A Conceptual Framework and Item Bank for Medical Mistrust: Comparing African Americans and Whites

The extent to which medical mistrust contributes to health disparities is not known, and needs to be accurately measured. Measurement of medical mistrust has been hampered by the lack of a conceptual framework that is based on the experiences of African Americans and whites of low socioeconomic standing.;Concept mapping, a mixed methods participatory approach, was used to develop a conceptualization of medical mistrust. Thirty-six African Americans and 24 whites participated in focus groups and sorting/rating activities. Data resulting from these was used as the input for multidimensional scaling and hierarchical cluster analysis, which provided pictorial representations of the groups' thinking.;While the two groups have experiences of mistrust in common. African Americans emphasized the institutional aspects of medical mistrust, while whites emphasized the interpersonal aspects. Medical mistrust is shaped by various cultural, social and historic contexts.