Association Between Sociodemographic Factors And Trust In Primary Care Providers In Emerging Adults

PURPOSE: Examine if sex-based or racial differences exist for trust in primary care providers among emerging adults. METHODS: This cross-sectional study included 45 emerging adults (mean age 20.33 ± 1.45) who provided demographic information and completed a survey concerning health behaviors prior to concussion baseline testing administered in a laboratory setting by a trained researcher. These analyses utilized the demographic details and Trust in Provider Scale (TPS) items. The TPS is an 11-item self-report measure assessing interpersonal trust between an individual and their primary care provider (PCP). All participants had a PCP. Independent variables were sex (39 female vs. 6 male) and race (White [n = 37] vs. Non-White[n = 8]). Due to the low sample size of non-White individuals (i.e., Asian, Black), race was dichotomized. Outcome variables were TPS item scores, measured on a 5-point Likert scale (0 = strongly disagree, 5 = strongly agree). Normality was assessed (Shapiro-Wilk <0.005), revealing a non-normal distribution. Mann-Whitney U tests examined group differences in TPS items by sex and race. RESULTS: Mann-Whitney U tests indicated differences between sexes on belief in provider authority (“If my primary care provider tells me something is so, then it must be true”) of the TPS (U = 198.500; z = 1.958; p = 0.025). Female participants had less belief in provider authority than males (median: 3; IQR 2-4 vs. median: 4; IQR 3-4). Regarding race, Mann-Whitney U tests indicated differences in perceived provider concern for the patient (“I doubt that my primary care provider really cares about me as a person”) of the TPS (U = 267.000; z = 2.585; p = 0.005). White participants had less doubt than non-white participants (median: 2; IQR 1-2 vs. median: 3; IQR 2-3). No additional sex or race differences were observed on the TPS. CONCLUSIONS: Sex differences observed for belief in provider authority, may stem from expectations in healthcare interactions. Racial differences in perceived provider concern for the patient, suggest diverse cultural perceptions or historical influences on trust in providers. Future exploration through qualitative and community-based research is warranted to investigate the nuanced impact of sex, race, and lived experience on trust in primary care providers among emerging adults.