Abstract
BACKGROUND: African Americans' mistrust of healthcare is often cited as a cause of racial disparities in health and has been linked to cultural mistrust. African-American parents' level of cultural mistrust while in a general healthcare setting has not been previously measured. OBJECTIVE: To determine the performance, participant acceptance, feasibility of administration and demographic associations of a measure of cultural mistrust, the Cultural Mistrust Inventory (CMI), in African-American parents seeking healthcare. METHODS: A cross-sectional sample of 69 self-identified African-American parents of minor children recruited in a university-affiliated, urban pediatric/family practice outpatient clinic completed an anonymous, self-administered questionnaire containing demographic items and the CMI. RESULTS: The response rate was 91% (n=63), and 49 (78%) -- answered all questions. Measured mistrust did not vary with gender, insurance or education. The CMI's internal consistency was similar to previously published studies of the instrument (alpha=0.92). Parents indicating discomfort with the CMI's questions reported significantly less mistrust than parents who did not indicate discomfort (p=0.01). CONCLUSIONS: The CMI is feasible to administer in a clinic setting and demonstrates good internal consistency. It can be a useful tool to assess the effect of cultural mistrust on the healthcare decisions African-American parents make for their children. However, when measuring cultural mistrust in a healthcare setting, respondents' comfort with the survey questions should be assessed.
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