistrust (MM) Index, a k-means cluster analysis showed two clusters (Low MM, High MM) and differences in attitudes and perceptions about COVID-19 booster vaccines were assessed using F-tests.Results Respondents were 62% Black and female; mean age was 41; 46% reported earning less than $25,000 and 53% had a high school education or less. Overall intention to get boosted was low (mean 3.3 on 0-10 scale). Differences in COVID-19 booster perceptions between those with High (n = 56) vs. Low (n = 59) MM were found, independent of any demographic differences. Most statements (7/10) related to reasons to not be boosted were significant, with those with High MM indicating more concern about feeling sick from the vaccine (F=-3.91, p≤ .001), beliefs that boosters are ineffective for vaccinated people (F= −3.46, p≤ .001), and long-term side effect worries (F=-4.34, p≤ .001). Those with High MM were also more concerned about the adverse effects of the vaccine (F=-2.48, p=.02), but were more likely to trust getting information from doctors or healthcare providers (F= −2.25, p=.03).Conclusions Results indicate that medical mistrust is an important independent construct when understanding current COVID-19 booster hesitancy. While much work has looked at demographic differences to explain vaccine hesitancy, these results suggest that further research into understanding and addressing medical mistrust could be important for implementing interventions to increase booster rates.

ABSTRACTSubstantial evidence indicates that medical mistrust, resulting from experiences with discrimination and marginalisation, is a determinant of health disparities in minority populations. However, this research is largely limited to the US and other industrialised countries. To broaden our understanding of the role of medical mistrust on health-care decision making, we conducted a study on healthcare experiences and perceptions in a rural, underserved indigenous community in northwest Namibia (n = 86). Mixing semi-structured interview questions with the medical mistrust index (MMI), we aim to determine the relevance of the MMI in a non-industrialised population and compare index scores with reports of healthcare experiences. We find that medical mistrust is a salient concept in this community, mapping onto negative healthcare experiences and perceptions of discrimination. Reported healthcare experiences indicate that perceived incompetence, maltreatment and discrimination drive mistrust of medical personnel. However, reporting of recent healthcare experiences are generally positive. Our results indicate that the concept of medical mistrust can be usefully applied to communities in the Global South. These populations, like minority communities in the US, translate experiences of discrimination and marginalisation into medical mistrust. Understanding these processes can help address health disparities and aid in effective public health outreach in underserved populations.

While online sources of information, like support groups and wellness influencers, can be beneficial for those seeking additional information about their health conditions, these sources can also contain detrimental information. As misinformation and even conspiracies like QAnon proliferate in wellness discourse, particularly in online support groups and on the accounts of wellness influencers, it becomes increasingly important to understand what may contribute to individuals seeking information from these sources. Based on uncertainty in illness theory and the theory of motivated information management, we conducted a cross-sectional survey (N = 544) to test the role of negative health-care experiences and medical mistrust in uncertainty and information seeking from online support groups and wellness influencers across those with chronic and acute health concerns. Results indicated that negative healthcare experiences had an indirect effect on information seeking from both online support groups and wellness influencers. This indirect effect, however, operated through uncertainty anxiety but not uncertainty discrepancy. For those with chronic conditions, the indirect effect also included medical mistrust. Implications and future extensions of the results are discussed. [ABSTRACT FROM AUTHOR]

The increasing focus on precision medicine to optimize cancer treatments and improve cancer outcomes is an opportunity to consider equitable engagement of people racialized as Black or African American (B/AA) in biospecimen-based cancer research. B/AA people have the highest cancer incidence and mortality rates compared with all other racial and ethnic groups in the United States, yet are under-represented in biospecimen-based research. A narrative scoping review was conducted to understand the current literature on barriers, facilitators, and evidence-based strategies associated with the engagement of B/AA people with cancer in biospecimen research. Three comprehensive searches of MEDLINE, CINAHL, Embase, and Scopus were conducted. Of 770 studies generated by the search, 10 met all inclusion criteria for this review. The most frequently reported barriers to engagement of B/AA people in biospecimen research were lack of biospecimen research awareness, fear of medical harm, and violation of personal health information privacy, resource constraints, and medical mistrust. Key facilitators included previous exposure to research, knowledge about underlying genetic causes of cancer, and altruism. Recommended strategies to increase participation of B/AA people in biospecimen-based research included community engagement, transparent communication, workforce diversity, education and training, and research participant incentives. Inclusion of B/AA people in biospecimen-based research has the potential to advance the promise of precision oncology for all patients and reduce racial disparities in cancer outcomes. This scoping review explores the barriers, facilitators, and strategies for engaging Black individuals with cancer in biospecimen based research. [ABSTRACT FROM AUTHOR]

Background: Medical mistrust, rooted in unethical research, is a barrier to cancer‐related health care for Black/African American (AA) persons. Understanding trust, mistrust, and health care experiences is crucial, especially in multiple myeloma (MM), which disproportionately burdens Black/AA persons in incidence and survival. Study Purpose: This study qualitatively examines the experiences of Black/AA and White dyads (patient with MM and adult caregiver) to gain insights into these phenomena. Methods: From November 2021 to April 2022, we recruited 21 dyads from the UNC Lineberger Comprehensive Cancer Center. Participants completed a sociodemographic survey and a 60–90 min semi‐structured interview. We used ATLAS.ti v9 for project management and to facilitate data analysis using the Sort and Sift, Think and Shift approach (ResearchTalk Inc). Results: We interviewed 21 racially concordant dyads (11 Black/AA, 10 White) with mean patient ages of 70 (Black/AA) and 72 (White) at enrollment. Both Black/AA and White caregivers had a mean enrollment age of 68. The mean duration from MM diagnosis to enrollment for all patients was 5.5 years. Four key themes emerged: (1) knowledge and trust, (2) heightened emotions and discomfort, (3) differing mental constructs of health care experiences, and (4) mitigating mistrust, which varied by self‐identified race. Black/AA participants had greater knowledge of historical events like the U.S. Public Health Service Untreated Syphilis Study at Tuskegee and carried the emotional burden longer. They also emphasized self‐learning and self‐guided research about MM for informed medical decision‐making. Both Black/AA and White dyads emphasized the pivotal role of patient‐provider relationships and effective communication in fostering trust and addressing concerns. Conclusion: Our study offers contextual insights into the enduring challenges of medical mistrust, particularly within the Black/AA community, and its implications for patients and caregivers accessing and receiving MM‐related care. Future studies should leverage these insights to guide the development of multilevel interventions addressing medical mistrust within the Black/AA community. [ABSTRACT FROM AUTHOR]