Sexual victimization has been associated with significant negative health outcomes as well as increased healthcare utilization (e.g., Breiding et al., 2013; Sickel et al., 2002). However, due to fear, embarrassment, or confidentiality concerns (Logan et al., 2004; Nasta et al., 2005), women may mistrust medical advice and not adhere to treatment recommendations, exacerbating development of negative health outcomes. Some research (Meade et al., 2009) has identified sexual victimization as a predictor of medical nonadherence, but to our knowledge no research has examined the role of medical mistrust in this relationship. A sample of 857 women was recruited via social media. Regression analyses in R Markdown revealed that sexual trauma was a significant predictor of both medical nonadherence (b = 0.4, SE = .08, p < .0001) and medical mistrust (b = 1.36, SE = .027 p < .0001), and further that medical mistrust predicted medical nonadherence (b = 0.06 SE = .01, p < .0001). Additionally, medical mistrust was found to significantly mediate the relationship between sexual trauma and medical nonadherence (b = .09, SD = .03, 95% CI =.04, .14). Results emphasize the importance of trauma-informed care and patient-provider rapport in bolstering resiliency and strengthening survivors’ adherence to medical recommendations. Suggestions for further application and intervention will be discussed.

Abstract available in the Annals of Behavioral Medicine.

Abstract available in the Annals of Behavioral Medicine.

The current study is part of a broader study called the Women’s Reproductive Health Survey (WRHS) which aimed to examine various aspects of women’s life experiences. This study examined the moderating effect of rurality on several factors of healthcare in a sample of women between the ages of 18 and 50. Self-rated health (SRH) was hypothesized to predict healthcare satisfaction, healthcare adherence, and medical mistrust. Furthermore, rurality was hypothesized to weaken the relationships between SRH and healthcare satisfaction and adherence; it was further hypothesized to exacerbate the relationship between SRH and medical mistrust. A survey containing a single-item measure of SRH and rurality, a seven-item measure of medical mistrust, and an exploratory measure of both healthcare satisfaction and adherence, was uploaded to the Internet forum Redditt. Participants received informed consent and monetary compensation for their time. Bivariate correlations and moderation analysis was conducted on the resulting data. Self-rated health was found to be a significant predictor of healthcare satisfaction, healthcare adherence, and medical mistrust. Rurality was a nonsignificant moderator. Healthcare systems may consider enhancing patient portfolios with a measure of SRH. This may have implications for improved quality of care and health outcomes. Limitations within the study included the participant demographics, which were mostly White and of a high socioeconomic status, as well as the broader survey from which this study originated. Future studies may consider comparing populations from a high socioeconomic status to populations from a low socioeconomic status.

Research has documented the adverse health outcomes that may result from experiences of sexual trauma and medical mistrust. Stigmatization as a result of sexual trauma experience(s) may also cause significant distress. The current study examined the effect of sexual trauma stigma and the potential mediating role of medical mistrust on health. Resiliency was examined as a potential moderator, as it may buffer sexual trauma stigma’s effects on medical mistrust and health outcomes. A sample of 482 women with a sexual trauma history completed questionnaires regarding health and sexual trauma stigma. Study data was analyzed in SPSS v.25 and included correlations and moderated-mediational analyses. Results demonstrated that sexual trauma stigma and medical mistrust independently predicted somatic symptom burden but not BMI. Medical mistrust and resiliency did not emerge as significant mediators/moderators. Limitations include a homogenous sample and possible measurement error. Future research of other maintaining mechanisms is warranted.

Mistrust of the healthcare system is increased among the Black population compared to other race/ethnicity groups. Medical mistrust can lead to intensified health inequities and negative health outcomes among this population. Currently, there is limited research that explores ways to address medical mistrust, especially among the Black population. This study investigated medical mistrust to find ways to improve the quality of life amongst the Black population. Twenty-one participants in this study completed a Group Based Medical Mistrust Survey and five of those participants participated in a semi-structured interview. Descriptive and correlation analyses were conducted. The GBMMS was separated into three subscales: Factor 1) Suspicion, Factor 2) Group disparities in healthcare, and Factor 3) lack of support from healthcare providers. The mean score for the GBMMS was 3.41 (SD=0.74). Significant correlations were found between Factor 1 and income (r=-.459, p=.048). Results from the in-depth interview indicated, five primary themes were extracted from the interviews including 1) Historical references to racism in the healthcare system, 2) Racial discrimination common in a doctor's office, 3) Assumptions made about health issues amongst Black patients, 4) Not seeking medical attention when needed, and 5) Utilization of primarily Black doctors. Overall, this study found that medical mistrust in the Black population is multifactorial and offers insight on how to improve relationships between the Black population and the healthcare system.

Adults aged 65 years and above have grown substantially over with past decade. However, the chance of developing multiple comorbidities only increases with age. Because elderly residents of rural Appalachia often encounter barriers to healthcare, rural nurses, providers, and policy makers must overcome physical and structural barriers, but also gain a more in-depth understanding of the personal and cultural attitudes impacting the use of new and innovative forms of healthcare delivery. With a slow and variable uptake of telehealth adoption in rural Appalachia, and in the presence of well-documented medical mistrust, this study was designed to better understand the degree of medical mistrust existing in the elderly of rural Appalachia and to assess if medical mistrust may be inhibiting efforts related to telehealth acceptance. A correlational design was utilized administering the Medical Mistrust Index (MMI) and Technology Acceptance Model (TAM) questionnaire via electronic survey to those age 65 years and above living in rural Appalachia. Deemed well-established and validated, the MMI measures medical mistrust from a broader perspective, while TAM assesses telehealth acceptance in terms of perceived usefulness, perceived ease of use, and overall attitude towards telehealth as a technology. Demographics of gender, income, education, and previous telehealth experience were compared to MMI and TAM scores. The study revealed a moderate level of medical mistrust and telehealth acceptance among the elderly of rural Appalachia. A statistically significant negative relationship was found between MMI and TAM for those reporting previous telehealth experience, and among all demographics, with the strongest correlations found among females and participants of lower education. Elderly rural Appalachians have a rich social and cultural history, but past experiences and long-held beliefs have resulted in medical mistrust and slow telehealth uptake. Stakeholders have a responsibility to meet individuals where they are understanding that elderly residents of rural Appalachia may not be ready or fully prepared to incorporate telehealth into their management of care. However, quality rural nursing practice and continued research has the ability to evolve to meet the needs that exist among those of advancing age with limited healthcare resources such as those found in rural Appalachia.

In this paper I examine the factors that affect the likelihood an individual is a registered organ donor. Unlike many studies which focus on subpopulations in specific regions, I utilize national data to get a broader assessment of individuals from around the country across a number of racial and religious classifications. Using a probit model and controlling for a variety of parameters, I find that some racial and religious variables are negatively and significantly associated with organ donor registration rates, while education and being female are positively associated with organ donor registration rates. I conclude by discussing the implications of my results and the potential for future research.

No description available.