Understanding the Relationship between Trust in Healthcare and Attitudes toward Living Donor Transplant among African Americans with End Stage Renal Disease

• Type of Material: Article
• Authors: Evangeline L. McDonald, Brown University; C. Lamonte Powell, Emory University; Jennie P. Perryman, Emory Transplant Center; Nancy J Thompson, Emory University; Kimberly R Jacob Arriola, Emory University
• Language: English
• Date: 2013-07
• Publisher: Wiley: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2013 John Wiley & Sons A/S.
• Final Published Version (URL): http://onlinelibrary.wiley.com/doi/10.1111/ctr.12176/abstract
• Title of Journal or Parent Work: Clinical Transplantation
• ISSN: 0902-0063
• Volume: 27
• Issue: 4
• Start Page: 619
• End Page: 626
• Grant/Funding Information: The original project was supported by the Health Resources and Services Administration’s (HRSA) Division of Transplantation (Grant #HRSA-10-037, Social and Behavioral Interventions to Increase Organ and Tissue Donation).; This research was also supported by the National Institute of Diabetes and Digestive and Kidney Diseases (Grant # 5R01DK079713-05).
• Keywords: Trust in Healthcare; Transplant; Organ Donation; African American
• Research Categories: Health Sciences, Health Care Management; Health Sciences, Rehabilitation and Therapy; Sociology, Ethnic and Racial Studies

Abstract

Transplantation is the favored therapy for End-Stage Renal Disease (ESRD) patients. Unfortunately, demand for available organs far outpaces the supply. African Americans are disproportionately affected by the ever-widening gap between organ supply and demand. Additionally, structural, biological and social factors contribute to feelings of unease some African Americans may feel regarding living donor transplant (LDT). The present research examines the relationship between trust in healthcare and attitudes towards LDT among African American ESRD patients. We hypothesized that lower trust in healthcare would be significantly associated with negative attitudes toward LDT, and that this relationship would be moderated by patient attitudes toward dialysis. Data were collected from August 2011 to April 2012 as part of a larger study. Measures included trust (of doctors, racial equity of treatment, and hospitals), and attitudes toward both LDT and dialysis. Bivariate analysis revealed that trust in one’s doctor, hospital, and in racial equity in healthcare were significantly correlated with attitudes toward LDT (r=.265; r=.131; and r=.202, respectively). Additionally, attitudes towards dialysis moderated the relationships between Trust in Doctors/Attitudes toward LDT and Trust in Racial equity of treatment/Attitudes toward LDT. Findings suggest a strong relationship between trust in healthcare and attitudes toward LDT. These findings also shed light on how dialysis experiences are related to the relationship between trust in healthcare and attitudes toward LDT.