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Trust and distrust among Appalachian women regarding cervical cancer screening: a qualitative study |
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| Authors: | McAlearney Ann Scheck Oliveri Jill M Post Douglas M Song Paula H Jacobs Elizabeth Waibel Jason Harrop J Phil Steinman Kenneth Paskett Electra D |
| Affiliation: | a Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, USA b Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, USA c Center for Population Health and Health Disparities, Ohio State University Comprehensive Cancer Center, Columbus, USA d Department of Family Medicine, College of Medicine, The Ohio State University, Columbus, USA e Department of Medicine and Division of General Internal Medicine, University of Wisconsin at Madison, Madison, USA f Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, USA g Division of Cancer Prevention and Control, Department of Internal Medicine, College of Medicine, The Ohio State University, USA h Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, USA |
| Abstract: | ObjectiveTo explore Appalachian women's perceptions of trust and distrust of healthcare providers and the medical care system as they relate to views about cervical cancer and screening.MethodsThirty-six Ohio Appalachia female residents participated in community focus groups conducted by trained facilitators. Discussion topics included factors related to cervical cancer, and the issues of trust and distrust in medical care. The tape-recorded focus groups were transcribed and analyzed to identify salient themes.ResultsFive themes emerged related to trust in healthcare. Patient-centered communication and encouragement from a healthcare provider led women to trust their physicians and the medical care system. In contrast, lack of patient-centered communication by providers and perceptions of poor quality of care led to distrust. Physician gender concordance also contributed to trust as women reported trust of female physicians and distrust of male physicians; trust in male physicians was reported to be increased by the presence of a female nurse.ConclusionsImportant factors associated with trust and distrust of providers and the medical care system may impact health-seeking behaviors among underserved women.Practice implicationsOpportunities to improve patient-centered communication around the issues of prevention and cervical cancer screening (such as providing patient-focused information about access to appropriate screening tests) could be used to improve patient care and build patients’ trust. |
| Keywords: | Cervical cancer Health services accessibility Vulnerable populations Patient-centered communication Cancer screening Trust Distrust Physician gender concordance Appalachian populations |
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