First Impressions Matter: The Influence of Provider Photographs on Medical Trust Among Minority Women

Objectives This study investigated how visual elements in healthcare environments, specifically provider images on welcome signage, influence medical trust among African American and Hispanic women aged 18–44. It explored the impact of provider race/ethnicity and gender on trust, addressing gaps in how identity representation in the built environment shapes perceptions. Background Medical trust is a critical factor influencing healthcare-seeking behavior, particularly among women and minoritized populations. Prior studies suggest that environmental cues and perceived identity alignment between patients and providers may impact trust. Social identity theory and status generalization theories offer competing explanations for these dynamics. Methods A pretest was conducted to refine provider image stimuli and waiting room signage used in the main study. Participants viewed variations of provider images on welcome signs in ambulatory waiting rooms. Trust was measured across four dimensions: fidelity, communication competence, fairness, and global trust. Covariates included prior healthcare satisfaction, baseline trust, and subjective social status. Results Provider images significantly enhanced perceptions of fidelity across groups. African American participants rated ingroup providers higher in fairness and communication competence, though no significant differences emerged in global trust or fidelity. Hispanic participants showed no significant trust variation based on provider identity. Subjective social status did not moderate trust outcomes. Conclusions Displaying provider images in waiting rooms may positively influence medical trust, particularly among African American women. Trust dynamics are complex and not uniformly affected by race or gender concordance, highlighting the nuanced role of identity representation in healthcare design.