Patient Trust in Physicians and Shared Decision-Making Among African-Americans with Diabetes

This article seeks to better understand the relationship between patient trust and shared decision-making (SDM) for African Americans, specifically looking at African Americans with both type 1 and type 2 diabetes.

Five focus groups (n=27) and in-depth, individual interviews (n=24) were conducted, using participants who were African American, diabetic, over 21 years old, and who had at least three visits over a two-year period to a primary care physician at an academic internal medicine practice. The focus groups and interviews were audiotaped, transcribed, and coded.

Key Findings:

  • Study participants mean age was 62 years; 85 percent were female. Most participants had completed at least some college (60%) and 39 percent had an annual household income of less than $25,000.
  • Key domains of patient trust and SDM, both interpersonal and relational aspects and medical skills and technical competences, are influenced by race.
  • This research shows a bidirectional relationship between patient trust and SDM.
  • Increased patient trust may have the potential to either enhance SDM or reduce SDM among African Americans.

The authors suggest that patient education efforts, physician training in interpersonal skills, and efforts to engage patients in SDM may positively impact African Americans’ mistrust of physicians and help improve health outcomes.