Black patients may be 1.6 times more likely to believe medical information presented by a Black speaker than information presented by a White speaker, according to a new study published by Loeb et al in JAMA Network Open. The findings highlight the importance of increasing racial diversity among health-care providers in order to improve communication with minority patients.
Background
Prostate cancer is one of the most prevalent cancer types among U.S. male patients—with over 30,000 deaths per year—according to the U.S. Centers for Disease Control and Prevention. Black patients may be more than twice as likely to die from the disease compared with other racial groups.
However, previous studies have shown that only a small percentage of online content about prostate cancer features Black speakers.
“Our findings demonstrate the need to increase diversity in the health-care workforce,” emphasized lead study author Stacy Loeb, MD, Professor of Urology and Population Health at the New York University (NYU) Grossman School of Medicine.
Study Methods and Results
In the new study, researchers randomly assigned over 2,900 U.S. patients aged 40 years and older to watch one of eight videos about prostate cancer—50% of which featured cancer screenings and the other 50% of which featured clinical trials—with the hope of better understanding the direct impact of underrepresentation. Notably, the clips from each category shared the same script, but the speaker was either a White or Black physician or a White or Black patient.
After watching the videos, the participants were asked to rate how strongly they trusted the information presented in the video using the following scale: “no trust at all,” “a little,” “somewhat,” or “very much.” They also answered questions about their age, race, and other information about their background.
The researchers found that while Black participants were more trusting of videos about prostate cancer that featured Black speakers, race made no difference for White participants. They also revealed that regardless of their race, the participants involved in the study were more trusting of the physicians discussing prostate cancer than the patients discussing the same topic.
Additionally, the participants’ responses indicated that they were more trusting of videos focused on prostate cancer screenings than on clinical trials—potentially reflecting the deep-seated distrust of clinical research that may have stemmed from a history of unethical practices prior to the 1950s, when strict protections for human research participants were enacted. The researchers also suggested that many U.S. patients generally have less understanding about clinical trials compared with other health topics.
Conclusions
“Our study emphasizes the responsibility of health-care providers to play an active role in public communication, particularly in an environment flooded with misinformation and confusion,” stressed co–study author Joseph Ravenell, MD, MS, Associate Professor of Population Health and Medicine at the NYU Grossman School of Medicine as well as Associate Dean for Diversity Affairs and Inclusion at NYU Langone Health. “Clearly, [patients] really do trust what [physicians] have to say,” he added.
The researchers cautioned that since their investigation only focused on videos about prostate cancer, they remain uncertain of whether their findings on public trust in medical information extend to other health topics such as misinformation about vaccines.
“These results underline the need to ensure that all patients, regardless of their racial or ethnic background, have knowledge of clinical trials and can participate if they are eligible,” said senior study author Aisha Langford, MPH, PhD, Assistant Professor of Population Health at the NYU Grossman School of Medicine and Co-Director of the Clinical and Translational Science Institute’s Recruitment and Retention Core at NYU Langone Health.
The researchers plan to lead focus groups with Black patients who have prostate cancer to discuss their experiences with online medical information and their suggestions for improving the quality, accessibility, and impact of those resources.
Disclosure: The research in this study was funded by a U.S. Department of Defense Health Disparity Research Award. For full disclosures of the study authors, visit jamanetwork.com.
