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A recent study found that patient trust in prostate cancer online videos was higher when information was delivered by a physician and was associated with racial concordance in Black adults.

Black men have a significantly higher risk of prostate cancer than White men. Despite that, Black adults are significantly underrepresented in prostate cancer online content and clinical trials. Black adults are more likely to trust online health information but show more medical mistrust than White adults. 

A randomized clinical trial published in JAMA Network Open assessed the association between racial representation in online videos about prostate cancer and patient trust in the content.

Study Population

The study comprised 2904 participants. Most were male (62%), with 8% having a history of prostate cancer. Fifty-nine percent of the participants were Black. The mean ages were 55.5 and 63 years among Black and White participants, respectively. Patients were randomized to watch the same video script on prostate cancer screening or clinical trials presented by one of four speakers: a White physician, a White patient, a Black physician, or a Black patient.

Trust Disparities in Health-Related Video Content

Among Black participants, a significantly greater proportion had high trust in videos presented by a Black vs. White speaker (72.7% vs. 64.3%) and physician vs. patient (72.5% vs. 64.6%). A slightly higher proportion of Black participants showed high trust in videos about screening vs. clinical trials (70.7% vs. 66.3%). Regarding videos with a Black presenter, Black participants showed significantly less trust in a Black patient vs. a Black physician.

Among White participants, a greater proportion had high trust in videos presented by physicians vs. patients (78.6% vs. 72%) and in content about screening vs. clinical trials (79.1% vs. 71.4%). No difference in trust was noted for a Black vs. White presenter (76.8% vs. 73.7%).

Individual Factors Influencing Trust

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Additional logistic regression models showed that among Black participants, Black speakers had a significant positive association with trust. In contrast, a patient speaker and clinical trial topic had lower odds of trust in the video. Among Black participants, a history of prostate cancer, gender, health literacy, ehealth literacy, and medical mistrust were also associated with trust in the video.

Among White participants, a patient vs. physician presenter and clinical trial topic vs. screening were associated with significantly lower odds of trust, while no significant difference related to the presenter’s race was seen. A history of prostate cancer, ehealth literacy, and medical mistrust were also associated with trust in the video.

Hence, prostate cancer information delivered by a physician was regarded as more trustworthy, but a significant association of racial concordance with trust was only seen among Black participants. These findings highlight the need for physician participation, racial diversity in health information dissemination, and continued public education regarding clinical trials.

Source:

Loeb, S., Ravenell, J., Scarlett Lin Gomez, Borno, H., Siu, K., Tatiana Sanchez Nolasco, Byrne, N., Wilson, G., Griffith, D. M., Crocker, R., Sherman, R., Washington, S. L., & Langford, A. T. (2023). The Effect of Racial Concordance on Patient Trust in Online Videos About Prostate Cancer: A Randomized Clinical Trial. JAMA Network Open, 6(7), e2324395–e2324395. https://doi.org/10.1001/jamanetworkopen.2023.24395