Distrust, Race, and Research | Research, Methods, Statistics | JAMA Internal Medicine | JAMA Network
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Original Investigation
November 25, 2002

Distrust, Race, and Research

Author Affiliations

From the Division of General Medicine and Clinical Epidemiology, Departments of Social Medicine and Internal Medicine, The University of North Carolina at Chapel Hill (Dr Corbie-Smith); Center for Minority Health, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pa (Dr Thomas); and Department of Public Health Education, The University of North Carolina at Greensboro (Dr St. George).

Arch Intern Med. 2002;162(21):2458-2463. doi:10.1001/archinte.162.21.2458

Background  Investigators have voiced concerns that distrust of research and the medical community impedes successful recruitment of African Americans into clinical research.

Objectives  To examine possible differences in distrust by race and to determine to what extent other sociodemographic factors explain any racial differences in distrust.

Methods  We analyzed data from 527 African American and 382 white respondents of a national telephone survey on participation in clinical research. Our main outcome measure was a 7-item index of distrust.

Results  African American respondents were more likely than white respondents not to trust that their physicians would fully explain research participation (41.7% vs 23.4%, P<.01) and to state that they believed their physicians exposed them to unnecessary risks (45.5% vs 34.8%, P<.01). African American respondents had a significantly higher mean distrust index score than white respondents (3.1 vs 1.8, P<.01). After controlling for other sociodemographic variables in a logistic regression model, race remained strongly associated with a higher distrust score (prevalence odds ratio, 4.7; 95% confidence interval, 2.9-7.7).

Conclusions  Even after controlling for markers of social class, African Americans were less trusting than white Americans. Racial differences in distrust have important implications for investigators as they engage African Americans in research.