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Open AccessArticle

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

1
Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH 44106, USA
2
University Hospitals Cleveland Medical Center, Seidman Cancer Center, Cleveland, OH 44106, USA
3
The Gathering Place, Beachwood, OH 44122, USA
4
Cleveland Clinic Taussig Cancer Institute, Cleveland, OH 44195, USA
5
NEOMED-CSU Partnership for Urban Health, Cleveland State University, Cleveland, OH 44115, USA
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(18), 3280; https://doi.org/10.3390/ijerph16183280
Received: 15 July 2019 / Revised: 31 August 2019 / Accepted: 2 September 2019 / Published: 6 September 2019
(This article belongs to the Special Issue Minority Health Issues and Health Disparities)
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. View Full-Text
Keywords: community-based participatory research (CBPR); community engagement; community listening tour; distrust; healthcare; health disparities; cancer community-based participatory research (CBPR); community engagement; community listening tour; distrust; healthcare; health disparities; cancer
MDPI and ACS Style

Webb Hooper, M.; Mitchell, C.; Marshall, V.J.; Cheatham, C.; Austin, K.; Sanders, K.; Krishnamurthi, S.; Grafton, L.L. Understanding Multilevel Factors Related to Urban Community Trust in Healthcare and Research. Int. J. Environ. Res. Public Health 2019, 16, 3280.

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