Table 3.
Adjusted Logistic Regression Mediation Models for Healthcare System Distrust (independent variable), Physician Trust (mediator), and Adjuvant Breast Cancer Treatment Discordance (dependent variable)
| MEDIATION MODEL A: Physician Trust (mediator) regressed on Healthcare System Distrust | MEDIATION MODEL B: Discordance (dependent variable) regressed on Healthcare System Distrust | FINAL MODEL: Discordance regressed on Healthcare System Distrust and Physician Trust | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| OR | Lower 95% CI | Upper 95% CI | P | OR | Lower 95% CI | Upper 95% CI | P | OR | Lower 95% CI | Upper 95% CI | P | |
| Health Care System Distrust | ||||||||||||
| Tertiles 1&2 | Ref | Ref | Ref | |||||||||
| Tertile 3 | 0.56 | 0.46 | 0.68 | <0.001 | 1.23 | 1.03 | 1.47 | 0.02 | 1.22 | 1.03 | 1.46 | 0.03 |
| Physician Trust | ||||||||||||
| Tertiles 1&2 | Ref | Ref | Ref | |||||||||
| Tertile 3 | -- | -- | -- | -- | -- | -- | -- | -- | 0.94 | 0.77 | 1.13 | 0.49 |
| Age (in years) | 0.98 | 0.97 | 0.99 | <0.001 | 1.00 | 0.99 | 1.01 | 0.56 | 1.00 | 0.99 | 1.01 | 0.60 |
| Race | ||||||||||||
| White | Ref | Ref | Ref | |||||||||
| Black | 0.81 | 0.66 | 1.01 | 0.06 | 0.89 | 0.73 | 1.09 | 0.25 | 0.89 | 0.72 | 1.09 | 0.24 |
| Other | 0.64 | 0.40 | 1.01 | 0.05 | 1.26 | 0.84 | 1.88 | 0.26 | 1.25 | 0.84 | 1.87 | 0.27 |
| Hispanic | 1.21 | 0.85 | 1.74 | 0.29 | 0.90 | 0.63 | 1.29 | 0.57 | 0.90 | 0.63 | 1.30 | 0.58 |
| Income | ||||||||||||
| < $10,000 | Ref | Ref | Ref | |||||||||
| $10,001 to $30,000 | 1.19 | 0.78 | 1.83 | 0.42 | 1.31 | 0.88 | 1.94 | 0.19 | 1.31 | 0.88 | 1.95 | 0.19 |
| $30,001 to $70,000 | 1.50 | 0.99 | 2.28 | 0.06 | 1.60 | 1.08 | 2.37 | 0.02 | 1.61 | 1.08 | 2.39 | 0.02 |
| > $70,000 | 1.66 | 1.06 | 2.59 | 0.03 | 1.52 | 0.99 | 2.33 | 0.05 | 1.53 | 1.00 | 2.34 | 0.05 |
| Education | ||||||||||||
| High school grad or less | Ref | Ref | Ref | |||||||||
| Some college | 1.14 | 0.90 | 1.44 | 0.27 | 1.12 | 0.89 | 1.40 | 0.33 | 1.12 | 0.90 | 1.40 | 0.32 |
| College grad or more | 1.01 | 0.79 | 1.29 | 0.95 | 1.09 | 0.86 | 1.39 | 0.46 | 1.09 | 0.86 | 1.39 | 0.46 |
| Married or Coupled | 0.92 | 0.75 | 1.13 | 0.42 | 0.78 | 0.64 | 0.94 | 0.01 | 0.78 | 0.64 | 0.94 | 0.01 |
| Not employed for wages | 1.11 | 0.92 | 1.34 | 0.30 | 1.12 | 0.93 | 1.35 | 0.22 | 1.12 | 0.93 | 1.35 | 0.22 |
| Insured | 1.26 | 0.82 | 1.94 | 0.29 | 0.91 | 0.62 | 1.34 | 0.63 | 0.91 | 0.62 | 1.34 | 0.64 |
| Stage at diagnosis | ||||||||||||
| Stage 1 | Ref | Ref | Ref | |||||||||
| Stage 2 | 1.13 | 0.94 | 1.35 | 0.20 | 0.71 | 0.60 | 0.84 | <0.001 | 0.71 | 0.60 | 0.85 | <0.001 |
| Stage 3 | 1.32 | 0.92 | 1.90 | 0.13 | 0.53 | 0.36 | 0.80 | <0.001 | 0.54 | 0.36 | 0.80 | <0.001 |
| State | ||||||||||||
| Florida | Ref | Ref | Ref | |||||||||
| Pennsylvania | 0.90 | 0.75 | 1.08 | 0.25 | 0.78 | 0.66 | 0.93 | 0.01 | 0.78 | 0.66 | 0.93 | 0.01 |
OR = odds ratio; CI = confidence interval