The 130th Annual Meeting of APHA

Abstract #49202

Vanessa B. Sheppard, PhD, MA¹, Ruth E. Zambrana, PhD², and Ann S. O'Malley, MD, MPH¹. (1) Lombardi Cancer Center, Cancer Control Program, Georgetown University Medical Center, 2233 Wisconsin Avenue, NW, Suite 317, Washington, DC 20007, (703) 521-0737, vls3@georgetown.edu, (2) University of Maryland, 2101 Woods Hall, College Park, MD 20742

BACKGROUND Trust is an important indicator of quality in the patient – clinician relationship. The aim of this study was to explore experiences that influence patient trust among lower income women.

METHODS Thirty-four participants were recruited from three prenatal care programs Virginia. Most women were black (67%) and had completed high school (85%). Four focus groups were conducted lasting from 1.5 to 2 hours. These groups were audio-recorded, transcribed, and coded by independent readers. A model was developed based on the major thematic categories. RESULTS Key factors related to trust were caring, competence, continuity of care, communication, and satisfaction. Most participants reported greater trust in nurses and paraprofessionals than in their physician. Experiences that increased trust were when women were satisfied with their healthcare or when the physician or other healthcare providers demonstrated caring about their well-being and helped to alleviate a negative situation. Perceptions of misinformation or medical errors were reported most often as experiences that reduced patient trust.

CONCLUSIONS Many lower income women lack strong interpersonal relationships with physicians during pregnancy. Women tended to have more trusting relationships with ancillary professionals and paraprofessionals than physicians. Nevertheless, women did not report concern regarding the technical skill of the physician. More information is needed to identify factors that influence patient trust and whether trust is related to patient compliance, use of preventive services and health status among lower income women.

Learning Objectives:

• To identify factors associated with women's trust in medical care
• To describe the patient - provider relationship among lower income women
• To explore implications of patient trust in the medical care setting

Keywords: Access to Care, Low-Income

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.