Shared Race Between Patients and Oncologists May Increase Trust

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When Black individuals learned about prostate cancer from Black doctors, they were more likely to trust the information, recent research showed.

Increased diversity within health care is impactful for patients, as Black patients felt more comfortable being paired with a black physician, and had more trust in health information, according to recent findings published in JAMA.

“Black men are more likely to be diagnosed with and die from prostate cancer. However, in a prior study we found that Black adults are underrepresented in online information about prostate cancer. The purpose of this study was to determine the importance of racial concordance and other characteristics of online prostate cancer information for trust among viewers, particularly for those groups at higher risk of worse outcomes, Dr. Stacy Loeb, from the Department of Urology and New York University Langone Health, explained in an interview with CURE®.

The study consisted of scripted videos about prostate cancer screenings or clinicals trials, and each video depicted different individuals: (Black physician, White physician, Black patient and White patient).

Although online video gives insight into important health information, they lack the representation of diverse communities, according to the study. Racial concordance (shared racial identity between a doctor and a patient) helps to instill trust for specific racial groups— something that may be particularly important since Black men are at higher risk for prostate cancer than any other racial group.

The videos were viewed by White and Black individuals aged 40 and older. Participants took a survey before viewing both scripts in order to identify gender, race and ethnicity. Only 8% of men within the study had a history of prostate cancer.

After the participants watched the video, they were asked whether they trusted one of the four clinicians involved in the video script.

The researchers then analyzed whether the specific subjects trusted the Black vs. White presenter; physician vs. patients; or screening vs. clinical trials. Black adults within the study tended to trust the Black speaker more than the White speaker, physician over patient, and screening vs clinical trials. When Black adults where asked whether they trusted a Black patient or a Black physician more, the majority picked a Black physician.

“Our results are in line with previous studies showing that racial concordance with clinicians is positively associated with perceived quality of health care for Black adults. For groups with a history of experiencing racism and other forms of discrimination, the opportunity to have health care providers who look like or have a shared life experience may help to foster trust,” explained Leob.

Within White adults, a majority trusted physicians vs patients and screening vs. clinical trials. Whether there was a Black or White presenter didn’t matter to the results for White adults.

“Our study provides new insights into the factors associated with trust in health communications and how we can make them more effective in the future. The findings show the importance of increasing racial diversity in online information about prostate cancer to improve trust and uptake. The study also shows that physicians are trusted sources to share health information, and that there is a need for more public education about the importance of clinical trials,” Leob discussed.

The importance of physician care can help patients feel more comfortable and feel like their medical professionals can be trusted. Results showed that it was significantly beneficial to consider racial concordance, especially when viewing the results from Black adults.

Steps to resolve this situation are possible, as Leob explained, “There are many action items from the study. First it is important for physicians to participate in public education. There is a significant amount of misinformation that is circulating online, and physicians are trusted voices who can help share evidence-based information. Second, diversifying the medical workforce is extremely important. It is also important that online health content represents diverse populations. Finally, we must continue to educate the public about the critical importance of clinical trials to advance human health and the protections in place for research participants.”

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