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Running head: AFRICAN AMERICAN TRUST MEDICAL SYSTEM 1
African American Trust in the United States Medical System
Ashley Fournillier
University of North Carolina at Charlotte
PSYC 2103: Research Methods 2
Dr. Hannah Peach
April 6, 2023
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Abstract
African Americans in the past until today have had to face the struggles of tolerating racism or discrimination when trying to get medical care or being taken advantage of by medical professionals. The present study sought to see if more exposure to negative experiences personally or historically was negatively associated with the trust African Americans have in White American healthcare providers. The sample (
N
=32) included African American from the University of North Carolina at Charlotte and other parts of the United States of America who were 18 to 73 (
M = 43.27). Participants were able to access an online survey through a link that took them to a Google Form containing the survey. The survey contained questions from the Group-Based Medical Mistrust Scale (GBMMS) and a scale to measure negative exposure experiences. The experimental hypothesis proved to be statistically significant indicating that there is a correlation between mistrust and exposure to negative medical experiences. These results are important as it validates not only existing literature but future research within this area
of study.
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AFRICAN AMERICAN TRUST MEDICAL SYSTEM
African American Trust in the United States Medical System
In a study by Szilagyi and colleagues (2021), the authors look at what role trust played in whether or not a person would get a COVID-19 vaccine. In the study, questions were asked to the participants about their trust that the vaccines were safe, their trust in the FDA’s judgment about the vaccines, and if they would get the vaccine (Szilagyi, 2021). Amongst all racial and ethnic groups that participated Black Americans were the least likely to get the vaccine and had the lowest amounts of trust (Szilagyi, 2021). This statistic is concerning, as this suggests Black Americans may be experiencing greater health risks, as well as mistrust in healthcare. If a person
has no trust that healthcare professionals will provide them with the service that they need this can possibly lead to self-diagnoses. Self-diagnoses can be very dangerous because if a person diagnoses themself with the wrong disease and takes medicines for it the medicine they take could make the situation worse. Further, when people do not regularly visit a healthcare professional they may lack participation in preventative measures for chronic illnesses or a timely diagnosis and treatment for health conditions.
A study conducted in South Korea gives evidence that government trust was a factor that helped ease the people’s worries of, and encouraged them to take preventative measures against COVID-19 (Jeong & Kim, 2023). In the findings of the article, the researchers were able to perceive that risk perception helps inspire preventative behaviors by way of information seeking and verification (Jeong & Kim, 2023). They also found that risk perception and information seeking does not necessarily constitute preventative behaviors and this is where they looked to trust in the government as a mediator between their variables (Jeong & Kim, 2023). When there was high trust in government actions there were more instances of the positive effect they found where risk prevention led to information seeking and verification which led to preventative
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AFRICAN AMERICAN TRUST MEDICAL SYSTEM
behaviors (Jeong & Kim, 2023). Taking preventative measures recommended by professionals is
very important to maintaining not only individual well-being but the well-being of others. With the COVID-19 pandemic, getting the vaccines and booster shots not only protects you from getting the virus, but also protects you from spreading it to other people like family members. Having trust in the FDA and government and seeking correct information could have possibly prevented as many people from becoming ill.
From the previous studies mentioned it is plausible that African Americans have a generalized distrust in medical judgments, which unfortunately, could result in the cost of lives. Within the next paragraphs we will be exploring the definition of African American exposure to negative medical experiences within this paper and its corrrelation to trust. The purpose of the present study was to examine if negative medical experiences of African Americans relates to trust in the medical system and healthcare providers and acknowledge the disconnection between
them.
History of Medical Malpractice among African Americans
The history between African American and healthcare providers is very long and sometimes horrific. Many events modern society would consider atrocities have taken place within the African Americans community. This is one reason why there is a disconnection between African Americans and healthcare providers. This history is full of experiences where trust was exploited and led to the suffering of many and within the present study trust is defined as this.
“Trust is the mutual assurance that, during an exchange, no party will exploit the vulnerabilities of another. Trust is the willingness of a person or group to be vulnerable to the actions of other
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group[s] of people, based on expectations that the other will do a certain action benefitting the trust” (Tang et al., 2021, para. 13).
Trust is part of the foundation of relationships no matter what kind and if that trust is broken then
the relationship suffers. The trust that was broken between African Americans and the medical system has echoed for generations. For example, an African American woman named Henrietta Lacks is a part of the reason why modern medicine has come so far. Henrietta Lacks’s cells, named ‘Immortal Cells’, have helped in the development of vaccines for diseases like COVID-
19 and polio, many different drugs, and other disorders (Klitzman, 2022). When she was alive Henrietta Lacks was diagnosed with cervical cancer at a time when scientists had been trying for a long time to grow cells outside of the human body (Klitzman, 2022). While Henrietta was being treated researchers secretly (e.g. without her knowledge or concent) removed cancer cells from her body and found that they were still able to grow despite not being in the human body (Klitzman, 2022). With those cells, the medical industry was able to make billions of dollars from the manufactured vaccines and drugs long after Henrietta Lacks died, yet the Lacks family reaped none of the benefits and were never told that researchers were using her cells (Klitzman, 2022). This case brought up many questions about the ethics of biospecimen donors and if they deserve monetary compensation (Klitzman, 2022). This case is significant because an African American woman was taken advantage of, which contributes to the community’s mistrust of the healthcare system because the researchers did not obtain Henrietta’s consent and did not fairly compensate her or her family (Klitzman, 2022).
Another historical event contributing to mistreatment of African Americans by the medical community is referred to as the In Re Cincinnati Radiation Litigation (Hawk, 1995). Starting from the year 1960 researchers at Cincinnati General Hospital, funded by the
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AFRICAN AMERICAN TRUST MEDICAL SYSTEM
Department of Defense, were given permission to conduct a series of experiments in which they exposed human cancer patients to radiation (Hawk, 1995). The reason why the Department of Defense funded this is that during the time period of the Cold War the United States was under threat of nuclear war (Hawk, 1995). The purpose of these experiments was to identify the first signs of radiation poisoning and its effect on cognitive functions and the central nervous system of soldiers (Hawk, 1995). The researchers exposed eighty-eight cancer patients, mostly African American to full body radiation (Hawk, 1995). Not only were patients not given any information about the ‘treatment’ they would receive, their families never knew either and neither party was ever informed about the risk of death or the side effects of radiation exposure (Hawk, 1995). These experiments took place up until 1971, nearly eleven years, and within that time ten of the patients died within forty days of exposure, the average length of time until death for patients was six months, and some patients fell in between surviving for around four and a half months (Hawk, 1995). It took four class action suits being filed for the doctors involved, the University of Cincinnati, and the City of Cincinnati to be held accountable to some degree (Hawk, 1995). This case also further showcases the historical mistreatment of African Americans within medical settings and the unwillingness of the medical system to take accountability, which likely
contributes to mistrust of medical providers within this community.
James M. Sims is known as, “the father of gynecology” however many people do not know the full story of how he obtained his knowledge (Washington, 2008). Sims researched tetanus which was an epidemic spread throughout mostly enslaved individuals (Washington, 2008). He had an idea that the disease was caused by skull bone displacement during the birthing
process, which as we know now was immensely incorrect as what he observed was the symptoms of chronic malnutrition (Washington, 2008). However, in order to cure this disease he
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experimented on enslaved African American children he would separate the sick child from their
mothers, create incisions on the child's scalp, and pry the skull bones into new positions using a cobbler’s tool (Washington, 2008). As one could infer many children died from this procedure and in the vent, this happened Sims would place the blame on the mother and midwife labeling them as slothful and ignorant (Washington, 2008). This is absolutely horrific and it’s hard to conceptualize that this actually happened here in the United States. However in order to move on
we must accept that this actually happened and spend even more time making things right. However, Sims’s experiments on enslaved individuals to find the cure for different ailments didn’t stop at children, as he acquired more slaves he experimented on them too (Washington, 2008). One of them was a nineteen-year-old boy who died after two operations, one such including the unanesthetized removal of bone fragments (Washington, 2008). Other mistakes like nearly suffocating a patient by forgetting to remove a sponge from their mouth after removing part of their cancerous jaw (Washington, 2008). There was also his work on examining
vesicovaginal fistula as while it was more common in enslaved African American women partially occurring because of vitamin D deficiency it had also started to affect White women (Washington, 2008). Sims acquired eleven enslaved women and conducted several experiments on them for the next four years (Washington, 2008). During this time period the women were subjected to violating, invasive tests so other physicians could look at their vaginas; several extremely painful surgeries; and he even forced the other women to restrain a woman in order for
him to make incisions at the site of infection (Washington, 2008). The list of atrocities he committed against African Americans still goes on and he was okay with committing these acts because he lived in a society that was okay with it.
Cognitive Dissonance
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It is a big question about how these kinds of horrific events could have ethically taken place at all. Recently in psychology, ‘cognitive dissonance theory’ has been proposed as an explanation. The predicament of cognitive dissonance:
“...is the tension between the self-esteem we get from being part of a benign national and professional narrative and the cognitive dissonance that will be caused and has to be worked through when we challenge this narrative” (Lepping & Poole, 2022, p.03).
Cognitive dissonance is present throughout history, especially during the Antebellum period whereby slaves were not seen as humans and not even as animals, but as property to own and mistreat. This behavior generates cognitive dissonance; European Americans viewed themselves as civilized and morally just, however, in order to justify the keeping of slaves and treating them so savagely, they had to dehumanize the slaves in every way. This mentality has persisted to present day.
The way to put this mentality to rest is to sincerely acknowledge the wrongdoing committed and come to terms with the fact that it happened then move on (Lepping & Poole, 2022). Once you acknowledge a shortcoming you are able to look at where things went wrong and take step to prevent it from happening. If you let it sit and fester then the risk of circling back
a repeating the same thing happens and we see this happening with the social and political climate surrounding the United States today. As things are now this is not likely to happen sooner than later however, as more people look into the phenomenon of cognitive dissonance and look to find the good it can do. A study by Aguilar et al. (2022) addresses this where they found that inducing cognitive dissonance could reduce placing blame on innocent victims. This article did a 2 x 2 study design in their first study to look at two induction conditions, dissonance induction and awareness induction, and given two victims' backgrounds with one victim being
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innocent and the other not (Aguilar et al., 2022). Their next study looked at the same induction conditions with an added control condition where they did not receive any induction (Aguilar et al., 2022). Their findings were that cognitive dissonance induction is effective against placing blame onto innocent victims (Aguilar et al., 2022). This study is important as it opens the door into learn more about what cognitive dissonance is and how it can be used for the good of not just victims, but people as a whole. While this may be good cognitive dissonance as we know it has cause much harm to African American indviduals that has echoed into future generations.
African American Generational Trauma
There are many saying that are still used in present day that show that the roots of history has reached into problems faced in present day. Some of them are harmful like the saying about how Black people don’t feel pain as greatly or in African American families how a lot of the time you will hear family members proclaim their mistrust in doctors or the FDA. The aversion African Americans have towards White American healthcare providers has been passed down not only through socialization, but ingrained through DNA. It’s a running joke about how African Americans run or hide while laughing, however it is known that at some plantations slaves weren’t allowed to laugh and if they were seen or heard laughing together they would be punished. There is a difference between the treatment of African American women and men and
this study will acknowledge that difference and provide information and what these differences are and intersectionalities. To start with a study recruited 1,506 cisgender Black women between 18 and 30 who completed an online survey about gendered racial microaggressions about Black women (Matsuzaka et al., 2022). The study found that Black LGBT women scoored higher on the Beauty and Sexual Objectification scale, which shows how being in both minority groups of LGBT and being Black can put one at a greater disadvantage (Matsuzaka et al., 2022).
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A study by Hammond (2010) examined African American men and their views and experiences about the medical system of the United States and why there is mistrust. However, African Americans could and would have the right to complain about the injustices they face daily however African Americans make an effort to change their situation for the better. Further,
a study by Petion et al. (2022) where they looked at the family dynamics of African American women and how they view generational trauma. What they found was that these women took generational trauma as a motivator for communication repair in their families and this study opened a door into looking at generational trauma therapy.
Present Study
This study will address a topic not many past studies have discussed in detail. A major limitation of the current literature is the exploration of looking at how history has affected the attitudes of African Americans today, the generational trauma present in African American families, the difference in treatment between men and women, and the intersectionality of being LGBT+ (Matsuzaka et al., 2022). This study will be acknowledging these limitations and correlating them in this study to closely examines the relationship between these variables.
Hypothesis:
I predict that among African Americans being exposed to negative medical experiences of African Americans is negatively associated with trust in White American healthcare providers.
Method
Participants
The sample included African Americans (N=32) from the University of North Carolina at
Charlotte and other states in the United States. Students completed the survey by accessing a link
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provided through email to the online survey. Only African Americans at least 18 years of age or older and English-speaking were eligible for the survey. The goal of the present study was to determine the relationship between exposure to negative medical experiences and trust in White American healthcare providers, specifically in African Americans. After considering the inclusion and exclusion criteria of the total participants 13 were males and 19 were females and 00 were other. The age range of the participants was 18 to 73. The sexualities of all participants who chose to disclose this information are as follows: 84.4% Heterosexual, 3.1% Gay, 3.1% Lesbian, 00% Bisexual, and 6.3% Other. This study proposed no benefit to any of the participants. All surveys were completed between March 21, 2023 through March 30, 2023 at any time up to the participant’s choosing. The first few questions that were asked to participants were a series of questions asking them to confirm that they are African American and questions asking age, ethnicity, sex, and sexuality.
Measures
A series of questions confirming age, race, sex, and sexuality were first asked to participants to gauge demographics. Participants were then asked to answer a question asking about their English comprehension.
Exposure to Negative Medical Experiences
. The Independent variable of this study was exposure to negative medical experiences which was measured using a series of questions. These
questions covered the domains of what they know regarding the historical mistreatment of African Americans and their personal experience with medical mistreatment. For every question participants were asked to rate how they associated with every question using a Likert scale in which 1 = strongly disagree, 2 = somewhat disagree, 3 = neither agree nor disagree, 4 = somewhat agree, and 5 = strongly agree. Using this point scale, responses were added
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together. The higher the score, the more exposure to negative medical experiences. You can refer
to these questions within the appendix.
Trust
. The dependent variable was also measured using the Group-Based Medical Mistrust Scale (GBMMS)
, a 12-item survey that aims to access medical mistrust (Thompson et al., 2004). The questions within this survey access every participant's individual mistrust and their thoughts about if others within their ethnic group should also have mistrust in the medical industry (Thompson et al., 2004). For every question participants were asked to rate how they associated with every question using a Likert scale in which 1 = strongly disagree, 2 = somewhat
disagree, 3 = neither agree nor disagree, 4 = somewhat agree, and 5 = strongly agree. Afterward, every individual score for each question will be added to an overall score between 12 to 60 (Thompson et al., 2004). The higher the overall score the more mistrust. You can refer to these questions within the appendix.
Procedure
The present study consisted of an online survey that was accessible to students at the University of North Carolina at Charlotte via a link provided by the researcher. Students were able to access the survey via a link provided on a Reddit post on the University's forum. The online survey was accessible to other participants via a link provided by the researcher through email. Only African Americans who had access to the link, were at least 18 years of age, and could speak English were eligible for the survey. Participants were able to take the survey anywhere and anytime they saw fit so long as they had internet access. Before further participation in the survey, all participants were asked to electronically sign an informed consent statement. What was stated in this statement was the purpose of the study, information about any possible risk associated with participation, informing them about their anonymity, assuring the
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confidentiality of the data, and a statement that tells them that consent is required for further participation in the study and the option to continue. In the event of a participant continuing they would then answer a series of demographic questions asking their age, race, sex, and sexuality. Participants were then asked questions from the GBMMS Scale which accessed their medical mistrust (Thompson et al., 2004). Lastly, participants were asked to answer questions about if they or someone they know had a bad medical experience, do they think they will get quality service going to White American healthcare professionals, and what they know about the past of African American and the medical industry. This survey lasted approximately 10 minutes for participants and they were able to take it any time they saw fit so long as they had internet access
between March 21, 2023 and March 30, 2023 on their computer or mobile device. In the debrief participants were notified that the study was being conducted for a class project and involved a web-based survey to understand trust between African American and White American healthcare
professionals. As some of the subject matter in this survey could cause feelings of anger, frustration, or resentment in the debrief, student participants were provided information regarding the University’s Counseling Center. Other participants were given resources from the American Psychological Association to help them look for a local therapist, online therapy, or help them deal with immediate emotions of anger in that moment (APA Psychologist Locator, 2008; “Controlling Anger — before It Controls You,” 2022; “What You Need to Know before Choosing Online Therapy”, 2021).
Plan of Analysis
The present study used a correlational study design to determine if among African Americans exposure to negative medical experiences (independent variable) was negatively correlated with trust in White American healthcare providers (dependent variable). IBM’s SPSS
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statistical software was utilized by the researcher to analyze the data collected in the study. To analyze the resulting data descriptive statistics (i.e. mean, range, standard deviation) and inferential statistics (i.e. one correlation) were used.
Results
The present study hypothesized that among African Americans being exposed to negative
medical experiences of African Americans is negatively associated with trust in White American
healthcare providers. To test the hypothesis, a correlation was examined. Participants all had a total score between 12 and 60 of mistrust (M=21.31, SD=6.84) and a total score between 8 and 40 of exposure to negative medical experiences (M=33.06, SD=6.05). A moderate, positive statistically significant correlation emerged, r = .359, p = .04. The hypothesis was supported and results suggest that negative experience with and exposure to medical experiences does affect trust negatively (see Figure 1).
Discussion
Summary
The study hypothesized that among African Americans being exposed to negative medical experiences of African Americans is negatively associated with trust in White American
healthcare providers. It was expected that a negative association would be found as there is a long history of medical malpractice taking advantage of or doing harm to African Americans. What was expected was what was found in this study and the reason could be because of how long African Americans have had problems with White American healthcare providers. From this study, we can learn about this problem and begin to take steps to address it and learn about the perspectives of African Americans. There is not much-existing literature very similar to this study however the findings of that literature are consistent with this study’s findings. One such example is the article by Rockich-Winston and colleagues (2022) that re-examines research that
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had been previously done about professional identity formation (PIF) in African American physicians. In the current article, the author looks at how African American students, residents, and attending physicians interpret and enact the social contract between African American patients and healthcare providers (Rockich-Winston et al., 2022). There is also a study by the Kaiser Family Foundation that looked into the racial health disparities that many African American families faced during the pandemic (Hammel et al., 2020). They found that many African American families had a mistrust of vaccines and that many still faced racism and discrimination within medical settings (Hammel et al., 2020). These findings although not specifically measuring what this study is, still found similar results in their findings. This is where one of the many strengths of this study stands out.
Strengths/Limitations
The present study demonstrated good external validity with a reasonable sample size (N=32), which reduced the chance of the data rejecting the hypothesis. The present study also uses the Group-Based Medical Mistrust Scale (GBMMS) which is validated and therefore more reliable as an instrument of measure. The research also expanded upon existing research within an under researched area of study. There is a lot of history between African Americans and the healthcare system which gives studies like this a lot to look into. It also shows how mistrust has been a widespread problem among African American and that has gone on for a long time without much research looking into the relationship.
Despite having a somewhat plentiful sample size the results drawn are not generalizable to African Americans as a whole. Also, between the two scales used participants may have misinterpreted what is meant by ‘strongly agree’ or ‘strongly disagree’ and overestimated or underestimated their feeling about the questions asked or statements made. More people took the
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survey than reported in the sample size however their data was scrapped due to an incomplete data set for all questions. So, maybe the questions and statements participants saw made them uncomfortable and instead, they opted to not answer. The scale to measure exposure is a non-
validated survey and may have contributed toward this issue, but because the subject matter can be hard to address may also be the reason. Many of the participants were adults, people who looked at the world through a different lens and already have established values, and not many younger people took the survey. This may have influenced how likely they were to agree or disagree with questions asked and statements seen. However, even with these limitations this research is important and can should be improved upon to start impacting the lives of African Americans positively.
Implications
The results of this study suggest that there is an association between mistrust and exposure to the negative medical experiences of African Americans. The reason for this can probably be attributed to the long-standing history of problems between African Americans and White American healthcare professionals. There were some odd results within my sample while there wasn’t a big difference between how many participants were male or female, yet the total scores for females on each scale were two times the total score for males. This shows us that females had higher mistrust along with higher exposure to medical experiences. These results point to females being treated worse by healthcare professionals than men which may be a topic to explore more. Many people can benefit from the knowledge gained from this study like non-
African Americans, to help them look into what African American face. This article can also contribute to changing the education of medical students to make them aware of the distress African Americans feel so they can act accordingly. There is a study conducted on African
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American medical students and within it, they found the participants of this study knew about the
racial contract within America and actively tried to extend the social contract to include African American patients and communities (Rockich-Winston et al., 2022). As this is a newer research topic continuing to expose what is happening helps dispel myths and harmful stereotypes and can
lead to getting funding for less-funded communities to improve the conditions of its inhabitants. These are just a few of many possible future directions this research could go in.
Future Research
The results of this study could be used to conduct further research on the relationship between African Americans and the healthcare system. Future research about the present study should focus on providing a more diverse age range of participants, gathering a large scale of participants, and formatting questions to be less uncomfortable. A possible way to gather these participants would be to provide a monetary reward for participation and an optional free therapy
session for all participants. Another way future research can build upon the ideas within this study is a longitudinal look into underfunded African American communities throughout the span of 15 years. Through this kind of study, we will be able to see how environmental racism affects health outcomes. There is still not much research about this subject and there are much ways research can go in the future.
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References
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Lepping, P., & Poole, R. (2022). Psychiatry’s need for Vergangenheitsbewältigung: ‘Culture wars’, cognitive dissonance and coming to terms with the past. BJPsych Open
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Figure 1
Scatterplot of the Correlation Between Mistrust and Experiences
Note.
This figure used a scatterplot to show the correlational relationship between the variable mistrust and the variable exposure to negative medical experiences. The horizontal axis displays the scores from the GBMMS scale, and the vertical axis displays scores from the mistrust scale used.
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Appendix
Demographics
1.
Are you African American?
a)
Yes
b)
No
2.
What is your sex?
a)
Male
b)
Female
c)
Non-binary/Third gender
d)
Prefer to self-describe______
e)
Prefer not to say
3.
What is your age?
a)
(Self-report numerical value)
4.
What is your sexuality?
a)
Heterosexual
b)
Gay
c)
Lesbian
d)
Bisexual
e)
Other
f)
Prefer to self-describe______
g)
Prefer not to say
5.
Are you English-speaking?
a)
Yes
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23
AFRICAN AMERICAN TRUST MEDICAL SYSTEM
b)
No
Exposure to Negative Medical Experiences
1.
Would you say you are knowledgeable about the story of Henrietta Lacks and her family?
a.
1=Strongly Disagree
b.
2= Somewhat Disagree
c.
3=Neither Agree nor Disagree
d.
4=Somewhat Agree
e.
5=Strongly Agree
2.
Would you say you are knowledgeable about the In Re Cincinnati Radiation Litigation?
a.
1=Strongly Disagree
b.
2= Somewhat Disagree
c.
3=Neither Agree nor Disagree
d.
4=Somewhat Agree
e.
5=Strongly Agree
3.
Would you say you are knowledgeable about James M. Sims’ Experiments on African American slaves?
a.
1=Strongly Disagree
b.
2= Somewhat Disagree
c.
3=Neither Agree nor Disagree
d.
4=Somewhat Agree
e.
5=Strongly Agree
4.
Would you say you are knowledgeable about James M. Sims Experiments on African American children?
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AFRICAN AMERICAN TRUST MEDICAL SYSTEM
a.
1=Strongly Disagree
b.
2= Somewhat Disagree
c.
3=Neither Agree nor Disagree
d.
4=Somewhat Agree
e.
5=Strongly Agree
5.
Have you personally had a medical experience where you felt feelings of anger, frustration, or resentment?
a.
1=Strongly Disagree
b.
2= Somewhat Disagree
c.
3=Neither Agree nor Disagree
d.
4=Somewhat Agree
e.
5=Strongly Agree
6.
Do you know other people within you racial/ethnic group who had a medical experience where they felt feelings of anger, frustration, or resentment?
a.
1=Strongly Disagree
b.
2= Somewhat Disagree
c.
3=Neither Agree nor Disagree
d.
4=Somewhat Agree
e.
5=Strongly Agree
7.
Have the experiences of the elders in your life affected your attitude towards White American healthcare providers?
a.
1=Strongly Disagree
b.
2= Somewhat Disagree
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AFRICAN AMERICAN TRUST MEDICAL SYSTEM
c.
3=Neither Agree nor Disagree
d.
4=Somewhat Agree
e.
5=Strongly Agree
8.
Was your attitude towards White American healthcare providers negatively affected?
a.
1=Strongly Disagree
b.
2= Somewhat Disagree
c.
3=Neither Agree nor Disagree
d.
4=Somewhat Agree
e.
5=Strongly Agree
Group-Based Medical Mistrust Scale (GBMMS)
1.
Doctors and health care workers sometimes hide information from patients who belong to
my ethnic group.
a.
1=Strongly Disagree
b.
2= Somewhat Disagree
c.
3=Neither Agree nor Disagree
d.
4=Somewhat Agree
e.
5=Strongly Agree
2.
Doctors have the best interests of people of my ethnic group in mind.
a.
1=Strongly Disagree
b.
2= Somewhat Disagree
c.
3=Neither Agree nor Disagree
d.
4=Somewhat Agree
e.
5=Strongly Agree
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AFRICAN AMERICAN TRUST MEDICAL SYSTEM
3.
People of my ethnic group should not confide in doctors and health care workers because it will be used against them.
a.
1=Strongly Disagree
b.
2= Somewhat Disagree
c.
3=Neither Agree nor Disagree
d.
4=Somewhat Agree
e.
5=Strongly Agree
4.
People of my ethnic group should be suspicious of information from doctors and health care workers.
a.
1=Strongly Disagree
b.
2= Somewhat Disagree
c.
3=Neither Agree nor Disagree
d.
4=Somewhat Agree
e.
5=Strongly Agree
5.
People of my ethnic group cannot trust doctors and health care workers.
a.
1=Strongly Disagree
b.
2= Somewhat Disagree
c.
3=Neither Agree nor Disagree
d.
4=Somewhat Agree
e.
5=Strongly Agree
6.
People of my ethnic group should be suspicious of modern medicine.
a.
1=Strongly Disagree
b.
2= Somewhat Disagree
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AFRICAN AMERICAN TRUST MEDICAL SYSTEM
c.
3=Neither Agree nor Disagree
d.
4=Somewhat Agree
e.
5=Strongly Agree
7.
Doctors and health care workers treat people of my ethnic group like “guinea pigs.”
a.
1=Strongly Disagree
b.
2= Somewhat Disagree
c.
3=Neither Agree nor Disagree
d.
4=Somewhat Agree
e.
5=Strongly Agree
8.
People of my ethnic group receive the same medical care from doctors and health care workers as people from other groups.
a.
1=Strongly Disagree
b.
2= Somewhat Disagree
c.
3=Neither Agree nor Disagree
d.
4=Somewhat Agree
e.
5=Strongly Agree
9.
Doctors and health care workers do not take the medical complaints of people of my ethnic group seriously.
a.
1=Strongly Disagree
b.
2= Somewhat Disagree
c.
3=Neither Agree nor Disagree
d.
4=Somewhat Agree
e.
5=Strongly Agree
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AFRICAN AMERICAN TRUST MEDICAL SYSTEM
10. People of my ethnic group are treated the same as people of other groups by doctors and health care workers.
a.
1=Strongly Disagree
b.
2= Somewhat Disagree
c.
3=Neither Agree nor Disagree
d.
4=Somewhat Agree
e.
5=Strongly Agree
11. In most hospitals, people of different ethnic groups receive the same kind of care.
a.
1=Strongly Disagree
b.
2= Somewhat Disagree
c.
3=Neither Agree nor Disagree
d.
4=Somewhat Agree
e.
5=Strongly Agree
12. I have personally been treated poorly or unfairly by doctors or health care workers because of my ethnicity.
a.
1=Strongly Disagree
b.
2= Somewhat Disagree
c.
3=Neither Agree nor Disagree
d.
4=Somewhat Agree
e.
5=Strongly Agree
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AFRICAN AMERICAN TRUST MEDICAL SYSTEM
Welcome, this is a web-based study that examines the trust African American peoples have in White American healthcare providers. In order to be eligible for this study, you must be at least 18 years of age and know how to read, speak, and write in the English language. Before taking part in this study, please read the consent form below and click on the "I Agree" button at the bottom of the page if you understand the statements and freely consent to participate in the study.
Consent Form
This study is being conducted to understand the attitudes of African Americans toward the United States Medical System and involves a web-based survey. Participation in the study typically takes 30 minutes and is anonymous. Participants participate by answering a series of questions. All responses are treated as confidential and your responses will not be linked to your identity. Be aware that confidentiality will be maintained to the extent possible. There is always the risk of compromising privacy, confidentiality and/or anonymity when using the internet. However, the risk to your physical, emotional, social, professional, or financial well-being is considered to be less than minimal. There are no direct benefits to you as a result of participation. The research may result in a better understanding of views on trust as an African American in the United States. Participation is voluntary, refusal to participate in the study involves no penalty or loss of benefits to which participants are otherwise entitled, and participants may withdraw from the study at any time without penalty or loss of benefits to which they are otherwise entitled.
If you have questions concerning the study, please contact the principal investigator, Ashley Fournillier, at afournil@uncc.edu or the responsible faculty member, Dr. Hannah Peach at hpeach@uncc.edu.
You may print a copy of this form. If you are African American, 18 years of age or older, have knowledge of the English language, understand the statements above, and freely consent to participate in the study, click on the "I Agree" button to begin the study.
I agree I do not agree
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