• Arshdeep Kaur, Laura M Gottlieb, Ettinger de CubaStephanieSFrom the California University of Science and Medicine, Colton, CA (AK); Social Interventions Research and Evaluation Network, Center for Health and Community, University of California San Francisco, San Francisco, CA (LMG); Depa, Elena Byhoff, Eric W Fleegler, Alicia J Cohen, Nathaniel J Glasser, Mark J Ommerborn, Cheryl R Clark, and Emilia H De Marchis.
• From the California University of Science and Medicine, Colton, CA (AK); Social Interventions Research and Evaluation Network, Center for Health and Community, University of California San Francisco, San Francisco, CA (LMG); Department of Family and Community Medicine, University of California San Francisco, San Francisco, CA (LMG, EHDM); Children's HealthWatch, Boston, MA (SEDC); School of Public Health & Chobanian and Avedisian School of Medicine, Boston University, Boston, MA (SEDC); Department of Medicine, University of Massachusetts Chan Medical School, North Worcester, MA (EB); Division of Emergency Medicine, Boston Children's Hospital, Boston, MA (EWF); Department of Pediatrics, Harvard Medical School, Boston, MA (EWF); Center of Innovation in Long Term Services and Supports, VA Providence Healthcare System, Providence, RI (AJC); Department of Family Medicine, Warren Alpert Medical School of Brown University (AJC); Department of Health Services, Policy, and Practice, Brown University School of Public Health (AJC); Section of General Internal Medicine, University of Chicago, Chicago, IL (NJG); Center for Community Health and Health Equity, Brigham and Women's Hospital, Boston, MA (MJO); Department of Medicine, Brigham and Women's Hospital, Boston, MA (CRC). arshdeep.kaur@student.cusm.edu.
• J Am Board Fam Med. 2024 Jul 1; 37 (4): 607636607-636.

BackgroundHigher trust in healthcare providers has been linked to better health outcomes and satisfaction. Lower trust has been associated with healthcare-based discrimination.ObjectiveExamine associations between experiences of healthcare discrimination and patients' and caregivers of pediatric patients' trust in providers, and identify factors associated with high trust, including prior experience of healthcare-based social screening.MethodsSecondary analysis of cross-sectional study using logistic regression modeling. Sample consisted of adult patients and caregivers of pediatric patients from 11 US primary care/emergency department sites.ResultsOf 1,012 participants, low/medium trust was reported by 26% identifying as non-Hispanic Black, 23% Hispanic, 18% non-Hispanic multiple/other race, and 13% non-Hispanic White (P = .001). Experience of any healthcare-based discrimination was reported by 32% identifying as non-Hispanic Black, 23% Hispanic, 39% non-Hispanic multiple/other race, and 26% non-Hispanic White (P = .012). Participants reporting low/medium trust had a mean discrimination score of 1.65/7 versus 0.57/7 for participants reporting high trust (P < .001). In our adjusted model, higher discrimination scores were associated with lower trust in providers (aOR 0.74, 95%CI = 0.64, 0.85). A significant interaction indicated that prior healthcare-based social screening was associated with reduced impact of discrimination on trust: as discrimination score increased, odds of high trust were greater among participants who had been screened (aOR = 1.28, 95%CI = 1.03, 1.58).ConclusionsPatients and caregivers reporting more healthcare-based discrimination were less likely to report high provider trust. Interventions to strengthen trust need structural antiracist components. Increased rapport with patients may be a potential by-product of social screening. Further research is needed on screening and trust.© Copyright by the American Board of Family Medicine.

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