TY - JOUR
KW - integrated care
KW - Medication Adherence
KW - Mental Health
KW - Provider trust
KW - Racism
AU - M. Pugh Jr
AU - P. B. Perrin
AU - B. Rybarczyk
AU - J. Tan
A1 - 
AB - There has been a growing research focus on social determinants to health disparities in general and medication adherence more specifically in low-income Black populations. The purpose of this study was to examine whether prior experiences of racism among Black patients in safety-net primary care indirectly predicts poor medication adherence through increased mental health symptoms and low healthcare provider trust. Two competing models were run whereby mental health leads to provider trust or provider trust leads to mental health in this multiple mediational chain. A group of 134 Black patients (76 men, average age 45.39 years) in a safety-net primary care clinic completed measures of these constructs. Results revealed that in the first model, mental health mediated the relationship between racism and provider trust, and provider trust mediated the relationship between mental health and medication adherence. All paths within this model were statistically significant, except the path between provider trust and medication adherence which approached significance. In the second model, provider trust and mental health significantly mediated the relationship between racism and medication adherence, and all direct and indirect paths were statistically significant, though the path between provider trust and medication adherence was omitted. These results may serve as catalysts to assess and attempt to mitigate specific minority-based stressors and associated outcomes within safety-net primary care settings.
AD - Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA.; Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA. pperrin@vcu.edu.; Departments of Psychology, Physical Medicine and Rehabilitation, Virginia Commonwealth University, 800 West Franklin St., Room 201, Box 842018, Richmond, VA, 23284-2018, USA. pperrin@vcu.edu.; Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA.; Department of Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, VA, USA.; Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA.; Hunter Holmes McGuire VA Medical Center, Richmond, VA, USA.
BT - Journal of clinical psychology in medical settings
C5 - Education & Workforce; Healthcare Disparities
CY - United States
DO - 10.1007/s10880-020-09702-y
JF - Journal of clinical psychology in medical settings
LA - eng
M1 - Journal Article
N2 - There has been a growing research focus on social determinants to health disparities in general and medication adherence more specifically in low-income Black populations. The purpose of this study was to examine whether prior experiences of racism among Black patients in safety-net primary care indirectly predicts poor medication adherence through increased mental health symptoms and low healthcare provider trust. Two competing models were run whereby mental health leads to provider trust or provider trust leads to mental health in this multiple mediational chain. A group of 134 Black patients (76 men, average age 45.39 years) in a safety-net primary care clinic completed measures of these constructs. Results revealed that in the first model, mental health mediated the relationship between racism and provider trust, and provider trust mediated the relationship between mental health and medication adherence. All paths within this model were statistically significant, except the path between provider trust and medication adherence which approached significance. In the second model, provider trust and mental health significantly mediated the relationship between racism and medication adherence, and all direct and indirect paths were statistically significant, though the path between provider trust and medication adherence was omitted. These results may serve as catalysts to assess and attempt to mitigate specific minority-based stressors and associated outcomes within safety-net primary care settings.
PP - United States
PY - 2020
SN - 1573-3572; 1068-9583
T1 - Racism, Mental Health, Healthcare Provider Trust, and Medication Adherence Among Black Patients in Safety-Net Primary Care
T2 - Journal of clinical psychology in medical settings
TI - Racism, Mental Health, Healthcare Provider Trust, and Medication Adherence Among Black Patients in Safety-Net Primary Care
U1 - Education & Workforce; Healthcare Disparities
U2 - 32008136
U3 - 10.1007/s10880-020-09702-y
VO - 1573-3572; 1068-9583
Y1 - 2020
Y2 - Feb 1
ER -