Race a major factor in trust of online information about prostate cancer
Key takeaways:
- Black individuals are 1.6 times more likely to believe medical information presented by a Black physician or patient.
- Race of the online video presenter did not significantly impact trust among white adults.
Black individuals are significantly more likely to trust the accuracy of online video content about prostate cancer presented by Black physicians or patients compared with white presenters, results of a randomized study showed.
Study participants reported less trust in information presented about clinical trials compared with information about prostate cancer screening, regardless of race.
Likewise, both Black and white study participants expressed significantly less trust in information delivered by patients with prostate cancer compared with physicians, according to data published in JAMA Network Open.
“The most important take-home messages are the importance of increasing racial diversity and physician participation in the dissemination of online information about prostate cancer to improve trust and uptake,” Stacy Loeb, MD, MSc, professor of urology in the departments of urology and population health at NYU Langone Health, told Healio.
“[There is] also a great need for more public education about clinical trials,” she added. “We should continue to educate our patients and their families about the importance of clinical research to advance human health and the protections that are in place for research participants.”
Background
Black men are far more likely to be diagnosed with and die of prostate cancer than their non-Hispanic white counterparts, according to Loeb.
“However, in a prior study we found that Black adults are underrepresented in online information about prostate cancer,” she said. “The purpose of this study was to determine the importance of racial concordance and other characteristics of online prostate cancer information for trust among viewers, particularly for those groups at higher risk for worse outcomes.”
Methodology
Loeb and colleagues sought to identify whether any race-related factors influence trust in online content about prostate cancer.
The study included 2,904 Black and white adults aged 40 years or older (median age, 59 years; interquartile range, 47-69; 62% men; 59% Black).
Study participants completed an online survey that established baseline demographics and trust of medical information. Researchers then randomly assigned them to watch one of eight videos with information about prostate cancer screening or clinical trials. The videos included one of four different male presenters (Black physician, white physician, Black patient or white patient).
Researchers evaluated study participants’ trust in the information presented in the videos using a 4-point Likert scale of trust in clinicians.
Differences in trust served as the study’s primary outcome measurement.
Key findings
Black adults exhibited higher trust in videos with Black presenters compared with white presenters (72.7% vs. 64.3%; adjusted OR = 1.62; 95% CI, 1.28-2.05).
Conversely, Black study participants showed less trust in patient presenters compared with physician presenters (64.6% vs. 72.5%; adjusted OR = 0.63; 95% CI, 0.49-0.8) and in information about clinical trials compared with information about prostate cancer screening (66.3% vs. 70.7%; adjusted OR = 0.78; 95% CI, 0.62-0.99).
White adults expressed similar trust when comparing Black vs. white presenters (76.8% vs. 73.7%; adjusted OR = 1.11; 95% CI, 0.83-1.48).
However, a lower proportion of white participants expressed high trust in patient-presented videos compared with physician-presented videos (72% vs. 78.6%; adjusted OR = 0.71; 95% CI, 0.54-0.95) or in videos containing information about clinical trials compared with prostate cancer screening (71.4% vs. 79.1%; adjusted OR = 0.57; 95% CI, 0.42-0.76).
Clinical implications
The results underscore the need for “diversity of representation in online content” regarding prostate cancer, with physicians playing a key role due to their trustworthiness, according to Loeb.
“As physicians, I think it’s very important that we not only provide information to our own patients but participate actively in online communications,” she told Healio. “Historically, medical education has focused primarily on communications occurring within the patient-physician encounter, but moving forward there should be more emphasis placed on public-facing communications.”
The study by Loeb and colleagues established expertise and race as “important factors” with respect to trust in online heath education content for Black patients with prostate cancer, according to Yaw A. Nyame, MD, MS, MBA, and Jenney R. Lee, MS, both of the department of urology at University of Washington.
“Reliable, accurate and accessible resources are needed to support the equitable use of health services to support access to and utilization of high-quality health services and interventions,” they wrote in an accompanying editorial.
The authors demonstrate “there is tremendous opportunity to improve the quality of health information Black individuals with prostate cancer access and use,” they added. “This should be achieved through community-partnered and patient-centered research methods that help empower Black individuals with prostate cancer and the communities that support them. Using these approaches will ensure that credible and accessible resources are made available to all [patients with prostate cancer] — especially those who are the most vulnerable and those who demonstrate the most disparate outcomes.”
References:
- Loeb S, et al. JAMA Netw Open. 2023;doi:10.1001/jamanetworkopen.2023.24395.
- Nyame YA, et al. JAMA Netw Open. 2023;doi:10.1001/jamanetworkopen.2023.24359.
For more information:
Stacy Loeb, MD, MSc, can be reached at Department of Urology, New York University Langone Health, 227 E. 30th St., #612, New York, NY 10016; email: stacyloeb@gmail.com.
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